More evidence for early life determinants of COPD


By Mardi Chapman

14 Feb 2017

Lung function at seven years of age can help predict both COPD and Asthma-COPD Overlap Syndrome (ACOS) in later life, according to findings from one of the world’s longest running cohort studies on respiratory health.

Professor Paul Thomas, a respiratory physician from the Prince of Wales Clinical School at the University of New South Wales, said the research suggests maximising children’s lung function may have long-term benefits.

“The study shows that diminished lung function in early childhood is a risk factor for both COPD and ACOS later in life. Therefore it’s possible that interventions that address airway obstruction in children can reduce the risk of those two disorders in adulthood,” he said.

“For example if we treat children with recurrent lung infections earlier or more vigorously, we may be able to make a significant difference later in life.”

He said this might include the use of bronchodilators and inhaled steroids in children not currently recognised as having asthma.

Published in the American Journal of respiratory Care and Critical Medicine, the study was able to obtain pre-bronchodilator spirometry at seven years of age and pre and post-bronchodilator spirometry at 45 years for 1,389 participants in the Tasmanian Longitudinal Health Study.

The research, run nationally by the University of Melbourne, found lung function in the lowest quartile at seven years of age was associated with a later diagnosis of COPD and ACOS.

Adults with ACOS had the lowest pre-bronchodilator FEV1 as children while adults with either COPD alone or ACOS had the lowest FEV1/FVC at seven years. In contrast, the study found lung function as children was not associated with asthma alone as adults.

Professor Thomas said the findings could help solve the problem of unexplained respiratory symptoms in adults with no history of asthma or smoking.

“It is important to remember that a childhood history can be a defining factor in whether someone develops lung function abnormalities and probably symptoms in middle life.

The researchers suggested lung function screening in school-aged children would help identify individuals likely to have ongoing poorer lung health.

There was also a need for paediatric and adult respiratory physicians to collaborate more in research addressing interventions to improve lung function in these children.

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