Abstract

Asthma has a variable course over childhood and adolescent years. There are quite distinct wheezing phenotypes in children during the first years of life coexisting up to the adolescent year. Also, many cases of chronic, allergyrelated asthma have their first clinical manifestations during this period. One quarter of cases had wheezing during the first years of life that persisted from childhood to adulthood. Several longitudinal studies and unselected birth cohorts have assessed that asthma remits in adulthood in a large proportion of allergic asthmatic children. Most children with severe symptoms still have severe symptoms as adults and asthmatic children with mild symptoms either have no asthma or have mild asthma as adults. Optimal treatment early with anti-inflammatory drugs and allergen elimination in children with persistent symptoms may prevent the early loss of lung function. Conversely, those with infrequent episodes of asthma or viral-induced asthma do not require prophylactic therapy. They should be treated to control their symptoms. Predictors of progression of the asthma over puberty into adulthood are the early age at onset, the presence of atopy, the severe bronchial hyperreactivity, the persistently low pulmonary functions, and the active cigarette smoking.