Symptoms of atopic asthma often disappear around puberty. The authors
recently demonstrated that this clinical remission is accompanied with
ongoing airways inflammation in most subjects. The discrepancy between
lack of symptoms and persistent airway inflammation suggests that
perception of the symptoms is unclear. In the present study, young adults
in clinical remission of atopic asthma assigned themselves a modified Borg
score during methacholine and adenosine-5'-monophosphate induced
bronchoconstriction. Borg scores of subjects in clinical remission were
compared with those of symptomatic asthmatic subjects. A marked variation
in the Borg scores at a 20% fall in the forced expiratory volume in one
second was found. Significant differences in Borg scores between remission
patients and asthmatics could not be detected. It was concluded that
perception of dyspnoea, induced with methacholine and adenosine challenge,
is similar in young adults in clinical remission of atopic asthma compared
to that of patients with symptomatic asthma. Hence, an unclear perception
seems to be an unlikely explanation for the discrepancy between lack of
symptoms and ongoing inflammation. Other factors, including both physical
and psychological ones, may play a role in the apparent absence of
symptoms, thereby potentially leading to undertreatment
