Whether you or a loved one has asthma, you may be wondering if the condition can harm the lungs in the long run. With about 7.3 percent of adults and children in the United States affected by asthma, it's an important question. When you have asthma, wheezing, chest tightness, cough and shortness of breath are characteristic symptoms. Asthma can develop differently in different people, and responses to treatment can also vary. In some people, asthma can have a long-lasting impact on the lungs and how they function, but there are still some important unanswered questions.
Some people with asthma, particularly those diagnosed in childhood, can develop lung problems over time. Research published the August 2012 “Journal of Allergy and Clinical Immunology” suggests that long-term impact on lung function may be more likely in some people than others. Wheezing early in life that persists beyond the age of 3 was associated with diminished lung function, or reduced air flow, as an adult. People who developed asthma during adolescence also seemed to be more apt to have loss of lung function over time. The authors proposed that at both ages, early in life and during adolescence, significant lung growth occurs, perhaps increasing susceptibility to long-term injury. The lung function test that demonstrated this loss of lung function was the FEV1, which measures the amount of air that can be exhaled forcefully in one second -- that is, it was harder for some people with asthma to exhale the same amount of air in one second as others without asthma.
Why Lung Function Decreases
These changes in the lungs are thought to be related to chronic inflammation. When the immune system imbalance of inflammation persists over days, weeks and months, this not only leads to symptoms but also may increase the risk for long-term changes in the lungs -- changes such as scar formation, increase in the size and number of muscle cells around the airways, and an increase in mucous glands. While doctors have learned a great deal about asthma and have improved treatments based upon this understanding, further research is needed on ways to prevent these long-term changes. Other factors, such as smoking and obesity, may have an impact on lung function as well.
Benefits of Control
The mainstay of treatment for asthma is a steroid-containing inhaler. Steroids help reduce inflammation, and can come in a variety of forms -- pill or intravenous forms are the most potent but also have the highest potential for side effects. The inhaler allows the steroid medication to enter the lungs with inhalation and be deposited where it can work directly on the lung tissues; this can reduce side effects compared to pills. While treatment with a steroid inhaler may help, resulting in fewer trips to the hospital, fewer doctor visits and potentially less need for additional asthma medications, it is not clear that the long-term effects of asthma on the lungs are changed by using steroids.
Warnings and Precautions
Asthma is a disease that is diagnosed and treated by a medical professional. Discuss all of your concerns about asthma and the long-term impact on your body with your doctor. Do not make any changes to your medications without the advice of your doctor. If you have questions about proper use of your medications, or if you have shortness of breath that is not improved with the use of medication, discuss these concerns with your medical provider.
Medical Advisor: Shilpi Agarwal, MD