Asthma is the most common chronic lung disease in children. About 10% to 15% of children are affected by asthma worldwide. Asthma is a genetically inherited trait and for a large number of children the symptoms persist into adulthood. Occasionally, a period of remission seems to occur with the symptoms of asthma resurfacing in later adult life.
A recent long term follow-up study of adult patients with severe asthma in childhood has been published. The study is important in several ways not the least of which, is because it spans over 60 years. Approximately 90% of the patients report current asthma symptoms and /or treatment for asthma. Most of these patients had reduced airflow on pulmonary function testing. 10% of the patients reported that they were in remission which was defined as no asthma medications or symptoms in the last 12 months. Interestingly, while patients claiming remission had overall better lung function but still had reactive airways on challenge testing and elevated lab findings consistent with patients who had persistent asthma.
This study clearly tells us that severe asthma in childhood inflicts a burden of disease that can last a lifetime. What is not known is whether early treatments with appropriate medications can be disease modifying i.e., prevent the progression of disease and impairment of lung function in adult life. It may take some time to determine the answers to these questions. Currently, the best approach is to recognize asthma in children and treat it accordingly.
