Not all asthma is the same

Asthma is not a single disease, but a group of syndromes with different origins and characteristics and so it is best to scrap the name, it says.

In the same edition of The Lancet, researchers report that the prevalence of childhood allergies is increasing worldwide.

And allergic children are more prone to asthma, experts warn.

A collection of disorders

An estimated 300 million people live with asthma worldwide. This is expected to increase to 400 million by 2025.

Despite effective treatments, asthma deaths account for one in 250 deaths globally and there remains a great deal to be known about the group of conditions dubbed asthma, says the Lancet.

Asthma includes a range of different symptoms, such as wheezing, coughing and difficulty breathing.

The underlying cause is inflammation of the airways. But it is not known what triggers this inflammation and why some people develop asthma and others do not.

Asthma is indeed a complex ailment Dr Andrew Miller of the British Lung Foundation

The Lancet says people with asthma can have a range of different triggers, symptoms and responses to treatment, and the general consensus now emerging is that asthma is unlikely to be a single disease entity.

"Perhaps asthma as a symptom is really only the clinical manifestation of several distinct diseases.

"Rather than confusing scientists, doctors and patients even further, is it not time to step out of the straightjacket of a seemingly unifying name that has outlived its usefulness?" it asks.

What's in a name?

The word asthma originates from a Greek word that means "to breathe with mouth open or to pant".

The Lancet claims that the term is too vague and should be abolished.

"Until the 19th century fever was regarded as a disease and maybe in 20, 30 or 50 years' time we will look back at asthma in the same way," says the editorial.

It may be dangerous to throw out the existing term for clinical purposes Professor Martyn Partridge of Asthma UK

Dr Andrew Miller, a spokesman for the British Lung Foundation, said: "The Lancet article raises some interesting points; asthma is indeed a complex ailment.

"But whether this is a good enough reason to abandon a useful name which encompasses a range of symptoms treated in a similar way is not yet clear."

Professor Martyn Partridge of Asthma UK said lung experts had been debating for some time the same question as that asked in the Lancet editorial.

He said it was important to ensure that "asthma" patients taking part in clinical trials were very carefully characterised, so that management strategies which were proven only in some were not applied to all.

But he cautioned: "It may be dangerous to throw out the existing term for clinical purposes, especially if it ran the risk of consequent undertreatment.

"What is not in doubt is that as a condition or group or conditions it's a widespread, often serious, but controllable problem."