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Kahhaleh FG, Barrientos G, Conrad ML. The gut-lung axis and asthma susceptibility in early life. Acta Physiol (Oxf) 2024; 240:e14092. [PMID: 38251788 DOI: 10.1111/apha.14092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/06/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024]
Abstract
Asthma is the most common chronic disease among children, with more than 300 million cases worldwide. Over the past several decades, asthma incidence has grown, and epidemiological studies identify the modernized lifestyle as playing a strong contributing role in this phenomenon. In particular, lifestyle factors that modify the maternal gut microbiome during pregnancy, or the infant microbiome in early life, can act as developmental programming events which determine health or disease susceptibility later in life. Microbial colonization of the gut begins at birth, and factors such as delivery mode, breastfeeding, diet, antibiotic use, and exposure to environmental bacteria influence the development of the infant microbiome. Colonization of the gut microbiome is crucial for proper immune system development and disruptions to this process can predispose a child to asthma development. Here, we describe the importance of early-life events for shaping immune responses along the gut-lung axis and why they may provide a window of opportunity for asthma prevention.
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Affiliation(s)
- Fariz G Kahhaleh
- Institute of Microbiology, Infectious Diseases and Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Gabriela Barrientos
- Laboratory of Experimental Medicine, Hospital Alemán, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Melanie L Conrad
- Institute of Microbiology, Infectious Diseases and Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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Zhong Z, Chen M, Dai S, Wang Y, Yao J, Shentu H, Huang J, Yu C, Zhang H, Wang T, Ren W. Association of cesarean section with asthma in children/adolescents: a systematic review and meta-analysis based on cohort studies. BMC Pediatr 2023; 23:571. [PMID: 37974127 PMCID: PMC10652517 DOI: 10.1186/s12887-023-04396-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Whether cesarean section (CS) is a risk factor for asthma in offspring is controversial. The purpose of this study was to investigate the association between CS and asthma in children/adolescents. METHODS Pubmed, Embase, Web of Science, and Cochrane Library electronic databases were searched for cohort studies on the relationship between mode of delivery and asthma in children/adolescents up to February 2023. Birth via CS was considered an exposure factor. Asthma incidence was taken as a result. RESULTS Thirty-five cohort studies (thirteen prospective and twenty-two retrospective cohort studies) were included. The results showed that the incidence of asthma was higher in CS offspring (odds ratio (OR) = 1.18, P < 0.001) than in the vaginal delivery (VD) group. Partial subgroup analyses showed a higher incidence of asthma in female offspring born via CS (OR = 1.26, P < 0.001) compared with the VD group, while there was no difference in males (OR = 1.07, P = 0.325). Asthma incidence was higher in CS offspring than in the VD group in Europe (OR = 1.20, P < 0.001), North America (OR = 1.15, P < 0.001), and Oceania (OR = 1.06, P = 0.008). This trend was not found in the Asian population (OR = 1.17, P = 0.102). The incidence of atopic asthma was higher in offspring born via CS (OR = 1.14, P < 0.001) compared to the VD group. The CS group had a higher incidence of persistent asthma, but the difference did not reach statistical significance (OR = 1.15, P = 0.063). CONCLUSION In this meta-analysis, CS may be a risk factor for asthma in offspring children/adolescents compared with VD. The relationship between CS and asthma was influenced by sex and region.
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Affiliation(s)
- Ziwei Zhong
- Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China
| | - Meiling Chen
- The Public Health College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Senjie Dai
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yu Wang
- College of Pharmacy, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jie Yao
- The Public Health College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Haojie Shentu
- The Medical Imaging College, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jianing Huang
- The Public Health College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chiyuan Yu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hongrui Zhang
- The Medical Technology and Information Engineering College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Tianyue Wang
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wei Ren
- General Family Medicine, Ningbo Yinzhou No. 2 Hospital, 998 North Qianhe Road, Yinzhou District, Ningbo, 315100, Zhejiang, China.
