Impact of early life exposures on respiratory disease

被引：52

作者：

Bush, Andrew ^{[1
,2
,3
]}

机构：

[1] Imperial Coll, Paediat & Paediat Respirol, London, England

[2] Imperial Ctr Paediat & Child Hlth, London, England

[3] Royal Brompton Harefield NHS Fdn Trust, Consultant Paediat Chest, London, England

来源：

PAEDIATRIC RESPIRATORY REVIEWS | 2021年 / 40卷

关键词：

Asthma; Cardiovascular risk; Chronic obstructive pulmonary disease; Emphysema; Lung function trajectory; Pregnancy; Nicotine; Smoking; Spirometry; REDUCED LUNG-FUNCTION; GRANDMATERNAL SMOKING PATTERNS; SYNCYTIAL-VIRUS BRONCHIOLITIS; DIFFERENTIAL DNA METHYLATION; CHILDHOOD ASTHMA; BIRTH-WEIGHT; AIRWAY RESPONSIVENESS; CYTOKINE RESPONSES; MATERNAL SMOKING; TOBACCO-SMOKING;

D O I：

10.1016/j.prrv.2021.05.006

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

The antecedents of asthma and chronic obstructive pulmonary disease (COPD) lie before school age. Adverse effects are transgenerational, antenatal and in the preschool years. Antenatal adverse effects impair spirometry by causing low birth weight, altered lung structure and immune function, and sensitizing the foetus to later insults. The key stages of normal lung health are lung function at birth, lung growth to a plateau age 20-25 years, and the phase of decline thereafter; contrary to perceived wisdom, accelerated decline is not related to smoking. There are different trajectories of lung function. Lung function usually tracks from preschool to late middle age. Asthma is driven by antenatal and early life influences. The airflow obstruction, emphysema and multi-morbidity of COPD all start early. Failure to reach a normal plateau and accelerated decline in lung function are risk factors for COPD. Airway disease cannot be prevented in adult life; prevention must start early.

引用

页码：24 / 32

页数：9

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