Impaired Respiratory Health and Life Course Transitions From Health to Chronic Lung Disease

Primary prevention and interception of chronic lung disease are essential in the effort to reduce the morbidity and mortality caused by respiratory conditions. In this review, we apply a life course approach that examines exposures across the life span to identify risk factors that are associated with not only chronic lung disease but also an intermediate phenotype between ideal lung health and lung disease, termed impaired respiratory health. Notably, risk factors such as exposure to tobacco smoke and air pollution, as well as obesity and physical fitness, affect respiratory health across the life course by being associated with both abnormal lung growth and lung function decline. We then discuss the importance of disease interception and identifying those at highest risk of developing chronic lung disease. This work begins with understanding and detecting impaired respiratory health, and we review several promising molecular biomarkers, predictive symptoms, and early imaging findings that may lead to a better understanding of this intermediate phenotype. CHEST 2021; 160(3):879-889

Automated summary

To prevent chronic lung disease, early intervention and understanding of potential risk factors such as tobacco smoke, air pollution, obesity, and physical fitness are essential. Identifying impaired respiratory health, finding high-risk populations, and studying potential molecular biomarkers and early imaging findings can lead to a better understanding and prevention of chronic lung disease.