Can asthma go away in children? Cons: It cannot
10.4168/aard.2026.14.2.60
- Author:
Eun-Ae YANG
1
Author Information
1. Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
- Publication Type:MINI-REVIEW
- From:Allergy, Asthma & Respiratory Disease
2026;14(2):60-68
- CountryRepublic of Korea
- Language:English
-
Abstract:
Childhood asthma is a common chronic respiratory disease with a heterogeneous course, including remission, persistence, and relapse. Although about 50% of the affected children achieve clinical remission, many relapse; furthermore, airway inflammation or lung function impairment may persist even during remission. By synthesizing findings from cohort studies conducted in the United Kingdom, New Zealand, Australia, the United States, Canada, Sweden, The Netherlands, Denmark, Turkey, and Iran, we reviewed the long-term course of childhood asthma and prognostic factors influencing remission. Clinical remission rates ranged from 25% to 65% across cohorts, whereas complete remission defined as normal lung function with the absence of bronchial hyperresponsiveness was limited to 15%–30%. Even among the patients in clinical remission, many continued to show reduced lung function, bronchial hyperresponsiveness, and airway inflammation. Prognostic factors for remission failure and persistence included low forced expiratory volume in 1 second/forced vital capacity ratio, bronchial hyperresponsiveness, female sex, early onset, disease severity, atopy, parental history of asthma, and high healthcare utilization shortly after diagnosis. In contrast, children with normal lung function, normal eosinophil count and normal airway responsiveness had higher than 80% likelihood of remission in adulthood. Earlylife bronchiolitis, severe asthma, sensitization to house dust mite, Alternaria, and furred animals, elevated fractional exhaled nitric oxide levels and peripheral eosinophilia were associated with persistent or relapsing asthma. In addition, non-White populations showed lower remission rates compared with White populations. Therefore, symptom control, preservation of lung function, and prevention of exacerbations remain the most pragmatic treatment goals, while early intervention strategies based on prognostic factors may help reduce persistence and relapse.
