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Time-Specific Factors Influencing the Development of Asthma in Children
Daniele Russo1,2, Mauro Lizzi1,2, Paola Di Filippo1,2
1Department of Pediatrics, University of Chieti, 66100 Chieti, Italy.
Insights
Asthma development involves complex genetic and environmental factors from early life. Identifying risk and protective elements can guide future prevention strategies for better long-term health outcomes.
Area of Science:
- Pediatrics
- Environmental Health
- Genetics
Background:
- Asthma susceptibility is a complex interplay of genetic and environmental factors during critical developmental windows.
- The Developmental Origins of Health and Disease (DOHaD) paradigm highlights how early-life exposures influence later-life health.
- Understanding these influences is crucial for developing effective interventions.
Purpose of the Study:
- To review the latest evidence on predictive risk and protective factors for asthma development.
- To cover factors from the fetal period through adolescence.
- To inform strategic preventive and therapeutic interventions for asthma.
Main Methods:
- Literature review synthesizing current evidence on asthma risk and protective factors.
- Analysis of factors acting during critical developmental periods.
- Focus on evidence strength and areas of scientific debate.
Main Results:
- Strong evidence links cigarette smoke exposure, environmental pollutants, and family history to increased asthma risk.
- Certain protective factors demonstrate clear benefits, offering insights into primary prevention.
- Some factors remain controversial, necessitating further longitudinal research.
Conclusions:
- Early-life factors significantly impact asthma development.
- Identifying and mitigating risk factors, while promoting protective ones, is key for asthma prevention.
- Continued research is vital to resolve ongoing debates and refine interventions.
Abstract:
Susceptibility to asthma is complex and heterogeneous, as it involves both genetic and environmental insults (pre- and post-birth) acting in a critical window of development in early life. According to the Developmental Origins of Health and Disease, several factors, both harmful and protective, such as nutrition, diseases, drugs, microbiome, and stressors, interact with genotypic variation to change the capacity of the organism to successfully adapt and grow in later life. In this review, we aim to provide the latest evidence about predictive risk and protective factors for developing asthma in different stages of life, from the fetal period to adolescence, in order to develop strategic preventive and therapeutic interventions to predict and improve health later in life. Our study shows that for some risk factors, such as exposure to cigarette smoke, environmental pollutants, and family history of asthma, the evidence in favor of a strong association of those factors with the development of asthma is solid and widely shared. Similarly, the clear benefits of some protective factors were shown, providing new insights into primary prevention. On the contrary, further longitudinal studies are required, as some points in the literature remain controversial and a source of debate.
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