了解哮喘和COPD的儿童期起源：从出生队列和贯穿一生的研究中获得的见解
2025/04/30
摘要
出生队列确定了儿童和成人哮喘和呼吸系统健康的可改变的危险因素，表明早期生活事件不仅影响儿童结局，而且影响成年健康、疾病和死亡率的重要作用和途径。这是2021—2024年的重点文献更新，总结了整个生命周期的出生队列研究，有助于我们理解哮喘和COPD的危险因素及其儿童期起源，并可能为预防工作提供指导。我们得出的结论是，存在发育可塑性和易感性的关键时期，在此期间，早期生活事件和暴露可能对哮喘和慢性阻塞性肺疾病表型的发展产生最大影响，并且存在重要的产前和幼儿期暴露，如果这些暴露得到改善，可能是改善终生呼吸健康的候选因素。出生队列对于促进我们了解整个生命周期的肺健康和疾病（包括哮喘和COPD）一直是并且将继续是至关重要的。随着儿童死亡率下降和人口老龄化，需要来自出生队列研究的数据来指导优化健康寿命的策略，包括投资了解产前和幼儿期不良暴露的终身后果。
Understanding the childhood origins of asthma and COPD: insights from birth cohorts and studies across the lifespan
Tina Hartert, Julie Nyholm Kvysgaard, Linesri Thaver, Aisha Suara-Istanbouli, James P Allinson, Heather J Zar
Abstract
Birth cohorts have identified modifiable risk factors for asthma and respiratory health in children and adults, demonstrating the important role and pathways through which early life events influence not only child outcomes, but also adult health, disease and mortality. This is a focused literature update from 2021-2024 that summarizes birth cohort studies across the lifespan that contribute to our understanding of risk factors for and the childhood origins of asthma and COPD that may inform prevention efforts. We conclude that there are critical periods of developmental plasticity and susceptibility during which early life events and exposures likely have the greatest impact on the development of asthma and chronic obstructive lung disease phenotypes, and that there are important prenatal and early childhood exposures, which if modified, might be candidates for improving respiratory health across the lifespan. Birth cohorts have been and will continue to be critical to advancing our understanding of lung health and disease across the lifespan, including asthma and COPD. As child mortality declines and the human population ages, data from birth cohort studies are needed to inform strategies for optimizing healthy longevity, including the investment in understanding the lifelong consequences of adverse prenatal and early childhood exposures.
出生队列确定了儿童和成人哮喘和呼吸系统健康的可改变的危险因素，表明早期生活事件不仅影响儿童结局，而且影响成年健康、疾病和死亡率的重要作用和途径。这是2021—2024年的重点文献更新，总结了整个生命周期的出生队列研究，有助于我们理解哮喘和COPD的危险因素及其儿童期起源，并可能为预防工作提供指导。我们得出的结论是，存在发育可塑性和易感性的关键时期，在此期间，早期生活事件和暴露可能对哮喘和慢性阻塞性肺疾病表型的发展产生最大影响，并且存在重要的产前和幼儿期暴露，如果这些暴露得到改善，可能是改善终生呼吸健康的候选因素。出生队列对于促进我们了解整个生命周期的肺健康和疾病（包括哮喘和COPD）一直是并且将继续是至关重要的。随着儿童死亡率下降和人口老龄化，需要来自出生队列研究的数据来指导优化健康寿命的策略，包括投资了解产前和幼儿期不良暴露的终身后果。
（中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校）
（J Allergy Clin Immunol. 2025 Apr 17:S0091-6749(25)00419-1. doi: 10.1016/j.jaci.2025.04.012.）
Understanding the childhood origins of asthma and COPD: insights from birth cohorts and studies across the lifespan
Tina Hartert, Julie Nyholm Kvysgaard, Linesri Thaver, Aisha Suara-Istanbouli, James P Allinson, Heather J Zar
Abstract
Birth cohorts have identified modifiable risk factors for asthma and respiratory health in children and adults, demonstrating the important role and pathways through which early life events influence not only child outcomes, but also adult health, disease and mortality. This is a focused literature update from 2021-2024 that summarizes birth cohort studies across the lifespan that contribute to our understanding of risk factors for and the childhood origins of asthma and COPD that may inform prevention efforts. We conclude that there are critical periods of developmental plasticity and susceptibility during which early life events and exposures likely have the greatest impact on the development of asthma and chronic obstructive lung disease phenotypes, and that there are important prenatal and early childhood exposures, which if modified, might be candidates for improving respiratory health across the lifespan. Birth cohorts have been and will continue to be critical to advancing our understanding of lung health and disease across the lifespan, including asthma and COPD. As child mortality declines and the human population ages, data from birth cohort studies are needed to inform strategies for optimizing healthy longevity, including the investment in understanding the lifelong consequences of adverse prenatal and early childhood exposures.
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