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There is a real physiological argument, though one that should be taken with appropriate skepticism until human data accumulates, about receptor downregulation and what hitting three pathways at maximum dose may do to the bodys endogenous signaling architecture over years of continuous use

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Therefore in children with AD or AR or both there is the possibility of identifying those most liable to develop asthma

doi: 10.1289/ehp.0901332 30 CheongAJohnsonSAHowaldECEllersieckMRCamachoLLewisSMet al

However, despite their proven efficacy, challenges remain in long-term safety, adherence, and accessibility for adolescents