Jackson Daniel J, Gern James E, Lemanske Robert F
Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
J Allergy Clin Immunol. 2016 Mar;137(3):659-65; quiz 666. doi: 10.1016/j.jaci.2016.01.002.
Of the chronic diseases affecting grade-school children, asthma is the most common and accounts for the greatest number of school days missed. Moreover, it can influence family dynamics and function in other ways, and unfortunately, it can also be associated with mortality, particularly in the inner-city environments of the United States. Thus understanding factors that lead to its development in early life is essential in developing strategies aimed at primary prevention. Two risk factors that have been identified by a number of investigators include the development of allergic sensitization and wheezing respiratory tract illnesses caused by viruses and bacteria, either alone or in combination. Both of these factors appear to exert their influences within the first few years of life, such that asthma becomes established before the child enters grade school at age 5 to 6 years. Therefore, because both allergic sensitization and viral and bacterial illnesses can occur in children who do not have asthma, it is paramount to identify genetic and environmental factors that activate, interact with, and/or direct the immune system and components of the respiratory tract along pathways that allow asthma to become established and expressed clinically.
在影响小学生的慢性疾病中，哮喘最为常见，导致缺课天数最多。此外，它还会以其他方式影响家庭动态和功能，不幸的是，它还可能与死亡相关，尤其是在美国的城市中心环境中。因此，了解导致其在生命早期发展的因素对于制定一级预防策略至关重要。许多研究人员确定的两个风险因素包括过敏性致敏的发展以及由病毒和细菌单独或共同引起的喘息性呼吸道疾病。这两个因素似乎都在生命的最初几年内发挥作用，以至于在孩子5至6岁进入小学之前哮喘就已形成。因此，由于过敏性致敏以及病毒和细菌疾病都可能发生在没有哮喘的儿童中，识别激活、与呼吸道免疫系统及其组成部分相互作用和/或引导其沿着使哮喘得以形成并在临床上表现出来的途径发展的遗传和环境因素至关重要。
