Abstract

Although it is well known that childhood asthma tends to be in remission during adolescence, the mechanism for this remains unclear. Considering the features of childhood bronchial hyperresponsiveness (BHR), we discussed the relationship between BHR and the remission of asthma in adolescence. It has been reported that aging has an effect on BHR in children, and most reports suggest a decrease in BHR with aging. Thus, the decrease of BHR plays a role in remission of asthma during adolescence. However, BHR in asthmatics is significantly higher than that in normal controls, and the discrepancy between BHR and the symptoms of asthma become very noticeable during this period. Long-term follow-up studies have reported the relationship between the degree of BHR and the degree of asthma symptoms in children, and the relationship between the result of first challenge at infantile period and the result of second challenge at adolescent period. Furthermore, there is no significant difference between the individual result of first challenge and second challenge in patients with non-remission, although a small improvement is seen in patients with remission. These results suggest that the degree of BHR does not so change in individuals during childhood.
Considering the mechanism of asthma remission during adolescence, the decrease of BHR may have an effect. However, the discrepancy between BHR and asthma symptoms during this period and the persistence of the degree in BHR in individuals should be discussed further. It is important to evaluate the mechanism of asthma remission in adolescence, and further studies in this field are expected.