Outcome of childhood asthma in adult life and the interaction with COPD

墨尔本儿童哮喘研究（MESCA）是对儿童哮喘进行的时间最长、最全面的随访研究。这些成员于1964年招募，年龄为7岁，他们在10岁、14岁、21岁、28岁、35岁和42岁时接受了审查，在最近的随访中，幸存者的留存率为87%。迄今为止，MESCA研究提供了儿童哮喘至成年期结局的全面数据，在建立国内和国际儿科哮喘治疗方法方面特别有影响力。多年来，这项研究的结果被广泛发表，并被广泛引用。该队列的成员在2007年年满50岁，将被邀请参加进一步的审查，以重新评估他们的临床结果，以检查长期哮喘和COPD发展之间的关系。队列中那些在成年后一直患有哮喘的成员在肺功能测试中有一定程度的固定阻塞，并且有可能发生COPD。有些人的风险增加，因为大约30%的成员是经常吸烟者。在这篇综述中，在59岁的时候，有一个很好的机会来检查哮喘和COPD的相互作用，并比较那些患有持续哮喘的人，那些哮喘已经解决的人之间的炎症过程，并在每组中检查吸烟的影响。我们还将研究一些与COPD相关的遗传标记，以确定哪些人更容易患上COPD。第二个感兴趣的领域是影响哮喘的免疫系统成分。在早期的一项研究中，我们确定了免疫系统的一个组成部分，即T细胞系统，在哮喘缓解的患者中恢复正常。在这篇综述中，我们计划详细研究T细胞系统，以了解什么机制可能是负责儿童哮喘的解决。

The Melbourne Study of Childhood Asthma (MESCA) is the longest, most comprehensive follow-up study of childhood asthma. The members were recruited in 1964 at the age of 7 and they have been reviewed at ages 10, 14, 21, 28, 35 and 42 years of age with a retention rate of 87% of survivors at the most recent follow-up. To date, the MESCA study has provided comprehensive data on the outcome of childhood asthma through to their adult years and has been particularly influential in establishing approaches to treatment of paediatric asthma nationally and internationally. The results of the study have been published widely over the years and cited extensively. The members of this cohort turn 50 in 2007 and will be invited to participate in a further review to reassess their clinical outcome to examine the relationship between long standing asthma and the development of COPD. Those members of the cohort who have had asthma persisting through their adult years have a degree of fixed obstruction on their tests of lung function and are potentially at risk of developing COPD. Some are at increased risk as approximately 30% of the members are regular smokers. In this review, at age 59 years, there is an excellent opportunity to examine the interaction of asthma and COPD and to compare the inflammatory processes between those who have continuing asthma, those whose asthma has resolved and in each group examine the effect of smoking. We will also look at a numbers of genetic markers associated with COPD to identify those who are more susceptible to the development of COPD. A second area of interest is the components of the immune system that influence asthma.. In an earlier study we identified one component of the immune system, known as the T cell system, that had returned to normal in those whose asthma had resolved. In this review, we plan to examine the T cell system in detail to understand what mechanisms may be responsible for resolution of childhood asthma.