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Title: Asthma With Onset in Early Adulthood Has Origins in Early Childhood
URL: http://www.pslgroup.com/dg/22CDD2.htm
Doctor's Guide
September 19, 2008

NEW YORK -- September 19, 2008 -- Asthma with onset in early adulthood has its origins in early childhood, according to a study published in this week's Asthma Special Issue of The Lancet.

Debra Stern, MD, and Fernando D. Martinez, Arizona Respiratory Center, Tucson, Arizona, and colleagues used data from the Tucson Children's Respiratory Study, which enrolled 1,246 babies, of which 849 had follow-up data at 22 years.

Of the 181 cases of active asthma at 22 years, 49 (27%) were newly diagnosed, of which 35 (71%) were women. Men were twice as likely as women to have had asthma remission by age 22 years.

Factors independently associated with chronic asthma at 22 years included wheezing onset at 6 years (7.4 times increased risk); persistent wheezing in early life (14 times increased risk); sensitisation to Alternaria alernata (3.6 times increased risk); low airway function at age 6 years (twice the risk); and bronchial hyper-responsiveness at 6 years (4.5 times the risk).

Furthermore, increased risk of newly diagnosed asthma at age 22 years was associated with bronchial hyper-responsiveness at 6 years (by 7 times), low airway function at 6 years (by nearly 3 times), wheezing onset at 6 years (by 4.6 times), and persistent wheezing (by 4 times).

"In over 70% of people with current asthma and 63% of those with newly diagnosed asthma at age 22 years, episodes of wheezing had happened in the first 3 years of life or were reported by parents at age 6 years. ... Our findings support our previous proposition that most forms of asthma have their origins in early life, but we now extend that proposition to asthma diagnosed in early adult life," the authors wrote

In an accompanying comment, Susanne Lau, MD, Charité University Medicine, Berlin, Germany, said: "These findings identify a population at risk of chronic obstructive airway disease in early adulthood, and they already showed a predisposition during preschool years. Whether therapeutic approaches at early preschool age can affect progression of the disease is yet to be established."

SOURCE: The Lancet

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