Russo Daniele, Lizzi Mauro, Di Filippo Paola, Di Pillo Sabrina, Chiarelli Francesco, Attanasi Marina
Department of Pediatrics, University of Chieti, 66100 Chieti, Italy.
Pediatric Allergy and Respiratory Unit, Department of Pediatrics, University of Chieti, 66100 Chieti, Italy.
Biomedicines. 2022 Mar 24;10(4):758. doi: 10.3390/biomedicines10040758.
Susceptibility to asthma is complex and heterogeneous, as it involves both genetic and environmental insults (pre- and post-birth) acting in a critical window of development in early life. According to the Developmental Origins of Health and Disease, several factors, both harmful and protective, such as nutrition, diseases, drugs, microbiome, and stressors, interact with genotypic variation to change the capacity of the organism to successfully adapt and grow in later life. In this review, we aim to provide the latest evidence about predictive risk and protective factors for developing asthma in different stages of life, from the fetal period to adolescence, in order to develop strategic preventive and therapeutic interventions to predict and improve health later in life. Our study shows that for some risk factors, such as exposure to cigarette smoke, environmental pollutants, and family history of asthma, the evidence in favor of a strong association of those factors with the development of asthma is solid and widely shared. Similarly, the clear benefits of some protective factors were shown, providing new insights into primary prevention. On the contrary, further longitudinal studies are required, as some points in the literature remain controversial and a source of debate.
哮喘易感性复杂且具有异质性,因为它涉及在生命早期关键发育阶段(出生前和出生后)起作用的遗传和环境因素。根据健康与疾病的发育起源理论,营养、疾病、药物、微生物群和应激源等多种有害和保护性因素与基因型变异相互作用,改变机体在晚年成功适应和生长的能力。在本综述中,我们旨在提供关于从胎儿期到青春期不同生命阶段发生哮喘的预测性风险和保护因素的最新证据,以便制定战略性预防和治疗干预措施,预测并改善晚年健康。我们的研究表明,对于一些风险因素,如接触香烟烟雾、环境污染物和哮喘家族史,支持这些因素与哮喘发生密切相关的证据确凿且得到广泛认可。同样,一些保护因素的明显益处也得到了证实,为一级预防提供了新的见解。相反,由于文献中的一些观点仍存在争议且是争论的根源,因此需要进一步的纵向研究。