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Lung development and early origins of childhood respiratory illness
1Department of Epidemiology and Biostatistics, Institute of Child Health, London, UK.
Insights
Infant respiratory function impacts later childhood illness risk. Early airway changes, influenced by genetics and environment, predict wheezing and impaired lung function, highlighting the need for better infant lung function tests.
Area of Science:
- Pediatric Respiratory Medicine
- Environmental Health
- Genetics
Background:
- Five cohort studies initiated in the last two decades investigated infant respiratory function.
- Existing research links infant lung function to genetic and environmental factors and early childhood lower respiratory illness.
- Current infant respiratory function tests are complex, limiting sample sizes for powerful studies.
Purpose of the Study:
- To examine the association between infant respiratory function and genetic/environmental risk factors.
- To understand the link between infant respiratory function and subsequent lower respiratory illness in early childhood.
- To identify early indicators of respiratory health in infants.
Main Methods:
- Analysis of data from five initiated cohort studies.
- Longitudinal tracking of infant respiratory function and health outcomes.
- Examination of genetic and environmental risk factors.
Main Results:
- Premorbid alterations in airway function or lung development increase the risk of wheezing illnesses in preschool years.
- Impaired airway function at 5-6 years of age is associated with early respiratory alterations.
- Observed gender differences in airway function and response to maternal smoking.
Conclusions:
- Early alterations in infant airway function predict later respiratory issues.
- Maternal smoking and gender influence infant respiratory health.
- Development of less invasive infant lung function tests is crucial for future large-scale research.
Abstract:
In the last two decades, 5 cohort studies have been initiated to examine the association of infant respiratory function with genetic and environmental risk factors, as well as with subsequent lower respiratory illness in early childhood. While the current complexity of respiratory function tests in this age group precludes study samples with sufficient power to examine more complex issues, information from these studies has provided an exciting adjunct to that available from the longer cohort studies. Premorbid alterations in airway function or lung development increase the risk of wheezing lower respiratory illnesses during the preschool years and the risk of impaired airway function at 5-6 years of age. In addition, gender differences in airway function and the response to maternal smoking have been observed. Larger collaborative population-based studies are needed to explore the environmental, genetic and immunological mechanisms responsible, but will depend on the development of less invasive tests of airway function appropriate for use in healthy infants.