Predicting adult asthma in childhood.
OBJECTIVE
There still is no cure for asthma. Early identification of patients at risk for disease progression may lead to better treatment opportunities and hopefully better disease outcomes in adulthood. Recent literature on childhood risk factors associated with the outcome of asthma in adulthood is reviewed.


RESULTS
The role of sex and smoking on the outcome of childhood asthma is still uncertain. Better lung function in childhood is consistently associated with better prognosis in adulthood, whereas the severity of bronchial hyperresponsiveness is not a good predictor of asthma outcome. Childhood atopy is associated with the persistence of symptoms but not with lung function in adulthood. An important finding is that anti-inflammatory treatment can reduce the accelerated decline in forced expiratory volume in 1 s and airway remodelling, but there is considerable variety in treatment response between individuals, which possibly can be explained by genetic make-up. Although many studies have investigated the genetics of asthma susceptibility, longitudinal studies on genes associated with asthma outcome are scarce.


CONCLUSIONS
Despite many high-quality investigations, accurate prediction of adult asthma in childhood is still not feasible. Future studies should focus on associations between genetic background and asthma prognosis as an important area of research with great potential.
Vonk
Judith M
JM
Department of Epidemiology and Bioinformatics, University of Groningen, University Medical Center Groningen, The Netherlands. j.m.vonk@med.umcg.nl
Boezen
H Marike
HM
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics / Q000628:therapy; D016535:Bronchial Hyperreactivity; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D020022:Genetic Predisposition to Disease; D006801:Humans; D008168:Lung / Q000502:physiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking