The aetiology of childhood asthma

Asthma is an historic disease recorded clearly in ancient times by the Chinese and the Greeks. In developed countries the prevalence in children is very high, but the prevalence has been rising rapidly in the developing countries over the last 30 years. The aetiology is multifactorial and is a combination of genetic and environmental influences. Genetically, the mother plays a greater part than the father, but no single gene or polymorphism can account for symptoms and exacerbations in isolation. It is becoming evident that numerous environmental factors are crucial in symptom development, and include rhinoviral infections, diet, pets, endotoxins, seasonality, pollution, parental smoking, and obesity. Research helps us understand some of the mechanisms involved, but these mechanisms will vary hugely from one patient/family to another. Understanding this variation is key to personal management and the development of asthma control in this very common global disease.