Astma u dječjoj dobi jest heterogena kronična upalna bolest donjih dišnih puteva koja se očituje od rane životne dobi različitim fenotipovima i endotipovima, koji se mogu mijenjati tijekom djetinjstva. Promijenjena je paradigma liječenja astme u djece od koncepta „jedna veličina za sve“ prema konceptu personalizirane medicine. Liječenje astme je prema novim GINA (engl. global initiative for asthma) smjernicama personalizirano i prilagođeno svakom bolesniku u kontinuiranom ciklusu procjene bolesti, liječenja i redovitih kontrola. U kontroli i liječenju astme u djece personalizirani koncept temelji se na saznanjima o molekularnoj heterogenosti astme u dječjoj dobi, dostupnosti novih bioloških lijekova kao i inovativnih metoda praćenja adherencije na liječenje. Međutim, još uvijek značajan postotak djece s astmom ima nekontroliranu ili djelomično kontroliranu astmu, a personalizirani koncept se još uvijek rijetko primjenjuje u redovnoj kliničkoj praksi. Posebno se rijetko određuju biomarkeri i prepoznaju određeni fenotipovi/endotipovi, što se u praksi uglavnom provodi u rijetkim centrima, primarno za postavljanje indikacije za primjenu biološke terapije.Asthma in childhood is a heterogeneous chronic inflammatory disease of the lower respiratory tract that manifests itself from early life with different phenotypes and endotypes, which can change during childhood. The paradigm of asthma treatment in children is changing from the concept of “one size fits all” to the concept of personalized medicine. According to the new GINA guidelines, asthma treatment is personalized and adapted to each patient in a continuous cycle of disease assessment, treatment and regular check-ups. In the control and treatment of asthma in children, the personalized concept is based on knowledge about the molecular heterogeneity of childhood asthma, the availability of new biological drugs, as well as innovative methods of monitoring adherence to treatment. However, still a significant percentage of children with asthma have uncontrolled or partially controlled asthma, and the personalized concept is still rarely applied in regular clinical practice. In particular, biomarkers are rarely determined and certain phenotypes/endotypes are recognized, which in practice is mainly carried out in rare centers, primarily to establish an indication for the use of biological therapy
