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Evolution of asthma through childhood
1McMaster Asthma Research Group, McMaster University, Hamilton, Ontario, Canada.
Insights
Childhood asthma often resolves by adulthood, especially in non-atopic children. However, persistent asthma into adulthood is common in severe cases, influenced by family history, atopy, and environmental factors.
Area of Science:
- Pediatrics
- Allergology
- Epidemiology
Background:
- Childhood asthma incidence is highest in males under 5, decreasing with age.
- Many young children experience wheezing, often linked to infections or environmental tobacco smoke.
- Remission is common, particularly in non-atopic children without a family history of allergies or asthma.
Purpose of the Study:
- To analyze the prognosis and long-term outcomes of childhood asthma.
- To identify factors influencing the persistence of asthma into adulthood.
Main Methods:
- Review of population-based studies on childhood asthma.
- Analysis of follow-up data from wheezing children in clinical practice.
- Identification of predisposing factors for asthma persistence.
Main Results:
- Approximately two-thirds of wheezy children achieve symptom-free adulthood based on population studies.
- Clinical studies show a 60-80% likelihood of asthma persistence into adulthood for children with more severe cases.
- Key factors for persistence include positive family history, atopy, allergen/smoke exposure, and female gender.
Conclusions:
- Childhood asthma prognosis varies significantly based on disease severity and individual factors.
- Early identification of risk factors is crucial for managing persistent childhood asthma.
- Environmental exposures and genetic predispositions play a significant role in asthma's long-term course.
Abstract:
The greatest incidence of childhood asthma is among males under 5 years, with decreasing numbers of new cases with age. Many young children wheeze, but remission is common especially in non-atopic children without a family history of allergy or asthma, whose wheezing relates more to infections and environmental tobacco smoke exposure. The prognosis of childhood asthma is best established from population studies, in which some two-thirds of wheezy children become symptom-free as adults, whereas follow-up studies of wheezing children seen in office or specialty clinic practice, who generally have more severe asthma, show a much greater likelihood (60-80%) of persistence of asthma into adulthood. Factors predisposing to persistence of childhood asthma include a positive family history, development of atopy, environmental exposures to allergens and cigarette smoke, markers of severity of childhood asthma, and female gender.