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Childhood asthma increases risk for COPD in early adulthood
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Recent research in the New England Journal of Medicine found that persistent childhood asthma was associated with an increased risk for developing chronic obstructive pulmonary disease in early adulthood.
“This work tells us that persistent childhood asthma can develop into COPD, something that up until now has not been well-described,” Scott T. Weiss, MD, co-director of the systems genetics and genomics section of the Brigham and Women's Hospital Channing Division of Network Medicine, said in a press release. “Children who had low lung function at the start of the trial followed a series of predicted growth patterns: Most had reduced lung growth with time and a significant number would go on to meet the criteria for COPD.”
The researchers studied 684 children from ages 5 through 12 years to at least age 23 years. Study participants underwent lung functioning measurements once annually during the study period, at one of eight research centers. The researcher studied risk factors associated with abnormal lung functioning and growth. Study participants were compared with control participants without asthma from the National Health and Nutrition Examination Survey.
Study data indicated that 11% of participants had reduced lung functioning impairment consistent with a diagnosis of COPD before age 30 years. These participants had an increased risk for reduced pattern of lung growth, compared with a normal pattern of lung growth (18% vs. 3%; P < .001).
Stanley Szefler
“This CAMP follow-up study is important since it reports on lung development trajectories in children with mild to moderate asthma from an early age, aged 5 to 12 years, followed into early adulthood. A considerable number of these children had low lung function when they started the CAMP study and they continued to have low lung function into early adulthood.” Stanley Szefler, MD, director of the Pediatric Asthma Research Program in the Breathing Institute of the Pediatric Pulmonary Section at Children's Hospital Colorado, said in an interview. “In addition a proportion of these children demonstrated reduction in pulmonary function over time. This study reinforces the need to examine lung function in children with asthma and to follow it over time to determine if they may be at risk for irrecoverable loss of lung function and the development of chronic obstructive pulmonary disease.”
Weiss and colleagues also determined that impairment of lung function and male sex were the most reliable predictors of abnormal lung growth and functioning decline through adulthood (P < .001).
“With this understanding, physicians need to identify at-risk children earlier and counsel them about potential preventive measures,” Weiss said. “Since asthma itself is a risk factor for developing COPD, these patients should be advised against risk-related environmental exposures, like smoking, that could intensify their symptoms and increase their COPD risk. It is important that we recognize this link between persistent childhood asthma and COPD as a potential problem and focus on prevention efforts.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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