Can asthma be predicted from an early age?
OBJECTIVE
The ability to identify risk factors for asthma as early as possible in life would be valuable as it would allow accurate prognoses to be made and interventional therapies to be tested. The aim of this article is to review the most important approaches made in this area and to consider their relevance.


RESULTS
Epidemiological studies have started to include genetic analyses and this combined approach has provided new information on genetic susceptibility to disease and its interactions with the environment. For example, genetic variations in innate immunity genes may explain why particular individuals are substantially less likely to develop asthma when exposed to farm animals in early life. Another example is using populations with long-term, longitudinal databases to determine the age relationships of specific genetic susceptibilities. Furthermore, genetic studies have started to provide new explanations for the known relationship between maternal smoking during pregnancy and adverse respiratory outcomes in the offspring. Genetic studies have also provided new insights into the latest physiological studies reporting that the level of infant respiratory function is associated with respiratory outcomes in the second decade of life. Finally, important advances continue to be made in our understanding of the immunological processes relevant to early life and their influence on the development of atopy and asthma.


CONCLUSIONS
Progress in defining early risk factors for asthma has been made in several areas. The most important findings have come from studies combining epidemiological, genetic and immunological assessments.
Le Souëf
Peter N
PN
School of Paediatrics and Child Health, Princess Margaret Hospital for Children, Perth, Australia. plesouef@paed.uwa.edu.au
D001249:Asthma / Q000209:etiology* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors