There has been a major change in our understanding of the natural history and risk factors for COPD, a frequent cause of illness and death. For example, in the United States, more people die from COPD than from any other condition except cancer and cardiovascular illnesses. Although smoking is still a major cause of COPD, genetic, environmental, and developmental factors both diminish the FEV1 and accelerate FEV1 decline in adult life. Prevention of prematurity, and especially of bronchopulmonary dysplasia, is a major public health priority. Promising advances in the development of vaccines against respiratory syncytial virus and prevention strategies for childhood asthma could decrease the risk of COPD. Efforts to reduce exposure to air contaminants during pregnancy and childhood and to decrease adolescent smoking could also decrease the incidence of COPD.
References:
Early-Life Origins of Chronic Obstructive Pulmonary Disease. Fernando D. Martinez, M.D.
N Engl J Med 2016; 375:871-878, September 1, 2016.
http://www.nejm.org/doi/full/10.1056/NEJMra1603287
The World Allergy Organization (WAO) Small Airways Working Group publishes a monthly "What's New?" summary and I have served as its editor since 2011. The summary features the top 3 asthma/small airways articles each month. The article above is a part of the project. The archive is here: http://www.worldallergy.org/small_airways_group/reviews/archive.php
Image source: Image source: FDA and Wikipedia, public domain.
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