Genetic epidemiology of chronic respiratory diseases from childhood to adulthood: A prospective study of sibships

慢性呼吸系统疾病(CRD)是一个主要的公共卫生问题。众所周知，CRD会随着时间的推移而变化，但我们没有关于这些变化的原因的信息。一些儿童哮喘患者在成年后继续患有哮喘和-或发展为慢性阻塞性肺疾病(COPD)，而另一些人则没有任何成人CRD。一些没有儿童哮喘的人在成年后会患上哮喘和-或COPD，而另一些人从童年到成年都没有CRD。要调查这些变化的风险因素，随着时间的推移对兄弟姐妹进行跟踪调查是一个强大的工具。由于兄弟姐妹共享童年环境而不是成人环境，这有助于将童年环境、成人环境和遗传因素分开。塔斯马尼亚哮喘研究(TAS)是世界上主要的纵向呼吸系统研究之一，它的独特之处在于它是一项家庭研究，调查了所有家庭成员和家庭环境。助教制度始于1968年，调查了8,585名1961年出生的学童(称为先证者)、他们的父母(16,267人)和兄弟姐妹(21,044人)。到2006年底，我们将完成对TAS先证者长达37年的随访，重点关注中年CRD的非遗传风险因素。这一后续行动和基线数据现在为开展兄弟姐妹研究提供了一个独特的机会，该研究可以同时检查基因、儿童环境和成人环境中CRD的变化。此外，它还将为未来的研究提供一个平台，以调查该家庭队列中CRD的进展情况。因此，我们现在寻求资金，以扩大目前的后续行动，以包括兄弟姐妹。这将是世界上唯一一项从儿童到成年的以人群为基础的呼吸兄弟姐妹研究。这将为今后预防慢性呼吸道疾病和残疾提供信息，这不仅在澳大利亚，而且在国际上都具有原创性和重大意义。

Chronic Respiratory Diseases (CRDs) are a major public health problem. It is known that CRDs change over time but we have no information on causes of these changes. Some childhood asthmatics continue to have asthma as adults and-or develop Chronic Obstructive Pulmonary Disease (COPD) while others are free of any adult CRD. Some of those who do not have childhood asthma develop asthma and-or COPD as adults while the others remain free of CRDs from childhood to adulthood. To investigate risk factors for these changes, following up siblings over time is a powerful tool. As siblings share the childhood environment but not the adult environment, it helps to disentangle childhood environment, adult environment and genetic factors. The Tasmanian Asthma Study (TAS) is amongst worlds' major longitudinal respiratory studies and it is unique because it was conceived as a family study, with all the family members and the family environment being surveyed. TAS commenced in 1968 by investigating 8,585 school children born in 1961 (referred to as probands), their parents (16,267) and siblings (21,044). By the end of 2006, we will have completed the 37-year follow-up of the TAS probands, which focuses on non-genetic risk factors for middle-age CRDs. This follow-up together with baseline data now provides a unique opportunity for conducting a sibling study, which can concurrently examine genes, childhood environment and adult environment for change in CRDs. Also, it will provide a platform for future studies to investigate the progression of CRDs in this family cohort. Therefore, we now seek funding to extend the current follow-up to include the siblings. This will be the world's only population-based respiratory sibling study that spans childhood to adulthood. This will provide information for preventing chronic respiratory morbidity and disability in the future, which will be original and significant not only in Australia but also internationally.