title: Risk factors for persistence of asthma in children: 10-year follow-up.
abstract: OBJECTIVE
  Risk factors related to the outcome of childhood asthma are not yet well established. We aimed to investigate the long-term outcome for children with asthma to determine the risk factors in predicting persistence of disease.
  
  
  METHODS
  Sixty-two children with asthma were evaluated retrospectively at the end of a 10-year follow-up. Patients were asked to complete a questionnaire requesting clinical information, and underwent physical examination, skin prick testing, a pulmonary function test and bronchial provocation testing. Immunologic parameters evaluated were allergen-specific IgE and IgG4 levels, and allergen-induced generation of CD4(+)CD25(+) cells.
  
  
  RESULTS
  Mean age at final assessment was 15.9 ± 3.6 years, and duration of follow-up was 10.30 ± 1.27 years. Fifty percent of patients outgrew their asthma during the 10-year follow-up period. All the non-atopic patients outgrew their disease during the study period, whereas 67% of atopic patients did not. We identified two risk factors independently related to the persistence of symptoms: presence of bronchial hyper-responsiveness and presence of rhinitis. Atopic children who were in remission demonstrated significantly higher allergen-induced CD4(+)CD25(+) T cells compared to healthy controls.
  
  
  CONCLUSIONS
  Atopy, presence of rhinitis, positive and presence of bronchial hyper-reactivity are important risk factors for the persistence of asthma in children. Allergen-induced CD4(+)CD25(+) T cells were higher in the atopic children who outgrew their disease, implicating an immunological mechanism of asthma remission in children.
authors.affiliation: Department of Pediatric Allergy/Immunology, Faculty of Medicine, Marmara University , Istanbul , Turkey and.
authors.forename: Metin
authors.initials: M
authors.lastname: Aydogan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozen
authors.forename: Tunc
authors.initials: T
authors.lastname: Akkoc
authors.forename: Aarif O
authors.initials: AO
authors.lastname: Eifan
authors.forename: Esin
authors.initials: E
authors.lastname: Aktas
authors.forename: Gunnur
authors.initials: G
authors.lastname: Deniz
authors.forename: Izlem
authors.initials: I
authors.lastname: Gocmen
authors.forename: Nerin N
authors.initials: NN
authors.lastname: Bahceciler
authors.forename: Isil
authors.initials: I
authors.lastname: Barlan
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000276:immunology* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology* / Q000503:physiopathology; D006969:Hypersensitivity, Immediate / Q000276:immunology* / Q000503:physiopathology; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007963:Leukocytes, Mononuclear / Q000276:immunology; D016015:Logistic Models; D008297:Male; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D007074:Immunoglobulin G; D007073:Immunoglobulin E