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Eur J Epidemiol. 2014 Dec;29(12):871-85. doi: 10.1007/s10654-014-9981-5. Epub 2014 Dec 24.

Early origins of chronic obstructive lung diseases across the life course.

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1
Division of Respiratory Medicine (Sp-3435), Department of Pediatrics, Erasmus Medical Center, PO Box 2060, 3000 CB, Rotterdam, The Netherlands, l.duijts@erasmusmc.nl.

Abstract

Chronic obstructive lung diseases, like asthma and chronic obstructive pulmonary disease, have high prevalences and are a major public health concern. Chronic obstructive lung diseases have at least part of their origins in early life. Exposure to an adverse environment during critical periods in early life might lead to permanent developmental adaptations which results in impaired lung growth with smaller airways and lower lung volume, altered immunological responses and related inflammation, and subsequently to increased risks of chronic obstructive lung diseases throughout the life course. Various pathways leading from early life factors to respiratory health outcomes in later life have been studied, including fetal and early infant growth patterns, preterm birth, maternal obesity, diet and smoking, children's diet, allergen exposure and respiratory tract infections, and genetic susceptibility. Data on potential adverse factors in the embryonic and preconception period and respiratory health outcomes are scarce. Also, the underlying mechanisms how specific adverse exposures in the fetal and early postnatal period lead to chronic obstructive lung diseases in later life are not yet fully understood. Current studies suggest that interactions between early environmental exposures and genetic factors such as changes in DNA-methylation and RNA expression patterns may explain the early development of chronic obstructive lung diseases. New well-designed epidemiological studies are needed to identify specific critical periods and to elucidate the mechanisms underlying the development of chronic obstructive lung disease throughout the life course.

PMID:
25537319
DOI:
10.1007/s10654-014-9981-5
[Indexed for MEDLINE]
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