Severe childhood asthma linked to COPD in adult life

By Nikki Withers, medwireNews Reporter

Children with severe asthma are at an increased risk of developing chronic obstructive pulmonary disease (COPD) in adult life, show findings of an Australian study.

Children with intermittent and persistent asthma, however, were not at an increased risk.

These findings therefore highlight that “suboptimal lung growth in childhood is a precursor to adult COPD”, say Andrew Tai (Women’s and Children’s Hospital, Adelaide) and colleagues.

The researchers analysed data for 197 individuals from the Melbourne Asthma Cohort. All participants were recruited at 6 or 7 years of age and followed up to age 50 years.

As reported in Thorax, 24% of the children had never wheezed (control or non-asthmatic), 12% had mild wheezy bronchitis, 22% had wheezy bronchitis, 25% had asthma and 17% had severe asthma.

At 50 years of age, 28 (14%) of the participants had COPD, 43% of whom had no history of smoking.

Multivariate analysis revealed that children with severe asthma were 32 times more likely to develop COPD in adult life than children with no symptoms of wheeze at 7 years of age.

This was despite the absence of a smoking history, note Tai et al. “Tobacco smoke is by far the most important risk factor for COPD worldwide,” they write. However, in this cohort, a substantial subset of individuals with COPD had never smoked. “This confirms a phenotype of COPD which is potentially related to childhood asthma”, the researchers say.

When the team looked at the rate of decline of lung function from age 21 to 50 years, they found no significant difference between the COPD group and the other groups (non-asthmatics, asthma in remission and current asthma).

“The fixed abnormalities in lung function in adult life are clearly established in childhood and track at lower values progressing to irreversible airway obstruction in adulthood”, say Tai and co-authors.

They conclude: “The results of this study highlight the importance of suboptimal lung function growth in childhood as a predisposing factor towards adult COPD.”

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