The Childhood of Adult-Onset Asthma and the Asthma/Chronic Obstructive Pulmonary Disease Overlap
Year: 2016
Type: article
Abstract: Adult asthma is a heterogeneous condition and, in a significant proportion of patients, the disease first manifests during childhood.Recent evidence suggests, however, that even in bona fide adult-onset asthma, the roots of the disease may be found in early life.In longitudinal studies, patients with adult-onset asthma were more likely to have early life wheezing and bronchial hyperresponsivess at age six than subjects without asthma.Adult-onset asthma has also been consistently associated with preceding reports of both atopic and non-atopic rhinitis, suggesting that an alteration in mucosal/innate immunity may be common to both conditions.Of particular interest are the potential early origins of the asthma/chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS).Many patients with childhood-onset asthma reach the plateau phase of lung function with significant airflow limitation and are thus likely to eventually reach the levels of forced expiratory volume in 1 second and forced expiratory volume in 1 second/forced vital capacity ratio that codify the diagnosis of COPD, even after normal rates of age-related lung function decline.Active smoking has been shown to have synergistic effects with both a history of childhood asthma and with a history of lower respiratory illnesses due to the respiratory syncytial virus in determining increased airway narrowing and a diagnosis of asthma in early adult life.Asthma diagnosis, in this case, could potentially be a surrogate for the first clinical manifestations of chronic obstructive pulmonary disease.It is thus plausible to surmise that strategies for the
Source: Barcelona Respiratory Network
Author: Fernando D. Martinez
Institution: University of Arizona
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2759187121