Cited by 1,460Asthma and respiratory diseasesOccupational exposure and asthmaAllergic Rhinitis and Sensitization

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A Longitudinal, Population-Based, Cohort Study of Childhood Asthma Followed to Adulthood

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Sears, Malcolm R., Greene, Justina M., Willan, Andrew R., Wiecek, Elizabeth M., Taylor, D. Robin, Flannery, Erin M., Cowan, Jan O., Herbison, G. Peter, Silva, Phil A., Poulton, Richie·2003·New England Journal of Medicine

DOI 10.1056/nejmoa022363

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Abstract

BACKGROUND: The outcome of childhood asthma in adults has been described in high-risk cohorts, but few population-based studies have reported the risk factors for persistence and relapse. METHODS: We assessed children born from April 1972 through March 1973 in Dunedin, New Zealand, repeatedly from 9 to 26 years of age with questionnaires, pulmonary-function tests, bronchial-challenge testing, and allergy testing. RESULTS: By the age of 26 years, 51.4 percent of 613 study members with complete respiratory data had reported wheezing at more than one assessment. Eighty-nine study members (14.5 percent) had wheezing that persisted from childhood to 26 years of age, whereas 168 (27.4 percent) had remission, but 76 (12.4 percent) subsequently relapsed by the age of 26. Sensitization to house dust mites predicted the persistence of wheezing (odds ratio, 2.41; P=0.001) and relapse (odds ratio, 2.18; P=0.01), as did airway hyperresponsiveness (odds ratio for persistence, 3.00; P<0.001; odds ratio for relapse, 3.03; P<0.001). Female sex predicted the persistence of wheezing (odds ratio, 1.71; P=0.03), as did smoking at the age of 21 years (odds ratio, 1.84; P=0.01). The earlier the age at onset, the greater the risk of relapse (odds ratio, 0.89 per year of increase in the age at onset; P<0.001). Pulmonary function was consistently lower in those with persistent wheezing than in those without persistent wheezing. CONCLUSIONS: In an unselected birth cohort, more than one in four children had wheezing that persisted from childhood to adulthood or that relapsed after remission. The factors predicting persistence or relapse were sensitization to house dust mites, airway hyperresponsiveness, female sex, smoking, and early age at onset. These findings, together with persistently low lung function, suggest that outcomes in adult asthma may be determined primarily in early childhood.

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Behavioral Inhibition Is Associated With Airway Hyperresponsiveness but not Atopy in a Monkey Model of Asthma
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Prevalência e gravidade de sintomas relacionados à asma em escolares e adolescentes no município de Duque de Caxias, Rio de Janeiro
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BackgroundMethodInfluential
Asociación entre atopia familiar, exposición a humo de tabaco, tabaquismo activo, obesidad y asma en adolescentes
Nava, F. V., González, A. H. S., Perales, G. M. M., Ochoa, D., Gómez, M. D. C. B., Rodríguez, E. M. V., Vázquez-Rodríguez, C. F., & Guzmán, F. J. B. (2006) · Archivos de Bronconeumología · doi:10.1157/13095970 · Cited by 22
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Influential
Airway Function, Inflammation and Regulatory T Cell Function in Subjects in Asthma Remission
Boulet, L., Turcotte, H., Plante, S., & Chakir, J. (2012) · Canadian Respiratory Journal · doi:10.1155/2012/347989 · Cited by 22
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Background
Impulse oscillometry at preschool age is a strong predictor of lung function by flow‐volume spirometry in adolescence
Lauhkonen, E., Riikonen, R., Törmänen, S., Koponen, P. S., Nuolivirta, K., Helminen, M., Toikka, J., & Korppi, M. O. (2018) · Pediatric Pulmonology · doi:10.1002/ppul.23977 · Cited by 23
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Avoiding deep inspirations increases the maximal response to methacholine without altering sensitivity in non-asthmatics
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Epigenome-wide association study of lung function in Latino children and youth with asthma
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Age-Dependent Reduction in Asthmatic Pathology through Reprogramming of Postviral Inflammatory Responses
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Background
25 Years of translational research in the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC)
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Validation of Strasbourg environmental exposure chamber (EEC) ALYATEC® in mite allergic subjects with asthma
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Responsiveness to Parenteral Corticosteroids and Lung Function Trajectory in Adults with Moderate-to-Severe Asthma
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Authors: Sears, M. R., Greene, J. M., Willan, A. R., Wiecek, E. M., Taylor, D. R., Flannery, E. M., Cowan, J. O., Herbison, G. P., Silva, P. A., & Poulton, R.
Affiliations: St. Joseph’s Healthcare Hamilton (CA)
McMaster University (CA)
University of Otago (NZ)
ORCID: Sears, Malcolm R.
Willan, Andrew R.
Taylor, D. Robin
Poulton, Richie
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2003-10-09
Volume: 349
Issue: 15
Pages: 1414-1422
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa022363
OpenAlex: W2104537618
Cited by: 1,460
References: 28
Citations by year: 2026: 21 · 2025: 29 · 2024: 39 · 2023: 42 · 2022: 41 · 2021: 56 · 2020: 51 · 2019: 62 · 2018: 54 · 2017: 38 · 2016: 53 · 2015: 72 · 2014: 86 · 2013: 59 · 2012: 70
FWCI: 40.25
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
Keywords: childhood asthma, adult asthma, asthma persistence, asthma relapse, wheezing, house dust mite sensitization, airway hyperresponsiveness, sex differences, smoking, age at asthma onset, lung function, Dunedin birth cohort
MeSH terms: Adolescent, Adult, Asthma, Child, Child, Preschool, Environmental Exposure, Female, Humans, Longitudinal Studies, Male, New Zealand, Surveys and Questionnaires, Recurrence, Respiratory Function Tests, Respiratory Sounds, Risk Factors, Sex Factors, Smoking, Cohort Studies, Bronchial Hyperreactivity, Age of Onset, Disease Progression, Pyroglyphidae

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A Longitudinal, Population-Based, Cohort Study of Childhood Asthma Followed to Adulthood

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