Predicting adult asthma in childhood

There still is no cure for asthma. Early identification of patients at risk for disease progression may lead to better treatment opportunities and hopefully better disease outcomes in adulthood. Recent literature on childhood risk factors associated with the outcome of asthma in adulthood is reviewed.

The role of sex and smoking on the outcome of childhood asthma is still uncertain. Better lung function in childhood is consistently associated with better prognosis in adulthood, whereas the severity of bronchial hyperresponsiveness is not a good predictor of asthma outcome. Childhood atopy is associated with the persistence of symptoms but not with lung function in adulthood. An important finding is that anti-inflammatory treatment can reduce the accelerated decline in forced expiratory volume in 1 s and airway remodelling, but there is considerable variety in treatment response between individuals, which possibly can be explained by genetic make-up. Although many studies have investigated the genetics of asthma susceptibility, longitudinal studies on genes associated with asthma outcome are scarce.

Despite many high-quality investigations, accurate prediction of adult asthma in childhood is still not feasible. Future studies should focus on associations between genetic background and asthma prognosis as an important area of research with great potential.