Pathogenetic vector of neuroinflammation, psychosomatic concept in asthma in children: prospects for diagnosis and therapy

Asthma incidence is increasing worldwide. Despite significant advances made by world medicine in the diagnosis and treatment of asthma, half of patients receiving standard therapy fail to achieve disease control. As a result of the research, confirmation of the allergic theory of the origin of the disease was found. In 70–80 % of cases, children have an allergic variant of inflammation in asthma. But studies at the micro level cannot explain the causes of the development of chronic inflammation in asthma on a whole-organism scale. The immune system is not autonomous and is regulated by the neuroendocrine system. When analyzing the hormonal status of patients with asthma, a decrease in adaptation to stress was noted. Аsthma is characterized by a state of chronic psycho-emotional stress, the maintenance of which is facilitated by disturbances in neuroendocrine regulation. The psychological component is of great importance in the development of asthma. In this regard, the pharmacological approach alone does not solve problems of a psychological nature; there is a need to use methods of psychological correction for patients with asthma. In addition, a large number of studies have examined the similarities between asthma and epilepsy. The use of anticonvulsants significantly improves the condition of patients with epilepsy and asthma. In severe allergic eosinophilic asthma, it is possible to use the neuroprotector dexpramipexole with the effect of reducing the level of eosinophils and a cortico-sparing effect. Thus, the main cause of asthma development is dysregulation of the neuro-immuno-endocrine system, which results in inflammation and bronchospasm. Considering the importance of regulatory systems in the pathogenesis of asthma, it is advisable to identify the neurophenotype of the disease to increase the effectiveness of treatment and the use of anticonvulsants and psychological correction should be considered in addition to the adopted therapeutic program.