Asthma disappears in childhood

Asthma: From Child to Adult

Causes, diagnosis and course of the disease

27th Oct 2016

Why do not more than five percent of children with early asthma symptoms develop permanent illness? What happens during adolescence? And why are there so many new cases in adults? Despite extensive study data, numerous questions remain unanswered. Four doctors from the German Center for Lung Research (DZL) have summarized the current state of knowledge in a review article that has just been published in the journal 'Lancet Respiratory Medicine'. You advocate coordinated research by pediatric and adult pulmonologists.

Image: Photographee.eu/fotolia

With an estimated 300 million sufferers asthma the most common chronic respiratory disease worldwide. How complex the disease is can be seen when trying to describe the typical symptoms. Wheezing occurs in children, a characteristic breathing sound caused by a narrowing of the airways. This can later develop into more severe symptoms such as coughing fits and shortness of breath. However, how long and intense these seizures are varies from patient to patient. The trigger factors also vary: in allergic asthmatics, contact with allergens plays a role, in others, infections or cigarette smoke can trigger an acute illness. What they all have in common, however, is chronic inflammation of the airways.

Symptoms in children and adults
Epidemiological studies have followed how symptoms develop with age. It was found that only three to five percent of children who exhibit wheezing or early asthma symptoms keep the condition into adulthood. In another group, symptoms disappear only temporarily but reappear in adulthood. In addition, there are patients who do not have their first asthma attack until they are adults. Usually these patients with "adult asthma" suffer from particularly severe symptoms.

What do we know about the causes of asthma?
A number of risk factors for asthma have been found in the past. Genetic, epigenetic and environmental influences play a role. Anyone who already suffers from an allergy has an increased risk of developing asthma. One of the most important environmental triggers is cigarette smoking. This could even have an impact before birth if the mother smokes.

Especially in boys, the symptoms of asthma disappear in adolescence. The biological cause for this is unclear, however. In general, researchers assume that the underlying airway inflammation persists - even if typical asthma symptoms occur less often or do not occur at all.

diagnosis
In studies with adults, scientists use a wide range of examination methods: In addition to clinical data, various biomaterials such as sputum and small lung biopsies can be obtained, which is not possible in children.

Standardized molecular approaches for examinations in both children and adults can help to clarify open questions about different disease courses and causes of asthma. Whether asthma is a single disease or a multitude of different clinical pictures is currently the subject of intense discussion. It is very likely, however, that doctors will be able to treat their patients better and more personalized in the future because they know the different courses of illness more precisely.

Swell:

Airway Research Center North: Asthma in children, asthma in adults - one and the same? - Press release from October 24, 2016

Fuchs, O. et al .: Asthma transition from childhood into adulthood. Lancet Respir Med 2016 online on 09/22/2016