The Role of Lung Function in Determining Which Children Develop Asthma.
The Role of Lung Function in Determining Which Children Develop Asthma.
复制标题
肺功能在确定哪些儿童患有哮喘方面的作用。
DOI：
10.1016/j.jaip.2023.01.014
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Martinez,FernandoD
中科院分区：
文献类型：
--
作者：
McEvoy,CindyT;LeSouef,PeterN;Martinez,FernandoD
纵向研究表明，出生后不久评估的气道功能指数改变是随后发生喘息性疾病和哮喘的危险因素，这些指数可预测成年后的气道大小和气道壁厚度。直接改变早期气道功能的产前和产后因素，如极度早产和吸烟，可能会继续影响气道功能，从而增加喘息和哮喘的风险。早期气道功能和相关的哮喘风险也可能间接受到免疫系统反应、呼吸道病毒、气道微生物组、遗传学和表观遗传学的影响，特别是如果它们影响气道上皮功能障碍。除了避免吸烟外，很少有干预措施被证明可以改变哮喘的风险，但对怀孕吸烟者补充维生素C可能有助于减少子宫内吸烟对后代肺功能的影响。我们的结论是，气道大小和影响因素在确定一生中哮喘的风险中起着重要的作用。哮喘预防的进展姗姗来迟，这可能受益于精心设计的干预措施，在良好的表型纵向出生队列中进行早期气道功能评估，一直监测到成年。
Longitudinal studies have demonstrated that altered indices of airway function, assessed shortly after birth, are a risk factor for the subsequent development of wheezing illnesses and asthma, and that these indices predict airway size and airway wall thickness in adult life. Pre- and postnatal factors that directly alter early airway function, such as extreme prematurity and cigarette smoke, may continue to affect airway function and, hence, the risks for wheeze and asthma. Early airway function and an associated asthma risk may also be indirectly influenced by immune system responses, respiratory viruses, the airway microbiome, genetics, and epigenetics, especially if they affect airway epithelial dysfunction. Few if any interventions, apart from smoking avoidance, have been proven to alter the risks of developing asthma, but vitamin C supplementation to pregnant smokers may help decrease the effects ofin uterosmoke on offspring lung function. We conclude that airway size and the factors influencing this play an important role in determining the risk for asthma across the lifetime. Progress in asthma prevention is long overdue and this may benefit from carefully designed interventions in well-phenotyped longitudinal birth cohorts with early airway function assessments monitored through to adulthood.
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