Study: Persistent asthma in childhood has long-term effects

May 20, 2016
Originally published on May 16, 2016 8:34 pm

Children who live with persistent asthma in childhood are at a higher risk of developing lung problems later in life, according to new findings from a national asthma study that began in the 1990s. A small number of patients even exhibited symptoms of chronic obstructive pulmonary disease, or COPD, in early adulthood.

“It is astonishing … for people barely into adulthood to already have COPD is terrible. As the disease evolves, they are likely to have health problems that will make it difficult to participate in normal day-to-day responsibilities such as holding a job,” the late Dr. Rob Strunk, a Washington University pediatrician who co-authored the study, said earlier this year.

Strunk, who dedicated his career to studying childhood asthma, died last month, before he could see his latest results published last week in the New England Journal of Medicine. He was 73.

The study of 684 people with persistent asthma found that 75 percent had reduced lung function as adults, and 11 percent met criteria for COPD

Dr. Scott Weiss of Harvard University, a co-author for the study and a longtime colleague of Strunk, said the causes are hard to pinpoint, but it appears they are twofold:

“The underlying asthma and the inflammation that comes from that, can lead to narrowing of the airways, and asthma attacks themselves may lead to narrowing of the airways,” Weiss said.

Between 2006 and 2008, one in five children in the city of St. Louis had been diagnosed with asthma, according to the Missouri Department of Health & Senior Services. In a previous interview with St. Louis Public Radio, Strunk underscored the need for families to take preventative measures to manage their child’s asthma symptoms. Keeping a home smoke-free, avoiding mold, dust and pet dander all can help — but families should also make sure they know how to spot the warning signs of an asthma attack. They can include fatigue and appetite changes that progress to coughs and wheezing.

The study is part of the Childhood Asthma Management Program, a multi-center random clinical trial that followed more than 1,000 children living with asthma. Researchers sought more effective ways to treat the chronic disease.

Many participants visited Washington University in St. Louis for the checkups. Among them was Janae Smith, 32, of St. Louis County. Smith said that Strunk was a comfort to her and her family when, at 13, she was hospitalized after an asthma attack. When she participated in the study, he helped her learn how to manage her symptoms.  

“He was very nice, very caring,” Smith said of Strunk. “Normally when you have an asthma attack, it escalates very quickly.  So I knew what actions I needed to take. Before I participated in that research study, I didn’t know what the warning signs were.”

Smith said living with asthma as a child inspired her to work in health care; she is now a clinical nurse coordinator at Washington University.

Weiss, the study's co-author, said Strunk, who also had asthma, was devoted to children with the condition and determined to improve their lives.

“I have some solace in the fact that he knew that this was going to be published," Weiss said. "I just wish he had been here to see it.” 

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