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Hemstock EJ, Foong RE, Hall GL, Wheeler AJ, Dharmage SC, Dalton M, Williamson GJ, Gao C, Abramson MJ, Johnston FH, Zosky GR. Lung function changes in children exposed to mine fire smoke in infancy. Respirology 2024; 29:295-303. [PMID: 38219238 DOI: 10.1111/resp.14657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/12/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND OBJECTIVE Chronic, low-intensity air pollution exposure has been consistently associated with reduced lung function throughout childhood. However, there is limited research regarding the implications of acute, high-intensity air pollution exposure. We aimed to determine whether there were any associations between early life exposure to such an episode and lung growth trajectories. METHODS We conducted a prospective cohort study of children who lived in the vicinity of the Hazelwood coalmine fire. Lung function was measured using respiratory oscillometry. Z-scores were calculated for resistance (R5 ) and reactance at 5 Hz (X5 ) and area under the reactance curve (AX). Two sets of analyses were conducted: (i) linear regression to assess the cross-sectional relationship between post-natal exposure to mine fire-related particulate matter with an aerodynamic diameter of less than 2.5 micrometres (PM2.5 ) and lung function at the 7-year follow-up and (ii) linear mixed-effects models to determine whether there was any association between exposure and changes in lung function between the 3- and 7-year follow-ups. RESULTS There were no associations between mine fire-related PM2.5 and any of the lung function measures, 7-years later. There were moderate improvements in X5 (β: -0.37 [-0.64, -0.10] p = 0.009) and AX (β: -0.40 [-0.72, -0.08] p = 0.014), between the 3- and 7-year follow-ups that were associated with mean PM2.5 , in the unadjusted and covariance-adjusted models. Similar trends were observed with maximum PM2.5 . CONCLUSION There was a moderate improvement in lung stiffness of children exposed to PM2.5 from a local coalmine fire in infancy, consistent with an early deficit in lung function at 3-years after the fire that had resolved by 7-years.
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Affiliation(s)
- Emily J Hemstock
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Centre for Air Pollution, Energy and Health Research, NHMRC CRE, New South Wales, Australia
| | - Rachel E Foong
- Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia
| | - Graham L Hall
- Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia
| | - Amanda J Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Commonwealth Scientific and Industrial Research Organization, Melbourne, Victoria, Australia
| | - Shyamali C Dharmage
- Centre for Air Pollution, Energy and Health Research, NHMRC CRE, New South Wales, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Marita Dalton
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Grant J Williamson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Caroline Gao
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Youth Mental Health (Orygen), University of Melbourne, Parkville, Victoria, Australia
| | - Michael J Abramson
- Centre for Air Pollution, Energy and Health Research, NHMRC CRE, New South Wales, Australia
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Centre for Air Pollution, Energy and Health Research, NHMRC CRE, New South Wales, Australia
| | - Graeme R Zosky
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Centre for Air Pollution, Energy and Health Research, NHMRC CRE, New South Wales, Australia
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Dinh-Xuan AT, Graham BL, Thompson B, Miller MR, Stanojevic S. Reconciling the past and considering the future of pulmonary function test interpretation. Eur Respir J 2024; 63:2302225. [PMID: 38302177 DOI: 10.1183/13993003.02225-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/22/2023] [Indexed: 02/03/2024]
Affiliation(s)
- Anh Tuan Dinh-Xuan
- Cochin Hospital, Department of Respiratory and Sleep Medicine, Paris Cité University, Paris, France
| | - Brian L Graham
- Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Bruce Thompson
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Martin R Miller
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sanja Stanojevic
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
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Lepeule J, Pin I, Boudier A, Quentin J, Lyon-Caen S, Supernant K, Seyve E, Chartier R, Slama R, Siroux V. Pre-natal exposure to NO 2 and PM 2.5 and newborn lung function: An approach based on repeated personal exposure measurements. ENVIRONMENTAL RESEARCH 2023; 226:115656. [PMID: 36906269 DOI: 10.1016/j.envres.2023.115656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
CONTEXT While strong evidence supports adverse effects of pre-natal air pollution on child's lung function, previous studies rarely considered fine particulate matter (PM2.5) or the potential role of offspring sex and no study examined the effects of pre-natal PM2.5 on the lung function of the newborn. AIM We examined overall and sex-specific associations of personal pre-natal exposure to PM2.5 and nitrogen (NO2) with newborn lung function measurements. METHODS This study relied on 391 mother-child pairs from the French SEPAGES cohort. PM2.5 and NO2 exposure was estimated by the average concentration of pollutants measured by sensors carried by the pregnant women during repeated periods of one week. Lung function was assessed with tidal breathing analysis (TBFVL) and nitrogen multiple breath washout (N2MBW) test, performed at 7 weeks. Associations between pre-natal exposure to air pollutants and lung function indicators were estimated by linear regression models adjusted for potential confounders, and then stratified by sex. RESULTS Mean exposure to NO2 and PM2.5 during pregnancy was 20.2 μg/m3 and 14.3 μg/m3, respectively. A 10 μg/m3 increase in PM2.5 maternal personal exposure during pregnancy was associated with an adjusted 2.5 ml (2.3%) decrease in the functional residual capacity of the newborn (p-value = 0.11). In females, functional residual capacity was decreased by 5.2 ml (5.0%) (p = 0.02) and tidal volume by 1.6 ml (p = 0.08) for each 10 μg/m3 increase in PM2.5. No association was found between maternal NO2 exposure and newborns lung function. CONCLUSIONS Personal pre-natal PM2.5 exposure was associated with lower lung volumes in female newborns, but not in males. Our results provide evidence that pulmonary effects of air pollution exposure can be initiated in utero. These findings have long term implications for respiratory health and may provide insights into the underlying mechanisms of PM2.5 effects.
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Affiliation(s)
- Johanna Lepeule
- Université Grenoble Alpes, Inserm, CNRS, IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, 38000, Grenoble, France.
