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Effect of asthma exacerbations on natural history

Robert F. Lemanske, Jr., MD
University of Wisconsin School of Medicine and Public Health
Madison, WI, United States

Despite the availability of medications that provide substantial benefits on the impairment aspects of asthma control, asthma exacerbations (a major feature of the long term risk domain) continue to occur in both children and adults. Exacerbations contribute to the morbidity and mortality of asthma based on their frequency and severity and resultant impact on quality of life and overall health care costs. In addition, recent data in adult patients suggest that frequent exacerbations may be associated with an increased rate of loss of lung function, further underscoring their importance to overall risk. Many exacerbations in both children and adults are caused by viral respiratory tract illnesses, most commonly due to rhinovirus. For many asthmatic patients, the disease has its roots in early childhood, and loss of lung function can be demonstrated in children with persistent wheezing during the first six years of life. Since both rhinovirus and RSV are frequent causes of these wheezing episodes, which have been associated with asthma development, further insights into mechanisms underlying these relationships is needed. This presentation will review data concerning viral induced wheezing episodes, asthma exacerbations, loss of lung function, asthma development, and potential mechanisms surrounding these outcomes.

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