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Published on: April 12, 2021
Plasticity of Individual Lung Function States from Childhood to Adulthood
Gang Wang1,2,3,4, Jenny Hallberg2,5, Rosa Faner6,7
1Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Sichuan, China.
Insights
Childhood lung function is dynamic, with many experiencing lung function catch-up or growth failure. These changes impact adult respiratory health and may be linked to early-life factors and specific biomarkers.
Area of Science:
- Pediatric pulmonology
- Developmental biology
- Epidemiology
Background:
- Optimal lung development in childhood is crucial for lifelong health.
- Individual lung function trajectories during childhood are not fully understood.
- Plasticity in lung function may influence long-term respiratory outcomes.
Purpose of the Study:
- To investigate the plasticity of individual lung function states throughout childhood.
- To identify patterns of lung function change, including catch-up and growth failure.
- To explore associations between lung function states, early-life factors, and adult respiratory health.
Main Methods:
- Utilized data from the population-based BAMSE cohort (N=3,069) and validated in the PIAMA cohort.
- Applied a data-driven dependent mixture model to define lung function states based on FEV1 z-scores at ages 8, 16, and 24.
- Assessed respiratory symptoms, small airway function (multiple-breath washout), and proteomic profiles (IL-6, CXCL10) at age 24.
Main Results:
- Identified five distinct lung function states in childhood.
- Observed lung function catch-up in 14.5% and growth failure in 2.4% of participants.
- Early-life risk factors were associated with the very low lung function state and growth failure; the very low state and growth failure predicted adverse adult respiratory outcomes.
Conclusions:
- Individual lung function states during childhood exhibit significant plasticity.
- Lung function catch-up and growth failure are observable phenomena with lasting health implications.
- Proteomics identified IL-6 and CXCL10 as potential biomarkers for impaired lung development.
Abstract:
Rationale: Recent evidence highlights the importance of optimal lung development during childhood for health throughout life. Objectives: To explore the plasticity of individual lung function states during childhood. Methods: Prebronchodilator FEV1 z-scores determined at age 8, 16, and 24 years in the Swedish population-based birth cohort BAMSE (Swedish abbreviation for Child [Barn], Allergy, Milieu, Stockholm, Epidemiological study) (N = 3,069) were used. An unbiased, data-driven dependent mixture model was applied to explore lung function states and individual state chains. Lung function catch-up was defined as participants moving from low or very low states to normal or high or very high states, and growth failure as moving from normal or high or very high states to low or very low states. At 24 years, we compared respiratory symptoms, small airway function (multiple-breath washout), and circulating inflammatory protein levels, by using proteomics, across states. Models were replicated in the independent Dutch population-based PIAMA (Prevention and Incidence of Asthma and Mite Allergy) cohort. Measurements and Main Results: Five lung function states were identified in BAMSE. Lung function catch-up and growth failure were observed in 74 (14.5%) BAMSE participants with low or very low states and 36 (2.4%) participants with normal or high or very high states, respectively. The occurrence of catch-up and growth failure was replicated in PIAMA. Early-life risk factors were cumulatively associated with the very low state, as well as with catch-up (inverse association) and growth failure. The very low state as well as growth failure were associated with respiratory symptoms, airflow limitation, and small airway dysfunction at adulthood. Proteomics identified IL-6 and CXCL10 (C-X-C motif chemokine 10) as potential biomarkers of impaired lung function development. Conclusions: Individual lung function states during childhood are plastic, including catch-up and growth failure.
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