Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Pediatr Allergy Immunol. 2021 Aug;32(6):1238-1254. doi: 10.1111/pai.13516. Epub 2021 May 13.
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.
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.
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.
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.
目前尚不清楚肺功能缺陷在生命的哪个阶段发展，以及这些缺陷是否受到哮喘、支气管高反应性（BHR）和过敏合并症等危险因素的影响。本系统评价的目的是确定哮喘、BHR 和过敏合并症与从出生到成年早期肺功能峰值期间大、小气道肺功能发育的时间关联。
我们检索了 MEDLINE、EMBASE、Web of Science 和 CINAHL，以获取 2020 年 1 月 1 日之前发表的关于大、小气道风险因素和肺功能测量的论文。研究必须报告出生至肺功能峰值（21-26 岁）期间的任何时间点或时间段的肺功能，并至少纳入一个候选风险因素。
在确定的 45 篇论文中，44 篇为队列研究，1 篇为临床试验且有随访。生命早期的哮喘、喘息、BHR 和多种过敏原过敏与对照人群相比，在儿童早期大、小气道的肺功能生长发育较差。患有哮喘或持续性喘息的个体在儿童期后的肺功能发育，尽管仍以较低水平增长，但在达到峰值功能之前，在很大程度上与未受影响的个体平行。
肺功能生长发育缺陷发生在儿童早期，患有哮喘、BHR 和生命早期 IgE（多）致敏的儿童处于危险之中。这一时期可能是识别高危人群并提供旨在预防肺功能长期后果的治疗的关键机会窗口。
