Early life environmental risk factors are associated with chronic respiratory morbidity in child- and adulthood. A possible mechanism for this sustained effect is their influence on early life lung functional growth and development, a susceptible phase of rapid lung growth with increased plasticity. We summarize evidence of hereditary and environmental ante-, peri-, and early postnatal factors on lung functional development, such as air pollution, tobacco exposure, nutrition, intrauterine growth retardation, prematurity, early life infections, microbiome, and allergies and their effect on lung functional trajectories. While some of the factors (e.g., prematurity) directly impair lung growth, the influence of many environmental factors is mediated through inflammatory processes (e.g., recurrent infections or oxidative stress). The timing and nature of these influences and their impact result in degrees of impaired maximal lung functional capacity in early adulthood; and they potentially impact future long-term respiratory morbidity such as chronic asthma or chronic obstructive airway disease (COPD). We discuss possibilities to prevent or modify such early abnormal lung functional growth trajectories and the need for future studies and prevention programs.

中文翻译：

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肺功能发展和哮喘的轨迹。

早期环境风险因素与儿童和成年期的慢性呼吸道疾病相关。这种持续作用的可能机制是它们对生命早期肺功能生长和发育的影响，这是肺快速生长且可塑性增强的易感阶段。我们总结了遗传和环境产前，产前和产后早期影响肺功能的证据，例如空气污染，烟草暴露，营养，子宫内发育迟缓，早产，早期感染，微生物组和过敏及其对疾病的影响肺功能轨迹。尽管某些因素（例如早产）直接损害肺部生长，但许多环境因素的影响是通过炎症过程（例如反复感染或氧化应激）介导的。这些影响的时间和性质及其影响导致成年早期最大肺功能能力受损的程度；它们可能会影响未来的长期呼吸道疾病，例如慢性哮喘或慢性阻塞性气道疾病（COPD）。我们讨论了预防或修改此类早期异常肺功能增长轨迹的可能性，以及未来研究和预防计划的需求。