| | - Isabelle Pin
- Université Grenoble Alpes, Inserm, CNRS, IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, 38000, Grenoble, France; Pediatric Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Anne Boudier
- Université Grenoble Alpes, Inserm, CNRS, IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, 38000, Grenoble, France; Pediatric Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Joane Quentin
- Université Grenoble Alpes, Inserm, CNRS, IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, 38000, Grenoble, France; Pediatric Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Sarah Lyon-Caen
- Université Grenoble Alpes, Inserm, CNRS, IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, 38000, Grenoble, France
| | - Karine Supernant
- Université Grenoble Alpes, Inserm, CNRS, IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, 38000, Grenoble, France
| | - Emie Seyve
- Université Grenoble Alpes, Inserm, CNRS, IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, 38000, Grenoble, France
| | | | - Remy Slama
- Université Grenoble Alpes, Inserm, CNRS, IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, 38000, Grenoble, France
| | - Valérie Siroux
- Université Grenoble Alpes, Inserm, CNRS, IAB, Team of Environmental Epidemiology Applied to Development and Respiratory Health, 38000, Grenoble, France
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Guilbert A, Hough I, Seyve E, Rolland M, Quentin J, Slama R, Lyon-Caen S, Kloog I, Bayat S, Siroux V, Lepeule J. Association of Prenatal and Postnatal Exposures to Warm or Cold Air Temperatures With Lung Function in Young Infants. JAMA Netw Open 2023; 6:e233376. [PMID: 36930155 PMCID: PMC10024202 DOI: 10.1001/jamanetworkopen.2023.3376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
IMPORTANCE Little is known about long-term associations of early-life exposure to extreme temperatures with child health and lung function. OBJECTIVES To investigate the association of prenatal and postnatal heat or cold exposure with newborn lung function and identify windows of susceptibility. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study (SEPAGES) recruited pregnant women in France between July 8, 2014, and July 24, 2017. Data on temperature exposure, lung function, and covariates were available from 343 mother-child dyads. Data analysis was performed from January 1, 2021, to December 31, 2021. EXPOSURES Mean, SD, minimum, and maximum temperatures at the mother-child's residence, estimated using a state-of-the-art spatiotemporally resolved model. MAIN OUTCOMES AND MEASURES Outcome measures were tidal breathing analysis and nitrogen multiple-breath washout test measured at 2 months of age. Adjusted associations between both long-term (35 gestational weeks and first 4 weeks after delivery) and short-term (7 days before lung function test) exposure to ambient temperature and newborn lung function were analyzed using distributed lag nonlinear models. RESULTS A total of 343 mother-child pairs were included in the analyses (median [IQR] maternal age at conception, 32 [30.0-35.2] years; 183 [53%] male newborns). A total of 246 mothers and/or fathers (72%) held at least a master's degree. Among the 160 female newborns (47%), long-term heat exposure (95th vs 50th percentile of mean temperature) was associated with decreased functional residual capacity (-39.7 mL; 95% CI, -68.6 to -10.7 mL for 24 °C vs 12 °C at gestational weeks 20-35 and weeks 0-4 after delivery) and increased respiratory rate (28.0/min; 95% CI, 4.2-51.9/min for 24 °C vs 12 °C at gestational weeks 14-35 and weeks 0-1 after delivery). Long-term cold exposure (5th vs 50th percentile of mean temperature) was associated with lower functional residual capacity (-21.9 mL; 95% CI, -42.4 to -1.3 mL for 1 °C vs 12 °C at gestational weeks 15-29), lower tidal volume (-23.8 mL; 95% CI, -43.1 to -4.4 mL for 1 °C vs 12 °C at gestational weeks 14-35 and weeks 0-4 after delivery), and increased respiratory rate (45.5/min; 95% CI, 10.1-81.0/min for 1 °C vs 12 °C at gestational weeks 6-35 and weeks 0-1 after delivery) in female newborns as well. No consistent association was observed for male newborns or short-term exposure to cold or heat. CONCLUSIONS AND RELEVANCE In this cohort study, long-term heat and cold exposure from the second trimester until 4 weeks after birth was associated with newborn lung volumes, especially among female newborns.
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Affiliation(s)
- Ariane Guilbert
- Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS, La Tronche, France
| | - Ian Hough
- Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS, La Tronche, France
- Institute of Environmental Geosciences, Université Grenoble Alpes, Saint Martin D’Hères, France
| | - Emie Seyve
- Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS, La Tronche, France
- Université de Paris Cité, INSERM, INRAE, Center of Research in Epidemiology and Statistics, Paris, France
| | - Matthieu Rolland
- Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS, La Tronche, France
| | - Joane Quentin
- Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS, La Tronche, France
- Pediatric Department, Grenoble Alpes University Hospital, La Tronche, France
| | - Rémy Slama
- Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS, La Tronche, France
| | - Sarah Lyon-Caen
- Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS, La Tronche, France
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Be’er Sheva, Israel
| | - Sam Bayat
- Lung Function Laboratory, Grenoble Alpes University Hospital, La Tronche, France
| | - Valérie Siroux
- Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS, La Tronche, France
| | - Johanna Lepeule
- Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Université Grenoble Alpes, INSERM, CNRS, La Tronche, France
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Tandra M, Walters EH, Perret J, Lowe AJ, Lodge CJ, Johns DP, Thomas PS, Bowatte G, Davis PG, Abramson MJ, Dharmage SC, Bui DS. Small for gestational age is associated with reduced lung function in middle age: A prospective study from first to fifth decade of life. Respirology 2023; 28:159-165. [PMID: 36197802 PMCID: PMC10947040 DOI: 10.1111/resp.14379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 09/05/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE The association between birth weight, particularly relative to gestational age, and adult lung function is uncertain. We investigated the associations between birth weight relative to gestational age and measures of lung function in middle age, and mediation of these associations by adult height. METHODS Participants in the Tasmanian Longitudinal Health Study who had both known birth weight and lung function assessment at age 45 years were included (n = 849). Linear regression models were fitted to investigate the association between small for gestational age and birth weight with post-bronchodilator lung function measures (forced expiratory volume in 1 second [FEV1 ], forced vital capacity [FVC], FEV1 /FVC, diffusing capacity for carbon monoxide [DL co], residual volume [RV] and total lung capacity [TLC]), adjusting for potential confounders. The contribution of adult height as a mediator of these associations was investigated. RESULTS Compared with infants born with normal weight for gestational age, those born small for gestational age had reduced FEV1 (coefficient: -191 ml [95%CI: -296, -87]), FVC (-205 ml [-330, -81]), TLC (-292 ml [-492, -92]), RV (-126 ml [-253, 0]) and DL co (-0.42 mmol/min/kPa [-0.79, -0.041]) at age 45 years. However, they had comparable FEV1 /FVC. For every 1 kg increase in birth weight, lung function indices increased by an average of 117 ml (95%CI: 40, 196) for FEV1 , 124 ml (30, 218) for FVC, 215 ml (66, 365) for TLC and 0.36 mmol/min/kPa (0.11, 0.62) for DL co, independent of gestational age, but again not for FEV1 /FVC. These associations were significantly mediated by adult height (56%-90%). CONCLUSION Small for gestational age was associated with reduced lung function that is likely due to smaller lungs with little evidence of any specific parenchymal impairment.
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Affiliation(s)
- Melvin Tandra
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - E. Haydn Walters
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
- School of Medicine and Menzies InstituteUniversity of TasmaniaHobartTasmaniaAustralia
| | - Jennifer Perret
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - Adrian J. Lowe
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - Caroline J. Lodge
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - David P. Johns
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
- School of Medicine and Menzies InstituteUniversity of TasmaniaHobartTasmaniaAustralia
| | - Paul S. Thomas
- Inflammation and Infection Research, Faculty of MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Gayan Bowatte
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
- Department of Basic Sciences, Faculty of Allied Health SciencesUniversity of PeradeniyaPeradeniyaSri Lanka
| | - Peter G. Davis
- Department of Obstetrics and GynaecologyUniversity of MelbourneMelbourneVictoriaAustralia
- Department of Newborn ResearchThe Royal Women's HospitalMelbourneVictoriaAustralia
| | - Michael J. Abramson
- School of Public Health & Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
| | - Dinh S. Bui
- Allergy and Lung Health Unit, School of Population and Global healthThe University of MelbourneMelbourneVictoriaAustralia
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Hedman L, Almqvist L, Bjerg A, Andersson M, Backman H, Perzanowski MS, Rönmark E. Early-life risk factors for development of asthma from 8 to 28 years of age: a prospective cohort study. ERJ Open Res 2022; 8:00074-2022. [PMID: 36655222 PMCID: PMC9835990 DOI: 10.1183/23120541.00074-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/16/2022] [Indexed: 01/21/2023] Open
Abstract
Background The objective was to estimate the incidence rate of asthma from age 8 to 28 years and evaluate early-life risk factors for asthma onset at different ages. Methods In 1996, within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a cohort of 3430 schoolchildren (97% of invited) was recruited at age 8 years to a prospective study about asthma. The cohort was followed annually from age 8 to 19 years and at 28 years by questionnaire surveys (67% of the original cohort participated). Asthma was categorised as never-asthma, onset age ≤8 years, onset age 9-13 years, onset age 14-19 years or onset age >19 years. Results Of the 3430 individuals in the cohort, 690 (20.1%) reported asthma in any survey. The average incidence rate was 10.0/1000 per year at ≤8 years, 11.9/1000 per year at 9-13 years, 13.3/1000 per year at 14-19 years and 6.1/1000 per year at >19 years. The incidence was higher among boys until age 10 years, but from age 15 years, it became higher among girls. Family history of asthma, allergic sensitisation and breastfeeding <3 months were associated with asthma onset throughout the study. Low birthweight, maternal smoking during pregnancy, severe respiratory infection, rhinoconjunctivitis and eczema were associated with asthma onset ≤8 and 9-13 years. Conclusions The incidence of asthma was high during childhood and the teenage period, and decreased substantially during young adulthood. Early-life factors were associated with asthma onset throughout childhood but had also a lasting effect on asthma incidence until adulthood.