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Peñaranda A, Pérez-Herrera LC, Gantiva M, Moreno-López S, Manrique J, Peñaranda D, García E. Factors associated with allergic rhinitis and combined allergic rhinitis and asthma syndrome (CARAS) in adults undergoing immunotherapy in a tropical country: Is ISAAC-III questionnaire useful in adult populations? Allergol Immunopathol (Madr) 2023; 51:78-86. [PMID: 37422783 DOI: 10.15586/aei.v51i4.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/30/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Allergic diseases affect about 10-30% of the population in low- or middle-income tropical countries. Few studies describe the factors associated with allergic diseases in adult patients undergoing immunotherapy in Latin American countries. OBJECTIVE This study aimed to determine the factors associated with allergic rhinitis (AR) and AR in comorbidity with asthma (CARAS) in adults treated with immunotherapy in two allergy referral centers in Bogotá (Colombia). MATERIAL AND METHODS Observational, cross-sectional study conducted between January 2018 and January 2019. ISAAC-III and sociodemographic questionnaires were applied to determine the factors associated with AR and CARAS in adults treated with immunotherapy who attended the allergy consult at the Fundación Santa Fe de Bogotá and Unimeq-Orl. RESULTS Among 416 adults aged 18-68 years, 71.4% (n = 297) were women. Regarding the sensitization results obtained by skin prick test, the most frequent allergens were house dust mites (64.18%): 49.03% were positive for both Dermatophagoides pteronyssinus and Dermatophagoides farinae, while 28.61% were positive for Blomia tropicalis. Excluding house dust mites, the most frequent allergens were dog hair (31.01%), cat hair (15.1%), grasses (15.9%), and food (15.9%). The main factor associated with exclusive AR was regular acetaminophen use more than four times a year: Prevalence ratio (PR) = 1.77 (95% CI: 1.12-2.25). The main factor associated with CARAS was cesarean delivery PR: 1.44 (95% CI: 1.09-1.78). CONCLUSION The main factor associated with AR was regular acetaminophen use, while that associated with CARAS was cesarean delivery. The ISAAC-III questionnaire can be a useful low-cost tool to assess the factors associated with allergic diseases in adults in tropical countries.
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Affiliation(s)
- Augusto Peñaranda
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Allergy and Otolaryngology Research Groups, UNIMEQ-ORL, Bogotá, Colombia
| | - Lucía C Pérez-Herrera
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Manuela Gantiva
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Section of Otolaryngology, Fundación Universitaria de Ciencias de la Salud - Hospital de San José, Bogotá, Colombia
| | - Sergio Moreno-López
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Julian Manrique
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Allergy section, Department of Pediatrics, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Daniel Peñaranda
- Allergy and Otolaryngology Research Groups, UNIMEQ-ORL, Bogotá, Colombia
- Section of Otolaryngology, Fundación Universitaria de Ciencias de la Salud - Hospital de San José, Bogotá, Colombia
| | - Elizabeth García
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Departmen of Otolaryngology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Section of Otolaryngology, Fundación Universitaria de Ciencias de la Salud - Hospital de San José, Bogotá, Colombia;
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Krupa-Kotara K, Grajek M, Grot M, Czarnota M, Wypych-Ślusarska A, Oleksiuk K, Głogowska-Ligus J, Słowiński J. Pre- and Postnatal Determinants Shaping the Microbiome of the Newborn in the Opinion of Pregnant Women from Silesia (Poland). Life (Basel) 2023; 13:1383. [PMID: 37374165 DOI: 10.3390/life13061383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Pre- and postnatal factors influence the formation of the newborn's microbiome as early as birth and the intrauterine period has a substantial impact on the composition of the baby's gastrointestinal microbiota and its subsequent development. This study intends to measure pregnant women's knowledge of the importance of microbiota for the health of the newborn. The sample was selected based on defined inclusion and exclusion criteria. The assessment of women's knowledge was assessed by the Kolmogorov-Smirnov and Kruskal-Wallis statistical tests. This study population comprised 291 adult pregnant women with a mean age of 28.4 ± 4.7 years. A total of 34% (n = 99), 35% (n = 101), and 31.3% (n = 91) were at the 1-3 trimester, respectively. The results showed that 36.4% of the women were aware that the intrauterine period changes the makeup of the gastrointestinal microbiota, whereas 5.8% exhibited awareness of the composition of the child's normal gut microbiota. Most of the women surveyed-(72.1%)-know that colonization of the tract occurs as early as the birth period. Women with student status (those who will pursue higher education in the future) and those who had given birth to the most children exhibited higher levels of knowledge.
