Asthma: a longitudinal perspective.
In the future, the important longitudinal studies will be those that divide the broad spectrum of asthma into phenotypic groups in order to provide more precise information about mechanisms and outcomes. Asthmatics who present in a clinical setting often have a combination of two or three different phenotypes, and may have more severe illness as a result, but subjects who are tested in epidemiological studies are frequently characterized by only one phenotype. Although the definition of asthma as a combination of symptoms plus either AHR or reduced lung function has greater predictive isolation for assessing the prognosis of respiratory illness that occurs in childhood (27,40,55,66-68), studies that are able to classify subjects according to their different phenotypes are more likely to lead to a better understanding of the factors that influence prognosis. More importantly, by using this approach, future research studies should be better able to separate the mechanisms whereby therapeutic or environmental interventions influence the prognosis of each phenotype. The potential benefits will be a better understanding and evaluation of the factors that make an important contribution to respiratory health.
Peat
J K
JK
Department of Medicine, University of Sydney, NSW, Australia.
D001249:Asthma / Q000235:genetics / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D010641:Phenotype; D011379:Prognosis; D012130:Respiratory Hypersensitivity / Q000503:physiopathology