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Affiliation(s)
- Linnéa Hedman
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden,These authors contributed equally to first authorship
| | - Linnéa Almqvist
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden,These authors contributed equally to first authorship
| | | | - Martin Andersson
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Helena Backman
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Matthew S. Perzanowski
- Dept of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Eva Rönmark
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
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Vila M, Faner R, Agustí A. Beyond the COPD-tobacco binomium: New opportunities for the prevention and early treatment of the disease. Med Clin (Barc) 2022; 159:33-39. [PMID: 35279314 DOI: 10.1016/j.medcli.2022.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 11/16/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) has been traditionally understood as a self-inflicted disease cause by tobacco smoking occurring in individuals older than 50-60 years. This traditional paradigm has changed over the last decade because new scientific evidence showed that there are many genetic (G) and environmental (E) factors associated with reduced lung function, that vary, accumulate, and interact over time (T), even before birth (G×E×T). This new perspective opens novel windows of opportunity for the prevention, early diagnosis, and personalized treatment of COPD. This review presents the evidence that supports this proposal, as well as its practical implications, with particular emphasis on the need that clinical histories in patients with suspected COPD should investigate early life events and that spirometry should be used much more widely as a global health marker.
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Affiliation(s)
- Marc Vila
- Equip d'Assistència Primària Vic (EAP VIC), Barcelona, España; Càtedra Salut Respiratòria, Universitat Barcelona, Barcelona, España
| | - Rosa Faner
- Càtedra Salut Respiratòria, Universitat Barcelona, Barcelona, España; Respiratory Institute, Hospital Clínic, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - Alvar Agustí
- Càtedra Salut Respiratòria, Universitat Barcelona, Barcelona, España; Respiratory Institute, Hospital Clínic, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; CIBER Enfermedades Respiratorias, Madrid, España.
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Lukić A, Buchvald F, Agertoft L, Rubak S, Skov M, Perch M, Nielsen KG. National multi-centre study found a low prevalence of severely impaired lung function in children and adolescents. Acta Paediatr 2022; 111:1044-1051. [PMID: 35051297 DOI: 10.1111/apa.16262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/27/2022]
Abstract
AIM As no data to our knowledge exist, the aim of the study was to describe the national prevalence and characteristics of Danish children and adolescents with severely impaired lung function. METHODS We performed a descriptive, cross-sectional Danish multi-centre study. Children and adolescents between 6 and 18 years old demonstrating severely impaired lung function from 2015 to 2018, defined by forced expiratory volume in 1 second (FEV1 ) <60% or who had lung transplantation, were eligible for inclusion. RESULTS This study included 113 children with a mean age (standard deviation) of 12.9 years (3.5 years). The prevalence of severely impaired lung function was approximately 13 in 100,000. The mean (standard deviation) FEV1 was 46.1% (10.1%) of predicted, and z-score was -4.5 (0.8). The most frequent diagnosis was cystic fibrosis (20.4%), followed by asthma (19.5%) and bronchiolitis obliterans (16.8%), while almost 25% had different elements of airway malformations or non-pulmonary conditions. Two adolescents with cystic fibrosis underwent lung transplantation. CONCLUSION The estimated prevalence of severely impaired lung function in Danish children and adolescents was low, and extremely, few children underwent lung transplantation. The most frequent diagnosis was cystic fibrosis, while almost 25% had different elements of airway malformations or non-pulmonary conditions, which may require clinical attention.
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Affiliation(s)
- Ana Lukić
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Frederik Buchvald
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Lone Agertoft
- Department of Paediatrics Odense University Hospital Odense Denmark
| | - Sune Rubak
- Department of Paediatrics Aarhus University Hospital Aarhus Denmark
| | - Marianne Skov
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Michael Perch
- Department of Cardiology Section for Lung Transplantation and Respiratory Medicine Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Kim G. Nielsen
- Department of Paediatrics and Adolescent Medicine Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
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Rosa MJ, Tamayo-Ortiz M, Mercado Garcia A, Rivera Rivera NY, Bush D, Lee AG, Solano-González M, Amarasiriwardena C, Téllez-Rojo MM, Wright RO, Wright RJ. Prenatal lead exposure and childhood lung function: Influence of maternal cortisol and child sex. ENVIRONMENTAL RESEARCH 2022; 205:112447. [PMID: 34875261 PMCID: PMC8760170 DOI: 10.1016/j.envres.2021.112447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Maternal hypothalamic-pituitary-adrenal (HPA) axis disruption in pregnancy may contribute to the programming of childhood respiratory disease and may modify the effect of chemical toxins, like lead (Pb), on lung development. Child sex may further modify these effects. We sought to prospectively examine associations between maternal HPA axis disruption, prenatal Pb and childhood lung function and explore potential effect modification by maternal cortisol and child sex on the association between prenatal Pb and lung function outcomes. MATERIALS AND METHODS Analyses included 222 mothers and children enrolled in a longitudinal birth cohort study in Mexico City. Maternal diurnal salivary cortisol was assessed in pregnancy; cortisol awakening response (CAR) and diurnal slope were calculated. Blood Pb was measured during the second trimester of pregnancy. Post-bronchodilator lung function was tested at ages 8-11 years. Associations were modeled using generalized linear models with interaction terms, adjusting for covariates. RESULTS A higher (flatter) diurnal slope was associated with lower FEV1/FVC ratio (β: 0.433, 95%CI [-0.766, -0.101]). We did not find any main effect associations between prenatal Pb and lung function outcomes. We report an interaction between Pb and cortisol in relation to FEV1/FVC and FEF25-75% (pinteraction<0.05 for all). Higher prenatal Pb was associated with reduced FEV1/FVC only in children whose mothers had a high CAR. Higher prenatal Pb was also associated with reduced FEV1/FVC and FEF25-75% in mothers with a flatter diurnal slope. A 3-way interaction between prenatal Pb, CAR and sex on FEV1/FVC, indicated that boys born to women with high CAR and higher prenatal Pb levels had lower FEV1/FVC ratios (pinteraction = 0.067). CONCLUSIONS Associations between prenatal Pb and childhood lung function were modified by disrupted maternal cortisol in pregnancy and child sex. These findings underscore the need to consider complex interactions to fully elucidate effects of prenatal Pb exposure on childhood lung function.
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Affiliation(s)
- Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA.
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Institute of Social Security (IMSS), Av. Cuahtemoc 330, Col. Doctores, 06720, Mexico City, Mexico.
| | - Adriana Mercado Garcia
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col, Santa Maria Ahuacatitlan C.P, 62100, Cuernavaca, Morelos, Mexico.
| | - Nadya Y Rivera Rivera
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA.
| | - Douglas Bush
- Kravis Children's Hospital, Department of Pediatrics, Division of Pediatric Pulmonology, Icahn School of Medicine at Mount Sinai, 1184 Fifth Avenue, 10029, New York, NY, USA.
| | - Alison G Lee
- Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, 10029, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
| | - Maritsa Solano-González
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col, Santa Maria Ahuacatitlan C.P, 62100, Cuernavaca, Morelos, Mexico.
| | - Chitra Amarasiriwardena
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA.
| | - Martha Maria Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col, Santa Maria Ahuacatitlan C.P, 62100, Cuernavaca, Morelos, Mexico.
