Outgrowing Asthma
Some kids with childhood asthma will outgrow it completely; for some the asthma will improve, but not go away; for others, the asthma will get worse. Do allergy shots make a difference in which kids will be which? And is there a way in childhood to look into the future and see what is likely to happen? Researchers contacted and evaluated 85 young adults who had all been in an asthma study as children between 1984 and 1994. That study looked at allergy shots as a way of improving asthma. These kids all had moderate to severe asthma more than a decade ago. The follow-up study appears in the January 2005 Journal of Allergy and Clinical Immunology. As expected, some of the former children have now outgrown their asthma, for some it has gotten better, and for some it has gotten worse. The allergy shots made no difference in the outcome. But blood tests and skin tests during childhood were predictive. The blood test was a simple measure of allergic antibodies (total IgE). Those with low levels as children (less than 500 ng/ml) were far more likely to have no asthma symptoms as adults than those with higher levels (>900 ng/ml). And those children who had fewer than 8 positive allergy skin tests were far more likely to outgrow their asthma than those who tested positive to 10 or more allergens. It seems that much of the long-term outcome of asthma is determined during childhood.
Alan Greene MD FAAP
