Early Origins of Chronic Obstructive Pulmonary Disease: Prenatal and Early Life Risk Factors

Deolmi, Michela; Decarolis, Nicola Mattia; Motta, Matteo; Makrinioti, Heidi; Fainardi, Valentina; Pisi, Giovanna; Esposito, Susanna

doi:10.3390/ijerph20032294

Cited by 12 publications

(6 citation statements)

References 191 publications

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“…obstructive lung disease in adulthood [5]. Recent studies have confirmed older investigations in describing the independent risk of dysanapsis in COPD [6].…”

Section: Computed Tomography Scans and Chronic Obstructive Pulmonary ...mentioning

confidence: 62%

“…Dysanapsis is believed to arise early in life [4]. A more recent study suggests that determination of lung morphology occurs at a young age and that genetic factors, prenatal, perinatal, and childhood lung development may be critical in the development of obstructive lung disease in adulthood [5]. Recent studies have confirmed older investigations in describing the independent risk of dysanapsis in COPD [6].…”

Section: Computed Tomography Scans and Chronic Obstructive Pulmonary ...mentioning

confidence: 87%

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The role of chest computed tomography in the evaluation and management of chronic obstructive pulmonary disease

Burkes,

Zafar,

Panos

2024

Current Opinion in Pulmonary Medicine

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Purpose of review The purpose of this review is to compile recent data on the clinical associations of computed tomography (CT) scan findings in the literature and potential avenues for implementation into clinical practice. Recent findings Airways dysanapsis, emphysema, chronic bronchitis, and pulmonary vascular metrics have all recently been associated with poor chronic obstructive pulmonary disease (COPD) outcomes when controlled for clinically relevant covariables, including risk of mortality in the case of emphysema and chronic bronchitis. Other authors suggest that CT scan may provide insight into both lung parenchymal damage and other clinically important comorbidities in COPD. Summary CT scan findings in COPD relate to clinical outcomes. There is a continued need to develop processes to best implement the results of these studies into clinical practice.

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“…obstructive lung disease in adulthood [5]. Recent studies have confirmed older investigations in describing the independent risk of dysanapsis in COPD [6].…”

Section: Computed Tomography Scans and Chronic Obstructive Pulmonary ...mentioning

confidence: 62%

Section: Computed Tomography Scans and Chronic Obstructive Pulmonary ...mentioning

confidence: 87%

The role of chest computed tomography in the evaluation and management of chronic obstructive pulmonary disease

Burkes,

Zafar,

Panos

2024

Current Opinion in Pulmonary Medicine

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“…Alterations in lung function during childhood have been found to predict adult lung function and the onset of clinical pathology, including the development of chronic obstructive pulmonary disease (COPD). The fact that premature patients, particularly those with BPD, exhibit initial lung function abnormalities makes them particularly vulnerable to the early onset of respiratory failure in adulthood [32,33]. Recent studies have indicated a higher incidence of COPD among individuals born at younger gestational ages [1], especially among those diagnosed with BPD [33].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Function and Bronchopulmonary Dysplasia Classification: Insights from the Spanish Registry

Ramos-Navarro,

Sánchez-Luna,

Pérez-Tarazona

et al. 2024

Preprint

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Background and Aims In 2016, the Spanish Research Group on Bronchopulmonary Dysplasia (BPD) (GEIDIS) established a national registry with participation of 66 hospitals to collect information on clinical characteristics and long-term outcomes of BPD infants into adulthood. The aim of this study is to examine forced spirometry data in early childhood and to assess their correlation with the respiratory support required at 36 weeks postmenstrual age (PMA). Methods The study analyzed data from preterm infants with BPD born between January 2016 and December 2017 who underwent forced spirometry at 5-7 years of age. Statistical analyses were conducted to investigate the relationships between spirometry results, perinatal factors, and the required respiratory support at 36 weeks PMA. Results The study involved 143 patients with a median gestational age (GA) of 27.3 weeks (range: 25.7-28.7) and a median weight of 880 grams (range: 740-1135). Pathological spirometry was observed in 39.2% (56) of the patients. Among patients diagnosed with BPD type 3, those requiring over 30% oxygen at 36 weeks PMA exhibited an increased risk of pathological spirometry (OR 4.48; 95% CI: 1.11-18.13) compared to those requiring positive pressure with less than 30% oxygen. In addition, this subgroup had a higher risk of developing a restrictive-mixed pattern compared to those with BPD type 1 (OR 10,65; 95% IC 2,06-54,98) and BPD type 2 (OR 6,76; 95% IC 1,09-42,06). No significant differences were found in the incidence of an obstructive pattern between BPD types. Additionally, the study revealed distinct etiopathogenic mechanisms underlying the development of restrictive versus obstructive patterns. Conclusions: The requirement of more than 30% oxygen at 36 weeks PMA serves as a risk indicator for pulmonary function impairment in school-aged children with BPD. These findings suggest persistent airway and parenchymal injury in this specific patient population, and highlight the importance of careful monitoring to evaluate their long-term effects on lung function.