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, 10029, New York, NY, USA; Division of Pulmonary, Critical Care and Sleep, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, 10029, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
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10
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Sakic A, Ekström M, Sharma S, Nilsson PM. Can birth weight predict offspring's lung function in adult age? Evidence from two Swedish birth cohorts. Respir Res 2022; 23:348. [PMID: 36522741 PMCID: PMC9753232 DOI: 10.1186/s12931-022-02269-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Associations between birth weight (BW) and adult lung function have been inconsistent and limited to early adulthood. We aimed to study this association in two population-based cohorts and explore if BW, adjusted for gestational age, predicts adult lung function. We also tested adult lung function impairment according to the mis-match hypothesis-small babies growing big as adults. METHODS We included 3495 individuals (aged 46.4 ± 5.4 years) from the Malmo Preventive Project (MPP), Sweden, born between 1921 and 1949, and 1401 young to middle-aged individuals (aged 28.6 ± 6.7 years) from the Malmo Offspring Study (MOS) with complete data on BW and gestational age. Adult lung function (forced vital capacity [FVC], forced expiratory volume in one second [FEV1] and the FEV1/FVC-ratio) were analysed as level of impairment (z-score), using multiple linear and logistic regressions. RESULTS BW (z-score) did not predict adult lung function in MPP, whereas BW was a significant (p = 0.003) predictor of FEV1 following full adjustment in MOS. For every additional unit increase in BW, children were 0.77 (95% CI 0.65-0.92) times less likely to have impaired adult lung function (FEV1). Moreover, adults born with lower BW (< 3510 g) showed improved lung function (FEV1 and FEV1/FVC in MOS and MPP, respectively) if they achieved higher adult body weight. CONCLUSIONS Adults born with lower birth weight, adjusted for gestational age, are more likely to have impaired lung function, seen in a younger birth cohort. Postnatal growth pattern may, however, compensate for low birth weight and contribute to better adult lung function.
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Affiliation(s)
- Aleksandra Sakic
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden
| | - Magnus Ekström
- grid.4514.40000 0001 0930 2361Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Shantanu Sharma
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden
| | - Peter M. Nilsson
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences, Lund University, Skane University Hospital, Malmö, Sweden ,grid.4514.40000 0001 0930 2361Department of Clinical Sciences, and Department of Internal Medicine, Lund University, Skåne University Hospital, Jan Waldenströms Gata 15, 5th floor, 20502 Malmö, Sweden
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11
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Talaei M, Hughes DA, Mahmoud O, Emmett PM, Granell R, Guerra S, Shaheen SO. Dietary intake of vitamin A, lung function and incident asthma in childhood. Eur Respir J 2021; 58:13993003.04407-2020. [PMID: 33795317 PMCID: PMC8551559 DOI: 10.1183/13993003.04407-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/18/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Longitudinal epidemiological data are scarce on the relationship between dietary intake of vitamin A and respiratory outcomes in childhood. We investigated whether a higher intake of preformed vitamin A or pro-vitamin β-carotene in mid-childhood is associated with higher lung function and with asthma risk in adolescence. METHODS In the Avon Longitudinal Study of Parents and Children, dietary intakes of preformed vitamin A and β-carotene equivalents were estimated by food frequency questionnaire at 7 years of age. Post-bronchodilator forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and forced expiratory flow at 25-75% of FVC (FEF25-75%) were measured at 15.5 years and transformed to z-scores. Incident asthma was defined by new cases of doctor-diagnosed asthma at age 11 or 14 years. RESULTS In multivariable adjusted models, a higher intake of preformed vitamin A was associated with higher lung function and a lower risk of incident asthma: comparing top versus bottom quartiles of intake, regression coefficients for FEV1 and FEF25-75% were 0.21 (95% CI 0.05-0.38; ptrend=0.008) and 0.18 (95% CI 0.03-0.32; ptrend=0.02), respectively; odds ratios for FEV1/FVC below the lower limit of normal and incident asthma were 0.49 (95% CI 0.27-0.90; ptrend=0.04) and 0.68 (95% CI 0.47-0.99; ptrend=0.07), respectively. In contrast, there was no evidence for association with β-carotene. We also found some evidence for modification of the associations between preformed vitamin A intake and lung function by BCMO1, NCOR2 and SCGB1A1 gene polymorphisms. CONCLUSION A higher intake of preformed vitamin A, but not β-carotene, in mid-childhood is associated with higher subsequent lung function and lower risk of fixed airflow limitation and incident asthma.
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Affiliation(s)
- Mohammad Talaei
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David A Hughes
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Osama Mahmoud
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Pauline M Emmett
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Raquel Granell
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Stefano Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Seif O Shaheen
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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12
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Koefoed HJL, Zwitserloot AM, Vonk JM, Koppelman GH. Asthma, bronchial hyperresponsiveness, allergy and lung function development until early adulthood: A systematic literature review. Pediatr Allergy Immunol 2021; 32:1238-1254. [PMID: 33835532 PMCID: PMC8453965 DOI: 10.1111/pai.13516] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND It is unclear in which periods of life lung function deficits develop, and whether these are affected by risk factors such as asthma, bronchial hyper-responsiveness (BHR) and allergic comorbidity. The goal of this systematic review was to identify temporal associations of asthma, BHR and allergic comorbidity with large and small lung function development from birth until peak function in early adulthood. METHODS We searched MEDLINE, EMBASE, Web of Science and CINAHL for papers published before 01.01.2020 on risk factors and lung function measurements of large and small airways. Studies were required to report lung function at any time point or interval from birth until peak lung function (age 21-26) and include at least one candidate risk factor. RESULTS Of the 45 papers identified, 44 investigated cohorts and one was a clinical trial with follow-up. Asthma, wheezing, BHR and allergic sensitization early in life and to multiple allergens were associated with a lower lung function growth of large and small airways during early childhood compared with the control populations. Lung function development after childhood in subjects with asthma or persistent wheeze, although continuing to grow at a lower level, largely tracked parallel to non-affected individuals until peak function was attained. CLINICAL IMPLICATIONS AND FUTURE RESEARCH Deficits in lung function growth develop in early childhood, and children with asthma, BHR and early-life IgE (poly)sensitization are at risk. This period is possibly a critical window of opportunity to identify at-risk subjects and provide treatment aimed at preventing long-term sequelae of lung function.
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Affiliation(s)
- Hans Jacob L. Koefoed
- Department of Pediatric Pulmonology and Pediatric AllergologyBeatrix Children’s HospitalUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC)University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Annelies M. Zwitserloot
- Department of Pediatric Pulmonology and Pediatric AllergologyBeatrix Children’s HospitalUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC)University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Judith M. Vonk
- Groningen Research Institute for Asthma and COPD (GRIAC)University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
- Department of EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Gerard H. Koppelman
- Department of Pediatric Pulmonology and Pediatric AllergologyBeatrix Children’s HospitalUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC)University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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13
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Alhamdow A, Zettergren A, Kull I, Hallberg J, Andersson N, Ekström S, Berglund M, Wheelock CE, Essig YJ, Krais AM, Georgelis A, Lindh CH, Melén E, Bergström A. Low-level exposure to polycyclic aromatic hydrocarbons is associated with reduced lung function among Swedish young adults. ENVIRONMENTAL RESEARCH 2021; 197:111169. [PMID: 33857464 DOI: 10.1016/j.envres.2021.111169] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/15/2021] [Accepted: 04/08/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to adverse pulmonary effects. However, the impact of low-level environmental PAH exposure on lung function in early adulthood remains uncertain. OBJECTIVES To evaluate the associations between urinary PAH metabolites and lung function parameters in young adults. METHODS Urinary metabolites of pyrene, phenanthrene, and fluorene were analysed in 1000 young adults from Sweden (age 22-25 years) using LC-MS/MS. Lung function and eosinophilic airway inflammation were measured by spirometry and exhaled nitric oxide fraction (FeNO), respectively. Linear regression analysis was used to evaluate associations between PAH metabolites and the outcomes. RESULTS Median urinary concentrations of 1-OH-pyrene, ∑OH-phenanthrene, and ∑OH-fluorene were 0.066, 0.36, 0.22 μg/L, respectively. We found inverse associations of ∑OH-phenanthrene and ∑OH-fluorene with FEV1 and FVC, as well as between 1-OH-pyrene and FEV1/FVC ratio (adjusted P < 0.05; all participants). An increase of 1% in ∑OH-fluorene was associated with a decrease of 73 mL in FEV1 and 59 mL in FVC. In addition, ∑OH-phenanthrene concentrations were, in a dose-response manner, inversely associated with FEV1 (B from -109 to -48 compared with the lowest quartile of ∑OH-phenanthrene; p trend 0.004) and FVC (B from -159 to -102 compared with lowest quartile; p-trend <0.001). Similar dose-response associations were also observed between ∑OH-fluorene and FEV1 and FVC, as well as between 1-OH-pyrene and FEV1/FVC (p-trend <0.05). There was no association between PAH exposure and FeNO, nor was there an interaction with smoking, sex, or asthma. CONCLUSION Low-level PAH exposure was, in a dose-response manner, associated with reduced lung function in young adults. Our findings have public health implications due to i) the widespread occurrence of PAHs in the environment and ii) the clinical relevance of lung function in predicting all-cause and cardiovascular disease mortality.
