Long-term outcomes of early-onset wheeze and asthma

Research output: Contribution to journalReview article

53 Scopus citations

Abstract

Evidence from longitudinal cohort studies demonstrates that wheezing that begins in early life and continues into the school years generally persists into adulthood. This persistent wheezing is associated with lung function deficits and airways hyperresponsiveness that appear to be established in the first few years of life. Allergic sensitization early in life, early-life infection with rhinovirus, or colonization with any of a number of bacteria have been associated with increased risk of persistent wheeze. Early life, whether in utero or in the first few years of life, presents a window of vulnerability during which airway injury results in persistent airways dysfunction. Available data further suggest that a second such window of vulnerability might be present in the preadolescent and adolescent years. Lung function growth patterns established by age 6 years generally continue into early adulthood to middle adulthood, typically leaving groups of subjects with wheezing that persists into or relapses during adulthood with a mean FEV 1 of about 10% of predicted value less than their peers who do not wheeze. Subgroups of patients with persistent asthma, however, can have progressive decreases in lung function and enter adulthood with even lower lung function. The concern exists that these deficits in lung function apparent in early adulthood might put subjects at risk for the later development of chronic obstructive pulmonary disease.

Original languageEnglish (US)
Pages (from-to)299-307
Number of pages9
JournalJournal of Allergy and Clinical Immunology
Volume130
Issue number2
DOIs
StatePublished - Aug 1 2012

Keywords

  • Asthma
  • airways hyperresponsiveness
  • atopy
  • childhood
  • early onset
  • infancy
  • lung function
  • outcomes
  • wheezing

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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