Early-life origins of chronic respiratory diseases: understanding and promoting healthy ageing

Abstract

Chronic obstructive respiratory disorders such as asthma and chronic obstructive pulmonary disease often originate early in life. In addition to a genetic predisposition, prenatal and early-life environmental exposures have a persistent impact on respiratory health. Acting during a critical phase of lung development, these factors may change lung structure and metabolism, and may induce maladaptive responses to harmful agents, which will affect the whole lifespan.Some environmental factors, such as exposure to cigarette smoke, type of childbirth and diet, may be modifiable, but it is more difficult to influence other factors, such as preterm birth and early exposure to viruses or allergens.Here, we bring together recent literature to analyse the critical aspects involved in the early stages of lung development, going back to prenatal and perinatal events, and we discuss the mechanisms by which noxious factors encountered early on may have a lifelong impact on respiratory health.We briefly comment on the need for early disease biomarkers and on the possible role of ''-omic'' technologies in identifying risk profiles predictive of chronic respiratory conditions. Such profiles could guide the ideation of effective preventive strategies and/or targeted early lifestyle or therapeutic interventions. @ERSpublications Early-life factors have a role in onset of asthma and COPD; early postnatal interventions may promote lung health http://ow.ly/BvUrx

GOLD 2017 recommendations for COPD patients: toward a more personalized approach

“…It seems that prenatal and early-life insults (e.g., maternal smoking during pregnancy, and lung infection in early childhood) may influence the correct development of the organs, including the lungs, and their capacity for repair [7,8]. Therefore, lung function has different trajectories of development and different trajectories of decline during the entire lifespan [9].…”

The Role of Mnk-1, Eukaryotic Translation Initiation Factors and Translation Control in the Pathogenesis of Asthma

“…Furthermore, hypertrophy of subepithelial fibroblasts and airway smooth muscle cells in the absence of inflammation was reported in childhood asthma and preterm born children [8][9][10]. Data in cohorts of preterm born people suggest that such a condition during embryogenesis pre-sets the lung to develop asthma or COPD later in life [11,12]. This correlation had been described earlier in rhesus monkeys exposed to ozone or allergens enriched air during pregnancy, which led to permanent rearrangement of airway smooth muscle cells and asthma like symptoms after birth [13][14][15].…”

Early-life risk factors for chronic nonrespiratory diseases

“…We will highlight links to chronic respiratory disease and potential common early-life exposures and risk factors, and point out knowledge gaps and research opportunities. While a full discussion of early-life exposures and risk factors for chronic respiratory disease is beyond the scope of this article and covered elsewhere in this series [19], a brief summary is warranted of exposures and risk factors that are common between respiratory and nonrespiratory disease. These factors are summarised in table 2.…”