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Paediatric Pulmonology and Allergology
2006 April, Vol. IX, No. 1 (3112-3126)
PROGNOSTIC FACTORS PREDICTING ASTHMA COURSE FROM CHILDHOOD TO ADULTHOOD
Valdone Miseviciene
Kaunas Medical University, Clinic of Children Diseases, Kaunas, Lithuania
Bronchial asthma is the most prevalent chronic respiratory disease in childhood. Due to the heterogeneous origin of the disease it is very complicate to predict asthma course in early childhood. The most recent literature and studies on factors associated with the prognosis of childhood asthma into adulthood is reviewed in this article. Most common risk factors such as sex, age of onset, clinical picture, atopy, lung function, bronchial hyperresponsiveness, smoking, treatment and genetic factors as well as asthma phenotypes and natural course of the disease are discussed. The prognosis of childhood asthma varies from complete remission to development of irreversible airway obstruction and decline in lung function, probably resulting from airway remodeling. Identification of prognostic factors and defining which children are at risk for persistent asthma is a priority because this could allow for more effective and efficient treatment regimens for children, especially in whom the disease does not spontaneously remit, and, potentially, for reduced morbidity and mortality from asthma and chronic obstructive pulmonary disease.