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Advancing Understanding of Childhood Asthma: Lessons Learned from Birth Cohort Studies

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Abstract

Asthma and allergies are some of the most common chronic disorders affecting children, the prevalence of which has been increasing in countries and regions undergoing rapid development like China. To curb the rising tide of allergies and safeguard the health of future generations, it is of critical importance to understand how asthma inception is influenced by factors acting at different life stages. Birth cohorts represent a powerful tool to investigate the temporal sequence of exposures along the natural course of asthma. We examined recent evidence on birth cohort studies of asthma and allergic diseases and evaluated their strengths and weaknesses. Essential elements for a successful birth cohort are proposed to further elucidate asthma etiology and pathogenies. Initiating new cohorts in understudied populations with the application of advanced analytical approaches will be needed. Moreover, fostering collaborative networks using standardized methodologies should be prioritized to enable integration of findings across diverse cohorts. There remains an urgent and unmet need to further translate the seminal findings from asthma birth cohort studies into targeted primary prevention strategies to eradicate the disease.

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Abbreviations

ALSPAC:

Avon Longitudinal Study of Parents and Children

BIGCS:

Born in Guangzhou Cohort Study

CAS:

Childhood Asthma Study

COAST:

Childhood Origins of Asthma

COCOA:

Cohort for Childhood Origin of Asthma and allergic diseases

COPSAC:

Copenhagen Prospective Studies on Asthma in Childhood

COVID-19:

Coronavirus disease 2019

DCHS:

Drakenstein Child Health Study

FeNO:

Exhaled nitric oxide fraction

FEV1 :

Forced expiratory volume in 1 s

GA2LEN:

Global Allergy and Asthma European Network

GUSTO:

Growing Up in Singapore Towards healthy Outcomes

HDM:

House dust mite

LMIC:

Low- and middle-income country

LRTI:

Lower respiratory tract infections

ISAAC:

International Study of Asthma and Allergies in Childhood

JECS:

Japan Environment and Children’s Study

MAAS:

Manchester Asthma and Allergy Study

MARC:

Multicenter Airway Research Collaboration

OR:

Odds ratio

PACAAS:

Perth Childhood Acute Asthma Study

PASTURE:

Protection against Allergy—Study in Rural Environments

RSV:

Respiratory syncytial virus

RV:

Rhinovirus

SAFFA cohort:

South African Food Allergy cohort

SBC:

Shanghai Birth Cohort

SCFA:

Short-chain fatty acid

SPT:

Skin prick test

TCRS:

Tucson Children’s Respiratory Study

URECA:

Urban Environment and Childhood Asthma

WHEALS:

Wayne County Health, Environment, Allergy and Asthma Longitudinal Study

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Acknowledgements

The authors would like to heartfully thank Prof. Gary W.K. Wong from The Chinese University of Hong Kong, Prof. Jing Li from Guangzhou Medical University, and Prof. Bianca Schaub from LMU Munich for their valuable insights during the preparation of this manuscript.

Funding

This study was supported by the National Natural Science Foundation of China (No. 82300031).

Author information

Author notes

  1. Yuhan Xing, Xinmeng Yang, and Zhaoyinqian Li contributed equally to this work.

Authors and Affiliations

  1. School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, 518107, China

    Yuhan Xing

  2. Department of Paediatrics, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin N.T., Hong Kong, SAR, China

    Yuhan Xing

  3. Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, Shandong, China

    Yuhan Xing, Xinmeng Yang, Ping Yang, Qinzheng Wang, Wei Ni & Guoju Li

  4. Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China

    Zhaoyinqian Li

  5. Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Luzhou, Sichuan, China

    Zhaoyinqian Li

  6. Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Luzhou, Sichuan, China

    Zhaoyinqian Li

  7. Department of Otorhinolaryngology, Children’s Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China

    Qiyuan Zou

  8. Department of Rheumatology and Immunology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China

    Dongze Wu

Authors
  1. Yuhan Xing
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  2. Xinmeng Yang
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  3. Zhaoyinqian Li
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  4. Qiyuan Zou
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  5. Ping Yang
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  6. Qinzheng Wang
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  7. Wei Ni
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  8. Dongze Wu
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  9. Guoju Li
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Contributions

YX, GL, and DW contributed to study design, data collection, data analysis, and interpretation; YX, XY, and ZL contributed to manuscript preparation; XY, ZL, QZ, PY, QW, and WN contributed to data collection and analysis. All authors made substantial contributions to manuscript revision and critical review and approved the final manuscript.

Corresponding authors

Correspondence to Dongze Wu or Guoju Li.

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Xing, Y., Yang, X., Li, Z. et al. Advancing Understanding of Childhood Asthma: Lessons Learned from Birth Cohort Studies. Clinic Rev Allerg Immunol 66, 50–63 (2024). https://doi.org/10.1007/s12016-024-08979-3

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