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Affiliation(s)
- Ayman Alhamdow
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Anna Zettergren
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Inger Kull
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, SE, 11883, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE, 11883, Stockholm, Sweden
| | - Jenny Hallberg
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, SE, 11883, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, SE, 11365, Stockholm, Sweden
| | - Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Craig E Wheelock
- Division of Physiological Chemistry 2, Department of Medical Biochemistry and Biophysics, Karolinska Institute, SE-171 77, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, SE, 17165, Stockholm, Sweden
| | - Yona J Essig
- Division of Occupational and Environmental Medicine, Lund University, SE, 22363, Lund, Sweden
| | - Annette M Krais
- Division of Occupational and Environmental Medicine, Lund University, SE, 22363, Lund, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, SE, 11365, Stockholm, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, SE, 22363, Lund, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, SE, 11883, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE, 11883, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, SE, 11365, Stockholm, Sweden.
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14
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Grant T, Brigham EP, McCormack MC. Childhood Origins of Adult Lung Disease as Opportunities for Prevention. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:849-858. [PMID: 32147138 DOI: 10.1016/j.jaip.2020.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/26/2019] [Accepted: 01/16/2020] [Indexed: 02/06/2023]
Abstract
Prenatal and childhood exposures have been shown to impact lung development, lung function trajectory, and incidence and prevalence of respiratory disease. Early life may serve as a window of susceptibility to such exposures, with the potential to influence lifelong respiratory health. Risk factors encountered in early life with potentially durable impact on lung health include prematurity, respiratory viral illness, allergen sensitization and exposure, tobacco use and exposure, indoor and outdoor pollution, diet, and obesity. These exposures vary in the extent to which they are modifiable, and interventions aimed at reducing harmful exposures range from individual-level behavior modification to policy initiatives implemented to promote population health. For many exposures, including tobacco-related exposures, multilevel interventions are needed. Future research is needed to provide insight as to early-life interventions to promote optimal lung growth and prevent development of chronic respiratory disease. Clinicians should play an active role, assisting individual patients in avoiding known detrimental exposures including maternal smoking during pregnancy and initiation of active smoking. Clinicians can be empowered by evidence to support policies promoting reduction of population-level risk factors, such as restriction on electronic cigarette sales and legislation to uphold air quality standards, to encourage attainment of maximal lung function and reduce risk of chronic lung disease.
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Affiliation(s)
- Torie Grant
- Division of Pediatric Allergy/Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Emily P Brigham
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Meredith C McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
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15
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Weber P, Menezes AMB, Gonçalves H, Perez-Padilla R, Jarvis D, de Oliveira PD, Wehrmeister FC. Characterisation of pulmonary function trajectories: results from a Brazilian cohort. ERJ Open Res 2020; 6:00065-2020. [PMID: 32864380 PMCID: PMC7445117 DOI: 10.1183/23120541.00065-2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/26/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Pulmonary function (PF) trajectories are determined by different exposures throughout the life course. The aim of this study was to investigate characteristics related to PF trajectories from 15 to 22 years in a Brazilian cohort. METHODS A birth cohort study (1993 Pelotas Birth Cohort) was conducted with spirometry at 15, 18 and 22 years. PF trajectories were built based on z-score of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and their ratio using a group-based trajectory model. Associations with exposures reported from perinatal to 22 years were described. RESULTS Three trajectories, low (LT), average (AT) and high (HT) were identified in 2917 individuals. Wealthiest individuals belonged to the HT of FEV1 (p=0.023). Lower maternal pregestational body mass index (BMI) (22.4±0.2; p<0.001 and 22.1±0.14; p<0.001) and lower birth weight (3164.8±25.4; p=0.029 and 3132.3±19.4; p=0.005) were related to the LT of FEV1 and FVC. Mother's smoking exposure during pregnancy (37.7%; p=0.002), active smoking at ages 18 and 22 years (20.1% and 25.8%; p<0.001) and family history of asthma (44.8%; p<0.001) were related to the LT of FEV1/FVC. Wheezing, asthma and hospitalisations due to respiratory diseases in childhood were related to the LT of both FEV1 and FEV1/FVC. Higher BMIs were related to the HT of FEV1 and FVC at all ages. CONCLUSIONS PF trajectories were mainly related to income, pregestational BMI, birth weight, hospitalisation due to respiratory diseases in childhood, participant's BMI, report of wheezing, medical diagnosis and family history of asthma, gestational exposure to tobacco and current smoking status in adolescence and young adult age.
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Affiliation(s)
- Priscila Weber
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College, London, UK
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16
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Goldberg S, Stein A, Picard E, Joseph L, Kedem R, Sommer A, Tzur D, Cohen S. Does birth season influence the odds for asthma? Large cohort analysis. Pediatr Pulmonol 2020; 55:1111-1115. [PMID: 32032463 DOI: 10.1002/ppul.24677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/25/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE Few studies have examined the possibility of a link between birth season and the risk for asthma. Those studies that mainly focused on young children, reached different conclusions regarding both the existence of such a link and the season with the highest risk. The purpose of this study was to reinvestigate the relationship between birth season and asthma in a very large cohort, larger than in all previous studies, focusing on adolescents. METHODS The medical records of consecutive 17-year-old conscripts, born between 1978 and 1999, undergoing medical evaluation before their military service, were reviewed. The prevalence of asthma among conscripts was calculated according to the season of birth. RESULTS Data from 6 26 460 males and 4 54 104 females were collected. Asthma prevalence was 6.6% of the males and 5.8% of the females. Asthma prevalence was highest among those born in the summer and was approximately 9% higher in women and 6% higher in men than those born in the winter. Those born in the winter had the lowest prevalence of asthma. June was the birth month with the highest prevalence of asthma in both genders together with September among males. CONCLUSIONS Being born in the summer, especially in June, is associated with an increased risk of asthma compared with a winter birth among Israeli army conscripts. Further research is required to determine the impact of the season of birth on the risk of asthma in higher risk populations.
