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Acute asthma attacks arise from a preset reduced lung function

Published online: November 7, 2019

Many children with asthma suffer from unpredictable acute asthma attacks imposing a massive distress for the affected children and their families, and a substantial burden for the healthcare system. It is the common belief that acute asthma attacks cause progressive scarring of the lungs, which leads to decreasing lung function. However, trials with inhaled anti-inflammatory treatment have shown a reduction in number of attacks, but without any effect on lung function, which challenge this belief.

In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Hallas et al. studied longitudinal lung function measurements assessed 11 times from infancy to adolescence in 97 children with asthma. Fifty of these children experienced at least one acute asthma attack during childhood whereas the remaining 47 children never experienced such an attack.

The children experiencing acute asthma attacks had reduced lung function compared to children who never experienced attacks. However, the reduction in lung function was already established in infancy before the first asthma attacks occurred and was fixed and without any progression until adolescence. The children experiencing most acute asthma attacks had the lowest lung function suggesting that frequency and severity of asthma symptoms depends on the child’s inborn preset level of lung function.

These findings suggest that acute asthma attacks are the consequence rather than the cause of reduced lung function in childhood, which directs preventive measures to the pregnancy period.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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