Impact of early life exposures on respiratory disease
Impact of early life exposures on respiratory disease
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DOI：
10.1016/j.prrv.2021.05.006
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发表时间：
2021-11-03
影响因子：
5.8
通讯作者：
Bush, Andrew
中科院分区：
文献类型：
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作者：
Bush, Andrew
哮喘和慢性阻塞性肺疾病(COPD)的先兆存在于学龄前。不良影响是跨代的、产前的和学龄前的。产前的不良影响会导致低出生体重，改变肺结构和免疫功能，并使胎儿对以后的侮辱敏感，从而损害肺活量测定。正常肺健康的关键阶段是出生时的肺功能，肺发育到20-25岁的平台期，然后是下降阶段；与人们所认为的相反，加速下降与吸烟无关。肺功能有不同的轨迹。肺功能通常跟踪从学龄前到中年后期。哮喘是由产前和早期生活的影响所驱动的。气流阻塞、肺气肿和COPD的多发病均起早。未能达到正常高原和肺功能加速下降是慢性阻塞性肺疾病的危险因素。呼吸道疾病在成人生活中是无法预防的；预防必须及早开始。
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.