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Affiliation(s)
- Shmuel Goldberg
- Department of Pediatrics, Institute of Pediatric Pulmonary Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Avital Stein
- Department of Pediatrics, Institute of Pediatric Pulmonary Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Elie Picard
- Department of Pediatrics, Institute of Pediatric Pulmonary Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Leon Joseph
- Department of Pediatrics, Institute of Pediatric Pulmonary Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Ron Kedem
- Medical Corps, Israel Defense Forces, Tel Hashomer, Israel
| | - Adir Sommer
- Medical Corps, Israel Defense Forces, Tel Hashomer, Israel
| | - Dorit Tzur
- Medical Corps, Israel Defense Forces, Tel Hashomer, Israel
| | - Shlomo Cohen
- Department of Pediatrics, Institute of Pediatric Pulmonary Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
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17
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Sunny SK, Zhang H, Rezwan FI, Relton CL, Henderson AJ, Merid SK, Melén E, Hallberg J, Arshad SH, Ewart S, Holloway JW. Changes of DNA methylation are associated with changes in lung function during adolescence. Respir Res 2020; 21:80. [PMID: 32264874 PMCID: PMC7140357 DOI: 10.1186/s12931-020-01342-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/25/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Adolescence is a significant period for the gender-dependent development of lung function. Prior studies have shown that DNA methylation (DNA-M) is associated with lung function and DNA-M at some cytosine-phosphate-guanine dinucleotide sites (CpGs) changes over time. This study examined whether changes of DNA-M at lung-function-related CpGs are associated with changes in lung function during adolescence for each gender, and if so, the biological significance of the detected CpGs. METHODS Genome-scale DNA-M was measured in peripheral blood samples at ages 10 (n = 330) and 18 years (n = 476) from the Isle of Wight (IOW) birth cohort in United Kingdom, using Illumina Infinium arrays (450 K and EPIC). Spirometry was conducted at both ages. A training and testing method was used to screen 402,714 CpGs for their potential associations with lung function. Linear regressions were applied to assess the association of changes in lung function with changes of DNA-M at those CpGs potentially related to lung function. Adolescence-related and personal and family-related confounders were included in the model. The analyses were stratified by gender. Multiple testing was adjusted by controlling false discovery rate of 0.05. Findings were further examined in two independent birth cohorts, the Avon Longitudinal Study of Children and Parents (ALSPAC) and the Children, Allergy, Milieu, Stockholm, Epidemiology (BAMSE) cohort. Pathway analyses were performed on genes to which the identified CpGs were mapped. RESULTS For females, 42 CpGs showed statistically significant associations with change in FEV1/FVC, but none for change in FEV1 or FVC. No CpGs were identified for males. In replication analyses, 16 and 21 of the 42 CpGs showed the same direction of associations among the females in the ALSPAC and BAMSE cohorts, respectively, with 11 CpGs overlapping across all the three cohorts. Through pathway analyses, significant biological processes were identified that have previously been related to lung function development. CONCLUSIONS The detected 11 CpGs in all three cohorts have the potential to serve as the candidate epigenetic markers for changes in lung function during adolescence in females.
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Affiliation(s)
- Shadia Khan Sunny
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38152 USA
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38152 USA
| | - Faisal I. Rezwan
- School of Water, Energy and Environment, Cranfield University, Cranfield Bedfordshire, MK43 0AL England
| | - Caroline L. Relton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN UK
| | - A. John Henderson
- Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK
| | - Simon Kebede Merid
- Department of Clinical Sciences and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Erik Melén
- Department of Clinical Sciences and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs’ Children’s Hospital, Stockholm, Sweden
| | - Jenny Hallberg
- Department of Clinical Sciences and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs’ Children’s Hospital, Stockholm, Sweden
| | - S. Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD UK
- The David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Parkhurst Road, Newport, Isle of Wight PO30 5TG UK
| | - Susan Ewart
- Large Animal Clinical Sciences, Michigan State University, East Lansing, MI USA
| | - John W. Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD UK
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18
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Sousa AW, Barros Cabral AL, Arruda Martins M, Carvalho CRF. Risk factors for fixed airflow obstruction in children and adolescents with asthma: 4-Year follow-up. Pediatr Pulmonol 2020; 55:591-598. [PMID: 31909900 DOI: 10.1002/ppul.24625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 12/23/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Asthma is a disease with reversible bronchoconstriction; however, some patients develop fixed airflow obstruction (FAO). Previous studies have reported the incidence and risk factors of FAO in adults; however, the corresponding factors in children remain poorly understood. AIM To evaluate the incidence and risk factors of FAO in children and adolescents with asthma. METHOD Observational and prospective cohort study with a 4-year follow-up of clinically stable patients with asthma (from 6-8 years old). Anthropometric data, history of asthma, number of hospitalizations, frequent exacerbations, asthma severity, asthma control, inhaled corticosteroid dose, atopy, and lung function were analyzed as potential risk factors for FAO. FAO was defined by a ratio of the forced expiratory volume in the first second to the forced vital capacity below the lower limit of normal, even after inhaled and oral corticosteroid treatment. RESULTS Four hundred and twenty-eight patients were recruited, and 358 were analyzed. The FAO incidence in children and adolescents with asthma was 9.5% (n = 34), starting at 10 years of age. Age, body mass index, hospitalizations for asthma, bronchodilator response, frequent exacerbations, length of exacerbations, and asthma severity were associated with FAO. Frequent exacerbations (odds ratio [OR] = 4.0; 95% confidence interval [CI] = 1.3-11.7) and asthma severity categorized as steps 4 to 5 (OR = 3.5; 95% CI = 1.6-7.6) remained risk factors. CONCLUSIONS Frequent exacerbations and asthma severity are the risk factors for FAO in children and adolescents with asthma.
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Affiliation(s)
- Andrey W Sousa
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Milton Arruda Martins
- Department of Clinical Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Celso R F Carvalho
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
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19
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Sdona E, Hallberg J, Andersson N, Ekström S, Rautiainen S, Håkansson N, Wolk A, Kull I, Melén E, Bergström A. Dietary antioxidant intake in school age and lung function development up to adolescence. Eur Respir J 2020; 55:13993003.00990-2019. [PMID: 31806717 PMCID: PMC7031707 DOI: 10.1183/13993003.00990-2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/08/2019] [Indexed: 12/12/2022]
Abstract
Dietary antioxidant intake has been hypothesised to influence lung function. The association between total antioxidant capacity (TAC) of the diet at age 8 years and lung function development up to 16 years in 2307 participants from the Swedish population-based birth cohort BAMSE (Children, Allergy, Milieu, Stockholm, Epidemiology) was investigated. Information on TAC was obtained from a food frequency questionnaire at 8 years. Lung function was measured by spirometry at 8 and 16 years, impulse oscillometry (IOS) and exhaled nitric oxide fraction (FeNO) at 16 years. Low lung function was defined as forced expiratory volume in 1 s (FEV1) z-score below the 25th percentile. Longitudinal associations between TAC and lung function were analysed by mixed effect models adjusted for potential confounders. Stratification by asthma at 8 years was performed to examine effect modification. The median TAC intake was 10 067 μmol Trolox equivalents (TE)·g−1, with males having a lower mean compared to females (9963 versus 10 819 μmol TE·g−1). In analyses of lung function change between 8 and 16 years, there were no statistically significant associations between TAC in tertiles and spirometry results for the total study population. Among children with asthma at 8 years (prevalence 7%), higher TAC was associated with higher mean FEV1 (0.46 sd, 95% CI 0.11–0.80) and decreased odds of low lung function at 16 years (OR 0.28, 95% CI 0.12–0.65). There were no associations between TAC and forced vital capacity or IOS/FeNO results. High dietary antioxidant intake in school age may be associated with improved lung function development from school age to adolescence among children with asthma. Dietary antioxidant intake at school age may influence lung function development as measured by FEV1 up to adolescence among children with asthma. In contrast, no association was observed among children without asthma.http://bit.ly/2CzEZ8W
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Affiliation(s)
- Emmanouela Sdona
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Hallberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Susanne Rautiainen
- Global and Sexual Health, Dept of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Dept of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Inger Kull
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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20
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Urman R, Garcia E, Berhane K, McConnell R, Gauderman WJ, Gilliland F. The Potential Effects of Policy-driven Air Pollution Interventions on Childhood Lung Development. Am J Respir Crit Care Med 2020; 201:438-444. [PMID: 31644884 PMCID: PMC7049927 DOI: 10.1164/rccm.201903-0670oc] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 10/18/2019] [Indexed: 11/16/2022] Open
Abstract
Rationale: Although elevated air pollution exposure impairs lung-function development in childhood, it remains a challenge to use this information to estimate the potential public health benefits of air pollution interventions in exposed populations.Objectives: Apply G-computation to estimate hypothetical effects of several realistic scenarios for future air pollution reductions on lung growth.Methods: Mixed-effects linear regression was used to estimate FEV1 and FVC from age 11 to 15 years in 2,120 adolescents across 3 cohorts (1993-2001, 1997-2004, and 2007-2011). Models included regional pollutants (nitrogen dioxide [NO2] or particulate matter with an aerodynamic diameter ≤2.5 μm [PM2.5]) and other important covariates. Using G-computation, a causal inference-based method, we then estimated changes in mean lung growth in our population for hypothetical interventions on either NO2 or PM2.5. Confidence intervals (CIs) were computed by bootstrapping (N = 1,000).Measurements and Main Results: Compared with the effects of exposure from observed NO2 concentrations during the study period, had communities remained at 1994 to 1997 NO2 levels, FEV1 and FVC growth were estimated to have been reduced by 2.7% (95% CI, -3.6 to -1.8) and 4.2% (95% CI, -5.2 to -3.4), respectively. If NO2 concentrations had been reduced by 30%, we estimated a 4.4% increase in FEV1 growth (95% CI, 2.8-5.9) and a 7.1% increase in FVC growth (95% CI, 5.7-8.6). Comparable results were observed for PM2.5 interventions.Conclusions: We estimated that substantial increases in lung function would occur as a result of interventions that reduce NO2 or PM2.5 concentrations. These findings provide a quantification of potential health benefits of air quality improvement.
