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JACI Highlights - January 2005
Adult asthma severity in individuals
with a history of childhood asthma
Childhood predictors of allergic asthma severity in adulthood Childhood asthma may wax and wane or remit altogether by the time an individual reaches adulthood. In this issue of the Journal, Limb et al. (p.) assess the current severity of asthma in a cohort of young adults with a history of moderate-to-severe, childhood allergic asthma. Half of the subjects had received specific immunotherapy in childhood. Approximately a third (37.6%) of the total cohort demonstrated improvement from childhood asthma severity; 15.3% were in complete remission for at least one year. Predictors of persistent adult disease included childhood asthma severity and a greater degree of atopy, as measured by number of positive skin tests and total serum IgE in childhood. Notably, inhaled corticosteroid use and childhood immunotherapy did not appear to mitigate adult asthma severity. These results suggest that the prognosis of childhood asthma is determined in the early stages of disease and may be predicted by the overall burden of atopy. Targeting the development of atopy in childhood may be an important intervention for improving long-term, allergic asthma outcomes.
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