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Published: 2024-05-15

Remission from childhood asthma more common than from adult-onset asthma

NEWS Early childhood factors affect the onset of asthma both in childhood and in young adulthood. They also play a significant role in the long-term prognosis of asthma. Most people with adult-onset asthma retained their disease after 15 years, while remission from childhood asthma was more common.

Asthma is a common disease that can debut both in childhood and adulthood. There are few studies that have followed people for a long time to find out how asthma develops and changes over time. The aim of the thesis was therefore to contribute new knowledge about 1) the onset, incidence, of asthma from childhood to young adulthood and factors of importance for both incidence and prognosis and 2) which clinical features are related to the long-term prognosis of asthma among adults.

The thesis is based on studies in which more than 3,000 people were followed from the age of 8 to 28. Asthma incidence was high in childhood, remained high during adolescence, but decreased during young adulthood. Up to the age of 10, asthma was more common among boys than girls, but from the age of 15 it became more common among girls. Factors in early childhood, such as smoking during pregnancy, low birth weight, having eczema, having a positive allergy test to airborne allergens (e.g., birch, grass, and fur animals), or severe respiratory infections before the age of 8, were primarily associated with asthma onset in childhood and adolescence. Short breastfeeding time and having a parent with asthma were related to asthma onset even in young adulthood.

Allergic eye and nose problems at age 8 years were strongly associated with asthma onset during childhood, adolescence, and young adulthood. Approximately 40% of those with asthma by the age of 8 were in remission from their asthma by the age of 28. Allergic sensitization, allergic eye and nose problems and severe respiratory tract infections in childhood, as well as increased sensitivity of the airways in adolescence, were more common among those who still had asthma at the age of 28.

The co-occurrence of asthma and hay fever increased from the age of 8 to 28, especially among those with a positive allergy test. However, in childhood as well as in adolescence and young adulthood, it was unusual to have all three conditions at the same time - asthma, eczema and allergic eye or nose problems. Among people who had asthma in adulthood, 9 out of 10 still had asthma after 15 years of follow-up. The people who were in remission from asthma had better lung function and less sensitive airways at onset than those in remission from asthma.

"Regardless of age, it is important to remember to ask about factors early in life and during the toddler years, such as birth weight, exposure to smoking, respiratory infections, and whether they have other allergic conditions as well as heredity for asthma and allergies. All these factors can affect the development of asthma but also the prognosis of the disease," says the author of the thesis, Linnéa Almqvist.

On Friday 17 May, Linnéa Almqvist, Department of Public Health and Clinical Medicine, Sustainable Health at Umeå University, will defend her thesis Asthma epidemiology – prognosis of asthma with onset in childhood and in adulthood. The dissertation will take place at 9.00 a.m. in the Aula, Sunderby Hospital, Luleå.

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+46 70 623 72 14
linnea.qvist@umu.se