Childhood Asthma May Lead to COPD Due to Reduced Lung Growth

Childhood Asthma and Reduced Lung Growth are Risks for COPD 

A long-term study of those with childhood asthma and daily symptoms was published on May 12, 2016, in the New England Journal of Medicine (volume 374, pages 1842-1852). Michael McGeachie, Ph.D., from Harvard Medical School was the first author. The findings are relevant to the diagnosis of COPD. Background: Cigarette smoking is the major risk factor for COPD. However, it is estimated that 15 – 20% of those with COPD have not smoked. Other possible causes for developing COPD include inhaling irritants in the air (such as construction workers) over a long time and persistent asthma with permanent damage to the breathing tubes (called airway remodeling). Study: 684 children with persistent (daily symptoms) of asthma were studied until an average age of 26 years. Breathing tests (pulmonary function tests) were performed frequently over approximately 20 years.
Child using inhaler with spacer

Child using inhaler with spacer as asthma treatment

Results: The authors found that the changes fit into four groups: ♦  Normal lung growth and no early decline – 25% ♦  Normal lung growth and an early decline – 26% ♦  Reduced lung growth only – 23% ♦ Reduced lung growth and an early decline – 26% 73 in the study (11%) had findings consistent with COPD as young adults. They did not smoke cigarettes and there was no evidence of long term exposure to inhaling irritants in the home.
Child receiving a Nebulized Treatment for Asthma

Child receiving a Nebulized Treatment for Asthma

Conclusions: Children with persistent asthma and reduced lung growth are at risk for possible COPD in early adulthood. My Comments: The results of this study suggest that some children with daily asthma symptoms may develop or progress into COPD as young adults. Whether aggressive asthma therapy during childhood might prevent the development of COPD is unknown.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.