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Affiliation(s)
- Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Mateusz Grajek
- Department of Public Health, Department of Public Health Policy, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Martina Grot
- Student Scientific Society, Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
- Doctoral School, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | - Martina Czarnota
- Student Scientific Society, Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Agata Wypych-Ślusarska
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Klaudia Oleksiuk
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Joanna Głogowska-Ligus
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Jerzy Słowiński
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
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Papadopoulou SK, Mentzelou M, Pavlidou E, Vasios GK, Spanoudaki M, Antasouras G, Sampani A, Psara E, Voulgaridou G, Tsourouflis G, Mantzorou M, Giaginis C. Caesarean Section Delivery Is Associated with Childhood Overweight and Obesity, Low Childbirth Weight and Postnatal Complications: A Cross-Sectional Study. Medicina (B Aires) 2023; 59:medicina59040664. [PMID: 37109623 PMCID: PMC10146198 DOI: 10.3390/medicina59040664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
Background and Objectives: In the last decades, simultaneously increasing trends have been recorded for both caesarean section delivery and childhood overweight/obesity around the world, which are considered serious public health concerns, negatively affecting child health. Aim: The present study aims to investigate whether caesarean section is associated with the increased rates of childhood overweight/obesity, low childbirth anthropometric indices and postnatal complications in pre-school age. Materials and Methods: This is a cross-sectional study in which 5215 pre-school children aged 2–5 years old were enrolled from nine different Greek regions after applying specific inclusion and exclusion criteria. Non-adjusted and adjusted statistical analysis was performed to assess the impact of caesarean section in comparison to vaginal delivery. Results: Children delivered by caesarean section were significantly more frequently overweight or obese at the age of 2–5 years, also presenting a higher prevalence of low birth weight, length and head circumference. Caesarean section was also associated with higher incidence of asthma and diabetes type I at the age of 2–5 years. In a multivariate analysis, caesarean section increased the risk of childhood overweight/obesity and low childbirth anthropometric indices even if adjusting for several childhood and maternal confounding factors. Conclusions: Increasing trends were recorded for both caesarean section delivery and childhood overweight/obesity, which are considered serious public health concerns. Caesarean section independently increased childhood overweight/obesity in pre-school age, highlighting the emergent need to promote health policies and strategies to inform future mothers about its short and long-term risks and that this mode of delivery should preferably be performed only when there are strong medical recommendations in emergency obstetric conditions.
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Affiliation(s)
- Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
- Correspondence: (S.K.P.); (C.G.)
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Georgios K Vasios
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Maria Spanoudaki
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece
| | - Maria Mantzorou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
- Correspondence: (S.K.P.); (C.G.)
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Papandreou D, Pavlidou E, Tyrovolas S, Mantzorou M, Andreou E, Psara E, Antasouras G, Vasios GK, Poulios E, Giaginis C. Relation of Maternal Pre-Pregnancy Factors and Childhood Asthma: A Cross-Sectional Survey in Pre-School Children Aged 2-5 Years Old. Medicina (Kaunas) 2023; 59. [PMID: 36676802 DOI: 10.3390/medicina59010179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/31/2022] [Accepted: 01/13/2023] [Indexed: 01/17/2023]
Abstract
Background and Objectives: Asthma constitutes a constant, prolonged, inflammation-related pulmonary disorder in childhood with serious public health concerns. Several maternal risk factors can enhance the prevalence of its development in this stage of life; however, the currently available data remain contradictory and/or inconsistent. We aim to evaluate the potential impacts of mothers' sociodemographic, anthropometric and prenatal and perinatal factors on the prevalence of developing asthma in pre-school children. Materials and Methods: This is a retrospective cross-sectional survey, which includes 5133 women and their matched pre-school children. Childhood asthma was diagnosed using validated questionnaires. Statistical analysis was accomplished to evaluate whether maternal sociodemographic, anthropometric and prenatal and perinatal factors can increase the probability of childhood asthma in pre-school age. Results: A prevalence of 4.5% of childhood asthma was recorded in pre-school age. Maternal age and pre-pregnancy overweight and obesity, caesarean section, gestational diabetes and hypertension and not breastfeeding were associated with childhood asthma after adjustment for multiple confounding factors. Conclusion: Our research showed that several maternal factors increase the prevalence of childhood asthma in pre-school age. Suitable and effective health policies and strategies should be taken into account to confront the predominant maternal factors that increase its prevalence in pre-school age.
