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

墨尔本儿童哮喘研究（MESCA）是儿童哮喘最长、最全面的随访研究。这些成员于1964年7岁时被招募，他们在10岁、14岁、21岁、28岁、35岁和42岁时被回顾，在最近的随访中，幸存者的保留率为87%。迄今为止，MESCA研究提供了关于儿童哮喘到成年期结局的全面数据，并在建立国内和国际儿科哮喘治疗方法方面具有特别的影响力。多年来，这项研究的结果被广泛发表，并被广泛引用。该队列的成员将于2007年年满50岁，并将被邀请参加进一步的审查，以重新评估他们的临床结果，以检查长期哮喘与COPD发展之间的关系。那些在成年后一直患有哮喘的队列成员在肺功能测试中有一定程度的固定阻塞，并且有发展为COPD的潜在风险。有些人的风险更高，因为大约30%的成员是经常吸烟的人。在这篇综述中，在59岁的年龄，有一个很好的机会来检查哮喘和慢性阻塞性肺病的相互作用，并比较持续哮喘患者和哮喘已经缓解的患者之间的炎症过程，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，以确定那些更容易患COPD的人。第二个令人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，我们发现免疫系统的一个组成部分，被称为T细胞系统，在哮喘消退的患者中恢复了正常。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.