pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2025-35-5-623-634pulmo-4713Research ArticleПЕРЕДОВЫЕ СТАТЬИEDITORIALSФенотипы и эндотипы бронхиальной астмы у детейPhenotypes and endotypes of asthma in childrenhttps://orcid.org/0000-0002-1605-7859ТерещенкоС. Ю.TereshchenkoS. Yu.

Терещенко Сергей Юрьевич – д. м. н., профессор, главный научный сотрудник, заведующий клиническим отделением соматического и психического здоровья детей

660022, Красноярск, ул. Партизана Железняка, 3Г, тел.: (391) 228-06-33 

Sergey Yu. Tereshchenko, Doctor of Medicine, Professor, Chief Researcher, Head of the Clinical Department of Somatic and Mental Health of Children

ul. Partizana Zheleznyaka 3G, Krasnoyarsk, 660022, tel.: (391) 228-06-33 

legise@mail.ruhttps://orcid.org/0000-0001-9984-2029СмольниковаМ. В.SmolnikovaM. V.

Смольникова Марина Викторовна – к. б. н., руководитель группы молекулярно-генетических исследований, ведущий научный сотрудник лаборатории молекулярно-клеточной физиологии и патологии

660022, Красноярск, ул. Партизана Железняка, 3Г, тел.: (391) 228-06-33 

Marina V. Smolnikova, Candidate of Biology, Head of the Molecular Genetic Research Group, Leading Researcher of the Laboratory of Molecular Cell Physiology and Pathology

ul. Partizana Zheleznyaka 3G, Krasnoyarsk, 660022, tel.: (391) 228-06-33 

smarinv@yandex.ruФедеральное государственное бюджетное научное учреждение «Федеральный исследовательский центр “Красноярский научный центр Сибирского отделения Российской академии наук” – Научно-исследовательский институт медицинских проблем Севера Министерства науки и высшего образования Российской ФедерацииРоссияFederal State Budgetary Scientific Institution “Federal Research Center Krasnoyarsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences” – separate division of the Research Institute for Medical Problems of the North, Ministry of Science and Higher Education of the Russian FederationRussian Federation202509102025355623634Copyright © Терещенко С.Ю., Смольникова М.В., 20252025Терещенко С.Ю., Смольникова М.В.Tereshchenko S.Y., Smolnikova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/4713

Бронхиальная астма (БА) остается наиболее распространенным хроническим неинфекционным заболеванием дыхательных путей у детей, затрагивая около 14–15 % детской популяции во всем мире. По данным современных исследований показано, что БА представляет собой не единое заболевание, а спектр различных эндотипов и фенотипов. Наблюдаемые демографические и клинические характеристики БА описывают фенотипы, в то время как эндотипы отражают составляющие основу заболевания патогенетические механизмы. Целью обзора являлась систематизация современных данных о клинических фенотипах (аллергическая и неаллергическая БА, БА дошкольного возраста, тяжелая БА) и воспалительных эндотипах (T2-high и T2-low) БА у детей. Результаты. Проанализированы биомаркеры, используемые для идентификации эндотипов, и их клиническая значимость. Выделены основные проблемы в определении фенотипов и эндотипов БА у детей, включая возможность сочетания нескольких фенотипов у одного пациента, временную нестабильность биомаркеров и влияние коморбидных состояний. Особое внимание уделено недостаточной изученности неаллергической БА и T2-low-эндотипа у детей. Заключение. Показано, что определение фенотипов и эндотипов БА имеет критическое значение для персонализации терапии и улучшения прогноза заболевания. Однако для более эффективного применения в клинической практике необходимы дальнейшие исследования их стабильности во времени и валидация в проспективных исследованиях.

Asthma remains the most common chronic non-infectious respiratory disease in children, affecting about 14 – 15% of the global pediatric population. Current research shows that asthma is not a single disease, but a spectrum of different endotypes and phenotypes. Phenotypes describe the observed demographic and clinical characteristics of asthma, while endotypes reflect the underlying pathogenetic mechanisms of the disease. The aim. The review systematizes current data on clinical phenotypes (allergic and non-allergic asthma, preschool-age asthma, severe asthma) and inflammatory endotypes (T2-high and T2-low) of asthma in children. Results. Biomarkers used to identify endotypes and their clinical significance are analyzed. The main problems in determining phenotypes and endotypes of asthma in children are highlighted, including the possibility of combining several phenotypes in one patient, temporal instability of biomarkers, and the influence of comorbid conditions. Particular attention is paid to insufficient study of non-allergic asthma and T2-low endotype in children. Conclusion. It is shown that the determination of phenotypes and endotypes of asthma is critical for personalizing therapy and improving the prognosis of the disease. However, further studies of their stability over time and validation in prospective studies are needed for more effective use in clinical practice.

бронхиальная астмадетифенотипыэндотипыбиомаркерыперсонализированная терапияasthmachildrenphenotypesendotypesbiomarkerspersonalized therapyРабота выполнена в рамках государственного задания Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр “Красноярский научный центр Сибирского отделения Российской академии наук” – Научно-исследовательский институт медицинских проблем Севера Министерства науки и высшего образования Российской Федерации» «Разработка технологий оценки факторов риска и маркеров неконтролируемого течения бронхиальной астмы у детей» (FWES-2024-0051).The work was carried out within the framework of the state assignment of the Federal State Budgetary Scientific Institution “Federal Research Center Krasnoyarsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences” – separate division of the Research Institute for Medical Problems of the North, Ministry of Science and Higher Education of the Russian Federation “Development of technologies for assessing risk factors and markers of uncontrolled asthma in children” (FWES-2024-0051).ReferencesGlobal Asthma Network. 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The authors declare that there are no conflicts of interest present.