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Wypych-Ślusarska A, Krupa-Kotara K, Niewiadomska E. Social Inequalities: Do They Matter in Asthma, Bronchitis, and Respiratory Symptoms in Children? Int J Environ Res Public Health 2022; 19:15366. [PMID: 36430088 PMCID: PMC9691006 DOI: 10.3390/ijerph192215366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
Background: Social inequalities (e.g., poverty and low level of education) generate inequalities in health. Aim: The aim of the study was to determine the relationships between indicators of social inequalities and the frequency of respiratory symptoms, asthma, and bronchitis in children. Material and Methods: In 2019, an epidemiological cross-sectional study on 3237 students from elementary schools in Silesia Voivodships (South Poland) was conducted. The students' parents completed a questionnaire based on the International Study on Asthma and Allergies in Childhood (ISAAC). Social inequalities in the children's families were determined according to parents' education and professional status (working vs. unemployed), self-assessment of economic status, and housing conditions. To determine the influence of social factors on the occurrence of asthma, bronchitis, and respiratory symptoms, the odds ratio (OR) was calculated. Results: Children living in apartments with traces of mold had a higher risk of developing asthma (OR = 1.5, 95%CI: 1.17-1.96; p = 0.002) or bronchitis (OR = 1.4, 95%CI: 1.13-1.72; p = 0.002), wheezing attacks at nights (OR = 1.4; 95%CI: 1.01-1.93), wheezy in the last 12 months (OR = 1.6; 95%CI:1.24-2.08; p < 0.001), and chronic cough (OR = 1.9; 95%CI: 1.49-2.46; p < 0.001). Exposure to environmental tobacco smoke (ETS) was associated with higher risk of cough (OR = 1.5 95%CI: 1.22-1.96; p < 0.001) and dyspnea in the last 12 months (OR = 1.4; 95%CI: 1.04-2.00; p = 0.02). Low socioeconomic status (SES) was associated with increased risk of chronic cough (OR = 1.5; 95%CI: 1.09-2.03; p = 0.009) and increased risk of wheezy in the last 12 months (OR = 1.4; 95%CI: 1.06-1.97; p = 0.008). Asthma and bronchitis were not dependent on parents' education or professional status. Conclusions: Social inequalities have significant impacts on the occurrence of respiratory symptoms, bronchitis, and asthma in children. Interventions aimed at preventing bronchitis and childhood asthma should also focus on social health determinants.
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Affiliation(s)
- Agata Wypych-Ślusarska
- Department of Epidemiology, Faculty of Health Sciences in Bytom, Medical University of Silesia, 40-055 Katowice, Poland
| | - Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Health Sciences in Bytom, Medical University of Silesia, 40-055 Katowice, Poland
| | - Ewa Niewiadomska
- Department of Biostatistics, Faculty of Health Sciences in Bytom, Medical University of Silesia, 40-055 Katowice, Poland
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Russo D, Lizzi M, Di Filippo P, Di Pillo S, Chiarelli F, Attanasi M. Time-Specific Factors Influencing the Development of Asthma in Children. Biomedicines 2022; 10:758. [PMID: 35453508 PMCID: PMC9025817 DOI: 10.3390/biomedicines10040758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/16/2022] [Accepted: 03/23/2022] [Indexed: 02/01/2023] Open
Abstract
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.
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