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Affiliation(s)
- Robert Urman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Erika Garcia
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Kiros Berhane
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Rob McConnell
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - W James Gauderman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Frank Gilliland
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
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21
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Lai SH, Chiang MC, Chu SM, Hsu JF, Yao TC, Tsai MH, Hua MC, Chiu CY, Yeh KW, Huang JL, Liao SL. Evolution and Determinants of Lung Function until Late Infancy among Infants Born Preterm. Sci Rep 2020; 10:490. [PMID: 31949250 PMCID: PMC6965604 DOI: 10.1038/s41598-019-57359-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 12/06/2019] [Indexed: 01/08/2023] Open
Abstract
To investigate the evolution of lung function in preterm infants with and without bronchopulmonary dysplasia (BPD) and to determine the perinatal characteristics associated with indexes of lung function in later infancy. Longitudinal lung function assessments were performed at approximately 6, 12, 18, and 24 months of corrected age in preterm infants. Perinatal characteristics were further analyzed to ascertain the determinants of lung function indexes. Although all preterm infants (n = 121; 61 without BPD and 60 with BPD) exhibited decreased lung function in early infancy (6 months of age), after body length was adjusted for, only infants with BPD exhibited poor performance. Furthermore, the lung function of infants with mild to moderate BPD caught up gradually, but the generally poor lung function performance of infants with severe BPD, especially in forced expiratory flow, persisted until later age (24 months). Regarding perinatal characteristics, the z-score of body length at the time of examination and total number of days on positive-pressure ventilation are the major determinants of lung function in later infancy.
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Affiliation(s)
- Shen-Hao Lai
- Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
- Prediction of Allergies in Taiwanese Children (PATCH) cohort study, Keelung, Taiwan
| | - Ming-Chou Chiang
- Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Ming Chu
- Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
| | - Jen-Fu Hsu
- Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
| | - Tsung-Chieh Yao
- Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
- Prediction of Allergies in Taiwanese Children (PATCH) cohort study, Keelung, Taiwan
| | - Ming-Han Tsai
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital Keelung Branch, Keelung, Taiwan
- Prediction of Allergies in Taiwanese Children (PATCH) cohort study, Keelung, Taiwan
| | - Man-Chin Hua
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital Keelung Branch, Keelung, Taiwan
- Prediction of Allergies in Taiwanese Children (PATCH) cohort study, Keelung, Taiwan
| | - Chih-Yung Chiu
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital Keelung Branch, Keelung, Taiwan
- Prediction of Allergies in Taiwanese Children (PATCH) cohort study, Keelung, Taiwan
| | - Kuo-Wei Yeh
- Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
- Prediction of Allergies in Taiwanese Children (PATCH) cohort study, Keelung, Taiwan
| | - Jing-Long Huang
- Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan
- Prediction of Allergies in Taiwanese Children (PATCH) cohort study, Keelung, Taiwan
| | - Sui-Ling Liao
- Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan.
- Department of Pediatrics, Chang Gung Memorial Hospital Keelung Branch, Keelung, Taiwan.
- Prediction of Allergies in Taiwanese Children (PATCH) cohort study, Keelung, Taiwan.
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22
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Jackson CM, Mukherjee S, Wilburn AN, Cates C, Lewkowich IP, Deshmukh H, Zacharias WJ, Chougnet CA. Pulmonary Consequences of Prenatal Inflammatory Exposures: Clinical Perspective and Review of Basic Immunological Mechanisms. Front Immunol 2020; 11:1285. [PMID: 32636848 PMCID: PMC7318112 DOI: 10.3389/fimmu.2020.01285] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/21/2020] [Indexed: 12/12/2022] Open
Abstract
Chorioamnionitis, a potentially serious inflammatory complication of pregnancy, is associated with the development of an inflammatory milieu within the amniotic fluid surrounding the developing fetus. When chorioamnionitis occurs, the fetal lung finds itself in the unique position of being constantly exposed to the consequent inflammatory meditators and/or microbial products found in the amniotic fluid. This exposure results in significant changes to the fetal lung, such as increased leukocyte infiltration, altered cytokine, and surfactant production, and diminished alveolarization. These alterations can have potentially lasting impacts on lung development and function. However, studies to date have only begun to elucidate the association between such inflammatory exposures and lifelong consequences such as lung dysfunction. In this review, we discuss the pathogenesis of and fetal immune response to chorioamnionitis, detail the consequences of chorioamnionitis exposure on the developing fetal lung, highlighting the various animal models that have contributed to our current understanding and discuss the importance of fetal exposures in regard to the development of chronic respiratory disease. Finally, we focus on the clinical, basic, and therapeutic challenges in fetal inflammatory injury to the lung, and propose next steps and future directions to improve our therapeutic understanding of this important perinatal stress.
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Affiliation(s)
- Courtney M. Jackson
- Division of Immunobiology, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH, United States
- Immunology Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Shibabrata Mukherjee
- Division of Immunobiology, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH, United States
| | - Adrienne N. Wilburn
- Division of Immunobiology, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH, United States
- Immunology Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Chris Cates
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Ian P. Lewkowich
- Division of Immunobiology, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Hitesh Deshmukh
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Neonatology/Pulmonary Biology, The Perinatal Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, United States
| | - William J. Zacharias
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Neonatology/Pulmonary Biology, The Perinatal Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, United States
| | - Claire A. Chougnet
- Division of Immunobiology, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- *Correspondence: Claire A. Chougnet
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23
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Yin L, Song Y, Liu Y, Ye Z. A risk factor for early wheezing in infants: rapid weight gain. BMC Pediatr 2019; 19:352. [PMID: 31615455 PMCID: PMC6792210 DOI: 10.1186/s12887-019-1720-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 09/12/2019] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study was to investigate the correlation between rapid weight gain and early wheezing. Methods This study screened 701 infants with lower respiratory tract infection who were no more than 4 months from Jan 1st to Dec 31st in 2018. According to weight-for-age Z-value (WAZ), these infants were divided into the considerably slow weight gain group (group I), the normal weight gain group (group II) and the excessively rapid weight gain group (group III), respectively. The clinical characteristics, weight growth speeds and serum lipid levels were analyzed, and multivariable Logistic model was conducted to select significant variables. Results Our results showed that male (OR = 1.841, 95%CI: 1.233–2.751), family wheezing (OR = 5.118, 95%CI: 2.118–12.365), age (OR = 1.273, 95%CI: 1.155–1.403), eczema (OR = 2.769, 95%CI: 1.793–4.275), respiratory syncytial virus (RSV) infection (OR = 1.790, 95%CI: 1.230–2.604), birth weight (OR = 1.746, 95%CI: 1.110–2.746) and total cholesterol (TC) (OR = 1.027, 95%CI: 1.019–1.036) and ΔWAZ (OR = 1.182, 95%CI: 1.022–1.368) were associated with early wheezing. Results indicated that serum TC (P = 0.018) and ΔWAZ (P = 0.023) were positive correlation with wheezing days. Conclusion Besides male, family wheezing, age, eczema, RSV infection, birth weight and TC, the rapid weight growth as a risk factor should be concerned in the early wheezing infants.
