Readers’ Corner | Can Asthma Be Cured?

Twice a month, our journalist answers readers’ questions about health and well-being.

“Is asthma curable? I have suffered from it chronically for 35 years. Even though I work out every day, it is destroying my life and I still need my damn pumps.” — Julie Bouchard, Châteauguay

If asthma developed during childhood, i.e. before puberty, yes, it can disappear spontaneously, answers Dr.^r Simon Couillard, a pulmonologist and professor at the Faculty of Medicine and Health Sciences at the University of Sherbrooke. This is the case for about 20% of people in this category, he says.

“There are people who have a very convincing history of asthma at a very young age. When they are older and we do lung function tests, they no longer have asthma, live a normal life and do not necessarily have a risk of recurrence,” summarizes Dr.^r Couillard. The prognosis is particularly good in boys and in those who suffered from a milder form of allergy. These remissions usually occur in the transition period between childhood and adolescence.

How can they be explained? Different hypotheses exist, explains the professor. First, children may have difficulty passing the tests, which means that their diagnosis is assumed rather than confirmed. Puberty also remains a pivotal moment in the development of immune maturity, he adds.

A chronic illness

In people who developed asthma as teenagers or adults, the chances of recovery are unfortunately “very, very, very” low, says Dr.^r Simon Couillard: These people can have long periods of calm, during which the asthma is controlled, but the underlying condition remains. Asthma, he points out, is a chronic disease.

The pulmonologist gives the example of episodes of “storm asthma,” including the one that occurred in Melbourne, Australia, in 2016. A particular combination of environmental factors (wind, torrential rain, high pollen counts) sent a large quantity of allergenic particles into the air… and a tidal wave of patients to the emergency room, prey to asthma attacks. Some of them were not taking a pump and considered themselves in remission. In total, 10 people died from it.

A good diagnosis

When you’re wondering about your chances of asthma remission, the first thing to do is ask yourself whether you’ve been diagnosed appropriately, says Dr.^r Couillard.

Studies (including one conducted in Canada) suggest that a third of adults and children diagnosed with asthma do not have it!

For example, it happens that the symptoms of bronchitis are confused with those of asthma. To confirm an asthma diagnosis, a breathing test is used, which involves inducing a mini asthma attack in hospital. Other, more specialized tests are used in Europe. “The solution is to have a good diagnosis,” continues the researcher.

In 2024, he points out, people with asthma do not necessarily need to have a pump every day. In consultation with health professionals and depending on their profile, patients can benefit from pumps that are both bronchodilators and anti-inflammatory, says Simon Couillard. “This helps protect people from extreme events, such as thunderstorm asthma,” he explains.

Can sport be a solution?

Physical activity is beneficial in many ways, and people with asthma have “the green light times 1,000” to move, says Dr.^r Couillard: If a person has an asthma attack during exercise, he says, it is a sign that their asthma is either poorly controlled or misdiagnosed: they need to seek medical attention.

But unfortunately, physical exercise does not cure asthma, even if you do a lot of it. High-level sport could even induce asthma, stresses Simon Couillard. Data shows that high-level swimmers and cross-country skiers develop more asthma because of the mechanical stress on their airways and the drying out of the airways.

Finally, anything that is cigarettes, cannabis and even electronic cigarettes can aggravate cases of asthma, recalls the pulmonologist. “And with global warming and forest fires, we can also expect more people to develop asthma in the coming years,” he concludes.

Biological drugs

There is a new class of asthma medications called biologics, which are given by injection. They are used in patients who have severe asthma with a lot of inflammation, says Dr.^r Couillard. The big research question right now is: could we administer these drugs earlier in the disease to induce remission before asthma causes damage? Simon Couillard invites people interested in participating in a research project to contact his team.

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