Persistent Childhood Asthma Linked to Long-Term Lung Function Deficits Interview with:

Dr. James P. Kiley Ph.D National Institutes of Health Bethesda Maryland

Dr. James Kiley

Dr. James P. Kiley Ph.D
National Institutes of Health Bethesda
Maryland What is the background for this study? What are the main findings?
Dr. Kiley: While a higher proportion of children have asthma compared to adults, the disease is limited to childhood for many individuals who appear to be unaffected as adults. Regardless of whether asthma continues into adulthood or reoccurs during adulthood, the impact of childhood asthma on lung function later in life is unclear. This study demonstrated that in children with chronic persistent asthma at the age of 5-12 years who continued to be followed through their early twenties, 75% of them had some abnormality in the pattern of their lung growth. The study examined the trajectory of lung growth, and the decline from maximum growth, in a large cohort of persons who had persistent, mild-to-moderate asthma in childhood and determined the demographic and clinical factors associated with abnormal patterns of lung growth and decline. What should readers take away from your report?

Dr. Kiley: Those children with chronic persistent asthma have some atypical lung growth or decline in lung function that was evident through young adulthood. The highest risk for being in the most compromised group (abnormal growth and early decline in function compared to normal growth without a decline in function) by the time of young adulthood included those with the following specific characteristics at the time of study enrollment: lower lung function, more bronchospasm and less response to bronchodilators, being younger, or male. What recommendations do you have for future research as a result of this study?

Dr. Kiley: We need to understand if children with mild asthma or recurrent wheezing episodes as infants and toddlers have detectable, clinically significant deficits in lung function later in life. We also need to understand if management affects the long-term consequences of childhood asthma. Hopefully, the Environmental Childhood Health Outcomes program that was initiated by the National Institutes of Health will be able to address some of these critical questions. Is there anything else you would like to add?

Dr. Kiley: All children with asthma should receive optimal management of their disease; those with persistent asthma should receive special counseling regarding the potential risks of the long-term consequences of their disease. Thank you for your contribution to the community.


Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma.

McGeachie MJ, Yates KP, Zhou X, Guo F, Sternberg AL, Van Natta ML, Wise RA, Szefler SJ, Sharma S, Kho AT, Cho MH, Croteau-Chonka DC, Castaldi PJ, Jain G, Sanyal A, Zhan Y, Lajoie BR, Dekker J, Stamatoyannopoulos J, Covar RA, Zeiger RS, Adkinson NF, Williams PV, Kelly HW, Grasemann H, Vonk JM, Koppelman GH, Postma DS, Raby BA, Houston I, Lu Q, Fuhlbrigge AL, Tantisira KG, Silverman EK, Tonascia J, Weiss ST, Strunk RC; CAMP Research Group.

N Engl J Med. 2016 May 12;374(19):1842-52. doi: 10.1056/NEJMoa1513737.


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