Univ Paris Est Creteil, INSERM, IMRB, Creteil, France.
Université Paris Cité and Univ Paris Est Créteil, CNRS, LISA, Paris, France.
Eur Respir Rev. 2022 Aug 10;31(165). doi: 10.1183/16000617.0059-2022. Print 2022 Sep 30.
COPD is a progressive and debilitating disease often diagnosed after 50 years of age, but more recent evidence suggests that its onset could originate very early on in life. In this context, exposure to air pollution appears to be a potential contributor. Although the potential role of air pollution as an early determinant of COPD is emerging, knowledge gaps still remain, including an accurate qualification of air pollutants (number of pollutants quantified and exact composition) or the "one exposure-one disease" concept, which might limit the current understanding. To fill these gaps, improvements in the field are needed, such as the use of atmosphere simulation chambers able to realistically reproduce the complexity of air pollution, consideration of the exposome, as well as improving exchanges between paediatricians and adult lung specialists to take advantage of reciprocal expertise. This review should lead to a better understanding of the current knowledge on air pollution as an early determinant of COPD, as well as identify the existing knowledge gaps and opportunities to fill them. Hopefully, this will lead to better prevention strategies to scale down the development of COPD in future generations.
COPD 是一种进行性和使人虚弱的疾病，通常在 50 岁以后被诊断出来，但最近的证据表明，它的发病可能很早就开始了。在这种情况下，暴露于空气污染似乎是一个潜在的致病因素。尽管空气污染作为 COPD 的早期决定因素的潜在作用正在显现，但仍存在知识空白，包括对空气污染物的准确定性（量化的污染物数量和确切组成）或“一暴露一疾病”的概念，这可能限制了目前的认识。为了填补这些空白，需要在该领域进行改进，例如使用能够真实再现空气污染复杂性的大气模拟室，考虑暴露组，以及加强儿科医生和成人肺部专家之间的交流，以利用互惠的专业知识。这篇综述应该有助于更好地了解空气污染作为 COPD 早期决定因素的现有知识，并确定现有的知识空白和填补这些空白的机会。希望这将导致更好的预防策略，以减少未来几代人 COPD 的发展。
