The spectrum of clinical asthma is broad, ranging from occasional mild wheezing or coughing on exertion to severe, persistent disease that occasionally can be fatal. Asthma, by definition, is characterized by airway narrowing, which, at least initially, is fully reversible.<sup>51 Sears M.R. The definition and diagnosis of asthma Allergy 1993 ;  48 : 12-16  [cross-ref]

Haga clic aquí para ir a la sección de Referencias</sup> The course of asthma is characterized by apparent remission in some instances, and persistence and worsening in others. The effects of treatment on the “natural history” of asthma remain uncertain.

The natural history of childhood asthma has been described in more than 50 studies.<sup>24 Grol M.H., Gerritsen J., Postma D.S. Asthma: From childhood to adulthood Allergy 1996 ;  51 : 855-869  [cross-ref]

Haga clic aquí para ir a la sección de Referencias</sup> Different outcomes have been reported, some studies suggesting that asthma improves or remits in adolescence and adulthood, and other studies reporting that most asthma persists, and may worsen with age. Some of the apparent conflict in the reported natural history of childhood asthma is related to the selection of the population in which the study is performed, the age of subjects when the cohort is first studied, the definition of asthma, the duration of follow-up, and the nature of the outcome assessments used.<sup>52 Sears M.R. Growing up with asthma. The two thirds with milder symptoms should grow out of asthma BMJ 1994 ;  309 : 72-73

Haga clic aquí para ir a la sección de Referencias</sup> The natural history of adult asthma has been less clearly defined, but remission is uncommon.

This article focuses largely on studies of the natural history of asthma reporting objective functional outcomes, rather than only subjective outcomes, because cessation of symptoms does not necessarily assure return of normal airway caliber or responsiveness. <sup>10 Canny G.J., Levison H. Pulmonary function abnormalities during apparent clinical remission in childhood asthma J Allergy CIin Immunol 1988 ;  82 : 1-4  [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 25 Gruber W., Eber E., Steinbrugger B. , y al. Atopy, lung function and bronchial responsiveness in symptom-free paediatric asthma patients Eur Respir J 1997 ;  10 : 1041-1045  [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 38 Nakadate T., Kagawa J. Pulmonary function development in children with past history of asthma J Epidemiol Community Health 1992 ;  46 : 437-442  [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 63 Teeter J.G., Bleecker E.R. Relationship between airway obstruction and respiratory symptoms in adult asthmatics Chest 1998 ;  113 : 272-277  [cross-ref]

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