Chronic asthma can be predicted before the age of 3
Recurring airway inflammation in sensitised children before the age of 3 is predictive of chronic asthma and impairment of lung function at school age. House dust mite, dog and cat allergens are implicated in this process. This study followed 1314 children from birth to 13 years of age. The children were regularly checked and tested for allergic response and allergen exposure. 90% of the study children with wheeze, but no atopy, lost their symptoms at school age and retained normal lung function. By contrast, study children sensitised to perennial inhaled allergens before the age of 3 were found to be associated with significant loss of lung function at school age. High exposure to inhaled allergen in these vulnerable children enhanced airway hyper-responsiveness and reduced lung function. Common inhaled allergens were from house dust mites, dog and cats. In conclusion the paper raises an important issue: “Given the good prognosis for non-atopic wheezing children, the need for these individuals to continue to take inhaled corticosteroids on a regular basis should be re-assessed.” Estimated cost of treating EU children with asthma is 3000 million Euros per annum.
‘Perennial allergen sensitisation early in life and chronic asthma in children: a birth cohort study’, Sabina Illi, Erika von Mutius, Susanne Lau, Bodo Niggeman, Christoph Gruber, Ulrich Wahn, on behalf of the Multicentre Allergy Study (MAS)group, Lancet, 2006, Vol. 368, p 763-770
