Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Chest. 2021 Sep;160(3):879-889. doi: 10.1016/j.chest.2021.04.009. Epub 2021 Apr 15.
Primary prevention and interception of chronic lung disease are essential in the effort to reduce the morbidity and mortality caused by respiratory conditions. In this review, we apply a life course approach that examines exposures across the life span to identify risk factors that are associated with not only chronic lung disease but also an intermediate phenotype between ideal lung health and lung disease, termed "impaired respiratory health." Notably, risk factors such as exposure to tobacco smoke and air pollution, as well as obesity and physical fitness, affect respiratory health across the life course by being associated with both abnormal lung growth and lung function decline. We then discuss the importance of disease interception and identifying those at highest risk of developing chronic lung disease. This work begins with understanding and detecting impaired respiratory health, and we review several promising molecular biomarkers, predictive symptoms, and early imaging findings that may lead to a better understanding of this intermediate phenotype.
慢性肺病的一级预防和干预对于降低呼吸疾病导致的发病率和死亡率至关重要。在本综述中，我们采用了一种贯穿生命全程的方法来研究暴露因素，以确定不仅与慢性肺病相关，而且与理想肺健康和肺病之间的中间表型（称为“呼吸健康受损”）相关的风险因素。值得注意的是，一些风险因素，如吸烟和空气污染暴露，以及肥胖和身体活动，通过与异常肺生长和肺功能下降相关，从而影响整个生命全程的呼吸健康。然后，我们讨论了疾病干预和确定那些患慢性肺病风险最高的人群的重要性。这项工作首先是理解和检测呼吸健康受损，我们综述了一些有前途的分子生物标志物、预测症状和早期影像学发现，这些可能有助于更好地理解这一中问表型。
