An expert opinion on the management of pediatric patients with wheezing and mild asthma: translating 2025 GINA strategy report into clinical practice in Italy
Italian Journal of Pediatrics · 2026 · Europe
Source and licence
- Authors
- Francesca Santamaria, Eugenio Baraldi, Luca Cavalieri et al.
- Title
- An expert opinion on the management of pediatric patients with wheezing and mild asthma: translating 2025 GINA strategy report into clinical practice in Italy
- Journal
- Italian Journal of Pediatrics, 2026
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC12958778
Licence statement of the original publication
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This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
This is a review of another guideline (Global Initiative for Asthma 2025 report (paediatric), GINA 2025). We do not reproduce that guideline's recommendations here – they belong to the original guideline.
Open the original publication →Full text on Europe PMC
Abstract
Background: Preschool wheezing and mild asthma are among the most frequent chronic respiratory conditions in children. These conditions can significantly affect quality of life, be associated with wheeze exacerbations, and predispose to persistent airway disease. Early recognition and tailored management are crucial to prevent long-term morbidity.
Objective: This Expert Opinion paper aims to translate the 2025 Global Initiative for Asthma (GINA) Strategy Report into the Italian clinical context, providing guidance for early recognition, risk stratification, and personalized management of pediatric patients with wheezing and mild asthma.
Content: The paper discusses the heterogeneity of preschool wheezing phenotypes and the emerging concept of “pre-asthma”, highlighting the prognostic role of biomarkers such as blood eosinophils, fractional exhaled nitric oxide (FeNO), and early aeroallergen sensitization in predicting disease persistence. It also addresses the impact of early-life wheezing on lung function trajectories, challenges in defining mild asthma, and the rationale for stepwise treatment strategies according to age. Particular emphasis is placed on practical aspects of care, such as the use of low dose of inhaled corticosteroids (ICS), suboptimal adherence to therapy, inhaler misuse, the benefits of dose counters to avoid pseudo-adherence, and the importance of caregiver education and shared decision-making in inhaler selection.
Summary: Applying GINA 2025 principles through individualized, biomarker-informed, and education-based strategies can improve outcomes in children with early or mild asthma, bridging the gap between evidence-based recommendations and usual pediatric care in Italy.
Supplementary Information: The online version contains supplementary material available at 10.1186/s13052-026-02206-9.
Contents of the original publication
The section headings of the original.
- Introduction
- Preschool wheezing
- Early clinical evaluation and phenotypic characterization
- Pre-asthma and risk factors progression from wheezing to asthma
- Biomarkers for early identification of asthma
- Early-life wheezing and its impact on lung function trajectories
- Mild asthma: still a challenge for pediatricians?
- GINA 2025 strategy report for the management of non-severe pediatric asthma
- Targeted and age-specific use of inhaled corticosteroids
- Optimizing pediatric asthma management: challenges in inhaler technique
- Incorrect inhalation technique
- Suboptimal adherence
- Healthcare professional training, caregiver education, and shared decision-making for choice of inhaler device
- Conclusions
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