CLINICAL AND INSTRUMENTAL APPROACH TO ENDOTYPING AND BASIC THERAPY OF BRONCHIAL ASTHMA IN CHILDREN

To study the significant characteristics of the endotypes of bronchial asthma (BA) in children, with the choice of a personalized, free or fixed form of basic therapy of inhalative corticosteroids and long-active beta agonists (ICS/LABA), 184 people were examined at the sanatorium stage. 6-12 years old, with moderate asthma. When determining the endotypes in this cohort of children with moderate asthma, the key criteria included: the level of nitric oxide in exhaled air (FeNOex), FEV1, body mass index (BMI), and the dynamics of quality of life (QOL). Features of BA endotypes included combinations of the following features: 1) Endotype 1 — low FeNoex level, low BMI, high sensitivity to ICS and LABA preparations, the need to combine the free form of ICS and LABA with non-drug effects; 2) Endotype 2 - average FeNOex level, normal or increased BMI, low sensitivity to ICS and LABA drugs, reduced effectiveness of high doses of IHC, the need to combine the free form of ICS and LABA with non-drug effects; 3) Endotype 3 - a high level of FeNOex, an increased BMI, high sensitivity to a fixed form of administration of ICS and LABA, the inappropriateness of taking ICS and LABA in a free form, reduced effectiveness of low doses of ICS, when taking basic therapy, rapid growth of QOL, against the background of the therapy.