Does COPD begin in childhood?

Chronic obstructive pulmonary disease (COPD) is strongly linked to behavioural and environmental exposures that occur mainly in adulthood. Almost exclusively diagnosed in adults, the disorder is characterised by symptoms and functional impairment that, in most cases, begin after the third decade of life. As such, COPD is an adult illness. However, growing attention is being given to the idea that factors and developmental processes that occur in childhood could predispose individuals to the disorder.

Work by Burrows and colleagues1 in the 1970s showed that adults with COPD were more likely to recall respiratory illnesses in childhood than were individuals without COPD.

Thus, recently prospective studies have established that lung function at birth is associated with that in childhood and young adulthood, and children with asthma and asthma-like symptoms have early lung function deficits that could put them at risk for COPD in later life. For this reason, preventive strategies should be used early in life to optimise long-term lung health.

In fact, some key—but still unanswered—questions emerge that might have important implications for prevention and suggest future directions for research (panel).

Reference: Guerra S, Stern DA, Morgan WJ. Does COPD begin in childhood?. Lancer Respir Med 2013; 1(4): 282-4. (Commentary)