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Affiliation(s)
- Lijuan Yin
- Department of Respiratory Center, Children's Hospital of Chongqing Medical University, No.136 Zhongshan Second Road, Yuzhong District, Chongqing, 400014, People's Republic of China.
| | - Ye Song
- Department of Pediatrics, The First Affiliated Hospital of Air Force Military Medical University, Xi'an, 710000, People's Republic of China
| | - Yongfang Liu
- Department of Nutrition, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Zehui Ye
- Department of Respiratory Center, Children's Hospital of Chongqing Medical University, No.136 Zhongshan Second Road, Yuzhong District, Chongqing, 400014, People's Republic of China
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24
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Melén E, Guerra S, Hallberg J, Jarvis D, Stanojevic S. Linking COPD epidemiology with pediatric asthma care: Implications for the patient and the physician. Pediatr Allergy Immunol 2019; 30:589-597. [PMID: 30968967 DOI: 10.1111/pai.13054] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 03/22/2019] [Indexed: 12/25/2022]
Abstract
What are the implications of a lower than expected forced expiratory volume in one second (FEV1) in childhood on respiratory health later in adulthood? Lung function is known to track with age, and there is evidence from recent epidemiologic studies that impaired lung function early in life is associated with later chronic airflow limitation, or even chronic obstructive pulmonary disease, COPD. This risk seems particularly strong in subjects with persistent and severe forms of childhood asthma. Can we translate findings from longitudinal cohort studies to individual risk predictions and preventive guidelines in our pediatric care? In this review, we discuss the clinical implementations of recent epidemiological respiratory studies and the importance of preserved lung health across the life course. Also, we evaluate available clinical tools, primarily lung function measures, and profiles of risk factors, including biomarkers, that may help identifying children at risk of chronic airway disease in adulthood. We conclude that translating population level results to the individual patient in the pediatric care setting is not straight forward, and that there is a need for studies specifically designed to evaluate performance of prediction of risk profiles for long-term sequelae of childhood asthma and lung function impairment.
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Affiliation(s)
- Erik Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Stefano Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Arizona.,ISGlobal, Barcelona, Spain
| | - Jenny Hallberg
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Sanja Stanojevic
- Translational Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
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25
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Naumburg E, Söderström L. Increased risk of pulmonary hypertension following premature birth. BMC Pediatr 2019; 19:288. [PMID: 31421674 PMCID: PMC6697958 DOI: 10.1186/s12887-019-1665-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 08/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background Pulmonary hypertension (PAH) among children and adults has been linked to premature birth, even after adjustments for known risk factors such as congenital heart disease and chronic lung disease. The aim of this population-based registry study was to assess the risk of PAH following exposure to premature birth and other factors in the decades when modern neonatal care was introduced and survival rates increased. Methods Data on pulmonary hypertension and perinatal factors were retrieved from population-based governmental and national quality registers. Cases were adults and children over five years of age with pulmonary hypertension born from 1973 to 2010 and individually matched to six controls by birth year and delivery hospital. Conditional multiple logistic regression was performed to assess the risk of pulmonary hypertension following premature birth and to adjust for known confounding factors for the total study population and for time of birth, grouped into five-year intervals. Results In total, 128 cases and 768 controls were included in the study group. Preterm birth was over three times more common among cases (21%) than among controls (6%). The overall adjusted risk of pulmonary hypertension was associated with premature birth, OR = 4.48 (95% CI; 2.10–9.53). Maternal hypertension, several neonatal risk factors and female gender were independently associated with PAH when potential confounders were taken into account. For each five-year period, the risk of PAH following premature birth increased several times for children born in the 2000s and later, OR = 17.08 (95% CI 5.60–52.14). Conclusions Preterm birth, along with other factors, significantly contributes to PAH. PAH following premature birth has increased over the last few decades. Our study indicates that new, yet unknown factors may play a role in the risk of preterm-born infants developing PAH later in life.
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Affiliation(s)
- Estelle Naumburg
- Department of Clinical Science, Pediatrics, Umeå University, Umeå, Sweden. .,Pediatrics department, Östersund Hospital, SE-831 83, Östersund, Sweden.
| | - Lars Söderström
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
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26
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Childhood Exposures, Asthma, Smoking, Interactions, and the Catch-Up Hypothesis. Ann Am Thorac Soc 2019; 15:1241-1242. [PMID: 30047779 DOI: 10.1513/annalsats.201807-444le] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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27
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Huang X, Mu X, Deng L, Fu A, Pu E, Tang T, Kong X. The etiologic origins for chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2019; 14:1139-1158. [PMID: 31213794 PMCID: PMC6549659 DOI: 10.2147/copd.s203215] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/18/2019] [Indexed: 12/27/2022] Open
Abstract
COPD, characterized by long-term poorly irreversible airway limitation and persistent respiratory symptoms, has resulted in enormous challenges to human health worldwide, with increasing rates of prevalence, death, and disability. Although its origin was thought to be in the interactions of genetic with environmental factors, the effects of environmental factors on the disease during different life stages remain little known. Without clear mechanisms and radical cure for it, early screening and prevention of COPD seem to be important. In this review, we will discuss the etiologic origins for poor lung function and COPD caused by specific adverse effects during corresponding life stages, as well as try to find new insights and potential prevention strategies for this disease.
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Affiliation(s)
- Xinwei Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China.,Medical School, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
| | - Xi Mu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
| | - Li Deng
- The Pathology Department, First People's Hospital of Yunnan Province, Kunming City, Yunnan Province, People's Republic of China
| | - Aili Fu
- Department of Oncology, Yunfeng Hospital, Xuanwei City, Yunnan Province, People's Republic of China
| | - Endong Pu
- Department of Thoracic Surgery, Yunfeng Hospital, Xuanwei City, Yunnan Province, People's Republic of China
| | - Tao Tang
- Medical School, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
| | - Xiangyang Kong
- Medical School, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
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28
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Agusti A, Faner R. Lung function trajectories in health and disease. THE LANCET RESPIRATORY MEDICINE 2019; 7:358-364. [PMID: 30765254 DOI: 10.1016/s2213-2600(18)30529-0] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/06/2018] [Accepted: 12/14/2018] [Indexed: 12/11/2022]
Abstract
The normal lung function trajectory from birth to death has three phases: a growth phase (from birth to early adulthood), a plateau phase (that lasts for a few years), and a decline phase resulting from physiological lung ageing. Numerous genetic and environmental factors can alter one or more of these phases. Evidence shows that several lung function trajectories exist throughout the life course and, importantly, that some of them are associated with substantial implications for health and disease. Here, we review the evidence, formulate a series of questions, and identify various challenges that need to be addressed to identify potential opportunities to promote respiratory health.
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Affiliation(s)
- Alvar Agusti
- Respiratory Institute, Hospital Clinic, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS) Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red, Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBER), Madrid, Spain.
| | - Rosa Faner
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS) Barcelona, Spain; Centro de Investigación Biomédica en Red, Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBER), Madrid, Spain
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