Document Detail


The early-life origins of asthma.
MedLine Citation:
PMID:  17218816     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Early-life events are pivotal in determining adult lung function and disease, and the prognosis of preschool wheeze is determined by gene-environment interactions, antenatally and in the first 3 years of life. RECENT FINDINGS: Birth cohort studies show that lung function tracks from the first 3 years of life into adolescence and probably beyond. Umbilical-cord-blood studies demonstrate that the immunological responses to viral infections are in part determined antenatally. The neutrophil not the eosinophil is the key effector cell in preschool wheeze. Allergic sensitization in the first 3 years of life is key to subsequent prognosis. Histological changes develop in the airway after the onset of symptoms, but by school age the full-blown airway pathology of atopic asthma is present. Although novel genes such as ADAM33 studied in isolation are of interest, unless gene expression is studied in the context of the environment, misleading conclusions will be reached. We need disease-modifying therapy; inhaled steroids do not prevent progression from intermittent to persistent wheeze. SUMMARY: The first 3 years of life are pivotal in determining lung function and prognosis of wheeze, probably throughout life. Further research requires focused hypotheses encompassing genes and the environment in which they are expressed.
Authors:
Sejal Saglani; Andrew Bush
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in allergy and clinical immunology     Volume:  7     ISSN:  1528-4050     ISO Abbreviation:  Curr Opin Allergy Clin Immunol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-12     Completed Date:  2007-03-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100936359     Medline TA:  Curr Opin Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  83-90     Citation Subset:  IM    
Affiliation:
Imperial School of Medicine at National Heart and Lung Institute, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Asthma / genetics,  immunology*,  physiopathology*
Child, Preschool
Humans
Infant
Infant, Newborn

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