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“…Epidemiological studies indicate that COPD is strongly associated with a history of exposure to tobacco smoke; however, a substantial proportion of patients with COPD (25–45%) report that they have never smoked 3. Other risk factors for the development of COPD, which are particularly relevant in developing countries, include biomass smoke exposure,4–6 poor lung growth and development,7–11 inadequately treated childhood respiratory infections,12 occupational air pollution,13 chronic childhood asthma11 and post-tuberculosis lung disease 13…”

Section: Introductionmentioning

confidence: 99%

Rate of severe exacerbations, healthcare resource utilisation and clinical outcomes in patients with COPD in low-income and middle-income countries: results from the EXACOS International Study

Athanazio,

Bernal Villada,

Avdeev

et al. 2024

BMJ Open Resp Res

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IntroductionTheEXAcerbations ofChronic obstructive lung disease (COPD) and theirOutcomeS(EXACOS) International Study aimed to quantify the rate of severe exacerbations and examine healthcare resource utilisation (HCRU) and clinical outcomes in patients with COPD from low-income and middle-income countries.MethodsEXACOS International was an observational, cross-sectional study with retrospective data collection from medical records for a period of up to 5 years. Data were collected from 12 countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Guatemala, Hong Kong, Mexico, Panama, Russia and Taiwan. The study population comprised patients ≥40 years of age with COPD. Outcomes/variables included the prevalence of severe exacerbations, the annual rate of severe exacerbations and time between severe exacerbations; change in lung function over time (measured by the forced expiratory volume in 1 s (FEV1)); peripheral blood eosinophil counts (BECs) and the prevalence of comorbidities; treatment patterns; and HCRU.ResultsIn total, 1702 patients were included in the study. The study population had a mean age of 69.7 years, with 69.4% males, and a mean body mass index of 26.4 kg/m2. The mean annual prevalence of severe exacerbations was 20.1%, and 48.4% of patients experienced ≥1 severe exacerbation during the 5-year study period. As the number of severe exacerbations increased, the interval between successive exacerbations decreased. A statistically significant decrease in mean (SD) FEV1from baseline to post-baseline was observed in patients with ≥1 severe exacerbation (1.23 (0.51) to 1.13 (0.52) L; p=0.0000). Mean BEC was 0.198 x109cells/L, with 64.7% of patients having a BEC ≥0.1 x109 cells/L and 21.3% having a BEC ≥0.3 x109 cells/L. The most common comorbidity was hypertension (58.3%). An increasing number of severe exacerbations per year was associated with greater HCRU.DiscussionThe findings presented here indicate that effective treatment strategies to prevent severe exacerbations in patients with COPD remain a significant unmet need in low-income and middle-income countries.

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Early Origins of Chronic Obstructive Pulmonary Disease: Prenatal and Early Life Risk Factors

Cited by 12 publications

References 191 publications

The role of chest computed tomography in the evaluation and management of chronic obstructive pulmonary disease

The role of chest computed tomography in the evaluation and management of chronic obstructive pulmonary disease

Pulmonary Function and Bronchopulmonary Dysplasia Classification: Insights from the Spanish Registry

Rate of severe exacerbations, healthcare resource utilisation and clinical outcomes in patients with COPD in low-income and middle-income countries: results from the EXACOS International Study

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