Fetal origins of asthma
Fetal origins of asthma
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DOI：
10.1016/j.siny.2012.01.006
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发表时间：
2012-04-01
影响因子：
3
通讯作者：
Warner, John O.
中科院分区：
文献类型：
--
作者：
Henderson, A. John;Warner, John O.
有令人信服的证据表明哮喘起源于生命早期。我们回顾了胎儿暴露可能与哮喘发展有因果关系的流行病学和生物学证据。然而，引起哮喘恶化的因素不一定与诱发疾病的因素相同。流行病学研究已经确定了许多与哮喘相关的潜在暴露，但这些并没有证实因果关系，也没有通过实验进行复制。哮喘是一种异质性疾病，对至少两个途径（气道结构和气道炎症）有发育影响。胎儿并非免疫学上的幼稚者，宫内暴露可直接引起免疫致敏，导致出生后气道炎症。其他潜在机制包括通过胎儿营养对气道和肺部生长的间接影响以及环境暴露对 DNA 表达的表观遗传修饰。确定致病因素将为预防疾病的干预措施提供目标。 (C) 2012 Elsevier Ltd. 保留所有权利。
There is convincing evidence that asthma has its origins in early life. We review the epidemiological and biological evidence for fetal exposures that may have a causal role in asthma development. However, those factors that provoke asthma exacerbations are not necessarily the same as those associated with disease induction. Epidemiological studies have identified many potential exposures linked to asthma but these do not confirm causality and have not been replicated by experiment. Asthma is a heterogeneous disease and there are developmental influences on at least two pathways, airway structure and airway inflammation. The fetus is not immunologically naive and intrauterine exposures can act directly to invoke immunological sensitisation leading postnatally to airway inflammation. Other potential mechanisms include indirect effects on airway and lung growth through fetal nutrition and epigenetic modifications of DNA expression by environmental exposures. Identifying the causal factors will provide the targets for interventions to prevent disease. (C) 2012 Elsevier Ltd. All rights reserved.