The development of lung damage in asthma is confined to infancy and early childhood.
In addition to its symptomatic impact, asthma may be associated with structural lung damage, which is reflected in impairment of lung function. An important and to some extent neglected aspect of the adverse effects of asthma on lung function has been their course: when do they first occur, and how do they progress? For example, does lung function progressively deteriorate, as it does in chronic obstructive pulmonary disease? These questions have in part been addressed by a number of prospective, longitudinal studies of asthma, including the Melbourne Asthma study (Australia), the Dunedin (New Zealand) and the Tucson study (Arizona, USA). Based on these three studies, I propose that the pathological changes which affect lung function occur in infancy and early childhood. The window of opportunity for preventing the development of these changes, and thus modify the course of the disease, is confined to this early period of life.
Behjati
Sam
S
North Middlesex University Hospital, Sterling Way, London, N18 IQX, UK. behjati@doctors.org.uk
D000293:Adolescent; D001249:Asthma / Q000473:pathology*; D002648:Child; D006801:Humans; D007223:Infant; D008168:Lung / Q000473:pathology* / Q000503:physiopathology; D008954:Models, Biological