COPD Risk Linked to Lung Function Development During Childhood & Adolescence

An international team of researchers recently discovered that a proper lung function development during childhood and adolescence has a major impact on the risk of developing chronic obstructive pulmonary disease (COPD) in the future. The study is entitled “Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease” and was published in the New England Journal of Medicine.

COPD is one of the most common lung diseases and a major cause of morbidity and mortality worldwide. It is the third leading cause of death in the United States. COPD is a progressive disease in which individuals develop serious problems in breathing with obstruction of the airways, shortness of breath (dyspnea), cough and acute exacerbations. Smoking is considered to be the leading cause of COPD. The disease can seriously impact the patient’s physical capacity, well-being and social functioning.

It is generally assumed that the development of COPD is the result of a rapid decline in lung function. However, researchers have now discovered that this is true for only about 50% of COPD patients, while the other 50% develop the disease with lung function decline close to normal levels. This finding may in fact explain why the efficacy of treatments based on reducing lung function decline in these patients has been difficult to establish.

The team analyzed data from three large independent cohorts (the Framingham Offspring Cohort, the Copenhagen City Heart Study and the Lovelace Smokers Cohort) with patients who were monitored through lung function measurements over several years (almost 25 years in two of the cohorts).

Researchers found two major courses related to lung function leading to COPD: one characterized by a rapid lung function decline, and a second one where suboptimal development of lung function during childhood and adolescence was the major COPD determinant in an older age.

The research team concluded that different from what has been previously assumed, a rapid lung function decline is not a prerequisite for COPD development; in fact, the maximally achieved level of lung function in childhood and early adulthood was found to be a crucial determinant of future COPD risk.

“This long-term chronic disease can be developed in different ways, so achieving normal growth in lung function in early adulthood is an important factor in terms of future risk,” concluded the study’s lead author Dr. Peter Lange from the University of Copenhagen referring to COPD development in a news release. “Thus, every effort should be undertaken to achieve normal growth of lung function including non-smoking during teenage years, treatment of asthma in childhood and reducing exposure to agents such as passive smoking,”