scientific rationale for the use of alpha-adrenergic agonists and glucocorticoids in the therapy of pediatric stridor科学原理的使用者受体激动剂和糖皮质激素治疗小儿喘鸣.pdfVIP

Hindawi Publishing Corporation International Journal of Otolaryngology Volume 2011, Article ID 575018, 12 pages doi:10.1155/2011/575018 Review Article Scientific Rationale for the Use of Alpha-Adrenergic Agonists and Glucocorticoids in the Therapy of Pediatric Stridor Gustavo Nino,1, 2 Orkun Baloglu,1 Maria J. Gutierrez,3 and Michael Schwartz1 1 Division of Pediatric Pulmonary Medicine, Penn State Hershey Children’s Hospital, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA 2 Penn State Sleep Research and Treatment Center, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA 3 Division of Allergy and Immunology, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA Correspondence should be addressed to Gustavo Nino, nino.gustavo@ Received 1 June 2011; Accepted 26 August 2011 Academic Editor: James Paul Dworkin Copyright © 2011 Gustavo Nino et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. The most common pharmacological therapies used in the treatment of stridor in children are glucocorticosteroids (GC) and alpha-adrenergic (αAR) agonists. Despite the long-standing reported efficacy of these medications, there is a paucity of data relating to their actual mechanisms of action in the upper airway. Summary. There is compelling scientific evidence supporting the use of αAR-agonists and GCs in pediatric stridor. αAR signaling and GCs regulate the vasomotor tone in the upper airway mucosa. The latter translates into better airflow dynamics, as delineated by human and nonhuman upper airway physiological models. In