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Asthma in young adults originates in childhood. Among a birth cohort of 1246 healthy babies in Tucson, Arizona (Lancet 2008;372:1058–64; see also editorial, ibid: 1009, and Comment article, ibid: 1014–5) 849 were followed up to age 22 years. The average incidence of asthma at age 16–22 years was 12.6 per 1000 person-years. At age 22 years 181 subjects had active asthma and, among these, it was of recent onset in 49 (35 women). The following factors were independently associated with chronic asthma at age 22: onset in the first 6 years of life, persistent wheezing in early childhood, sensitisation to Alternaria alternata, and reduced respiratory function and bronchial hyperresponsiveness by the age of 6 years. Asthma of recent onset at age 22 years was related to reduced respiratory function and bronchial hyperresponsiveness by the age of 6 years and to late-onset and persistent wheezing.
Measurement of the fraction of nitric oxide (NO) in exhaled air has been used as an indicator of airway inflammation in patients with asthma. Now a study in 10 US cities (Lancet 2008;372:1065–72; see also editorial, ibid: 1009, and Comment articles, ibid: 1015–7 and 1017–9) has shown that exhaled NO monitoring did not improve asthma control among adolescents and young adults (aged 12–20 …