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Early life influences on the development of chronic obstructive pulmonary disease.

Stocks, J; Sonnappa, S; (2013) Early life influences on the development of chronic obstructive pulmonary disease. Ther Adv Respir Dis , 7 (3) 161 - 173. 10.1177/1753465813479428. Green open access

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Abstract

There is increasing evidence that chronic obstructive pulmonary disease (COPD) is not simply a disease of old age that is largely restricted to heavy smokers, but may be associated with insults to the developing lung during foetal life and the first few years of postnatal life, when lung growth and development are rapid. A better understanding of the long-term effects of early life factors, such as intrauterine growth restriction, prenatal and postnatal exposure to tobacco smoke and other pollutants, preterm delivery and childhood respiratory illnesses, on the subsequent development of chronic respiratory disease is imperative if appropriate preventive and management strategies to reduce the burden of COPD are to be developed. The extent to which insults to the developing lung are associated with increased risk of COPD in later life depends on the underlying cause, timing and severity of such derangements. Suboptimal conditions in utero result in aberrations of lung development such that affected individuals are born with reduced lung function, which tends to remain diminished throughout life, thereby increasing the risk both of wheezing disorders during childhood and subsequent COPD in genetically susceptible individuals. If the current trend towards the ever-increasing incidence of COPD is to be reversed, it is essential to minimize risks to the developing lung by improvements in antenatal and neonatal care, and to reduce prenatal and postnatal exposures to environmental pollutants, including passive tobacco smoke. Furthermore, adult physicians need to recognize that lung disease is potentially associated with early life insults and provide better education regarding diet, exercise and avoidance of smoking to preserve precious reserves of lung function in susceptible adults. This review focuses on factors that adversely influence lung development in utero and during the first 5 years of life, thereby predisposing to subsequent COPD.

Type: Article
Title: Early life influences on the development of chronic obstructive pulmonary disease.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/1753465813479428
Publisher version: http://dx.doi.org/10.1177/1753465813479428
Language: English
Additional information: © The Author(s), 2013. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(http://www.uk.sagepub.com/aboutus/openaccess.htm). PMCID: PMC4107852
Keywords: adult, foetal origins of lung disease, foetal programming, infant, intrauterine growth restriction, lung function, lung growth and development, pollution, prematurity, Adult, Age Factors, Animals, Environmental Exposure, Environmental Pollutants, Humans, Lung, Pulmonary Disease, Chronic Obstructive, Risk Factors, Severity of Illness Index, Smoking, Time Factors
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
URI: https://discovery.ucl.ac.uk/id/eprint/1388431
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