{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:21:25Z","timestamp":1785525685683,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,12,21]],"date-time":"2019-12-21T00:00:00Z","timestamp":1576886400000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Investigation"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Chronic obstructive pulmonary disease (<jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>) is a leading cause of disability and death of adults in the <jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content> and worldwide. While environmental factors such as smoking and air pollution are major contributors to <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>, pediatric respiratory disease and more specifically early childhood wheezing are frequent predisposing factors. It is therefore possible that aggressive prevention and treatment of childhood respiratory illness may modify adult <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> risk. This article reviews some of the physiological factors that may explain the pediatric origins of childhood lung disease. One such factor is the \u201ctracking\u201d of normal lung function which occurs with growth. The maximal expiratory flow volume (<jats:styled-content style=\"fixed-case\">MEFV<\/jats:styled-content>) curve is an ideally suited tool to monitor tracking of airway function over the lifespan, as its relative effort independence makes it highly reliable. Study of the <jats:styled-content style=\"fixed-case\">MEFV<\/jats:styled-content> curve has demonstrated that individuals with similar lung volumes can have large differences in maximal flows, reflecting a disconnection between airway and lung growth (\u201cdysanapsis\u201d). Less than average airway size due to dysanaptic airway growth or airway remodeling may be independent risk factors for the development of <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> and the asthma\/<jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> overlap syndrome in adult life. There are intriguing early data suggesting that perhaps at least some of this risk is modifiable by improving asthma control with inhaled corticosteroids and minimizing asthma exacerbations.<\/jats:p>","DOI":"10.1002\/ped4.12165","type":"journal-article","created":{"date-parts":[[2019,12,21]],"date-time":"2019-12-21T18:38:26Z","timestamp":1576953506000},"page":"236-244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Airway function throughout the lifespan: Pediatric origins of adult respiratory disease"],"prefix":"10.1002","volume":"3","author":[{"given":"Julian Lewis","family":"Allen","sequence":"first","affiliation":[{"name":"Division of Pulmonary Medicine The Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,21]]},"reference":[{"key":"e_1_2_3_2_1","volume-title":"Respiratory Physiology: The Essentials","author":"West JB","year":"2012"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1977.43.3.498"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950150204"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1988.65.2.822"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12633-5"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1974.37.1.67"},{"key":"e_1_2_3_8_1","first-page":"339","article-title":"Dysanapsis in normal lungs assessed by the relationship between maximal flow, static recoil, and vital capacity","volume":"121","author":"Mead J","year":"1980","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1987.63.5.2042"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00562.2009"},{"key":"e_1_2_3_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0072899"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.500"},{"key":"e_1_2_3_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.501"},{"key":"e_1_2_3_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000441"},{"key":"e_1_2_3_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23488"},{"key":"e_1_2_3_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1513737"},{"key":"e_1_2_3_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411532"},{"key":"e_1_2_3_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022363"},{"key":"e_1_2_3_19_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00165106"},{"key":"e_1_2_3_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199810223391703"},{"key":"e_1_2_3_21_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.124.1.63"},{"key":"e_1_2_3_22_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201606-1272OC"},{"key":"e_1_2_3_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200010123431501"},{"key":"e_1_2_3_24_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200807-1126OC"},{"key":"e_1_2_3_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.02.029"},{"key":"e_1_2_3_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31399-X"},{"key":"e_1_2_3_27_1","unstructured":"Global Initiative for Asthma. Diagnosis of asthma COPD and asthma\u2010COPD overlap syndrome (ACOS): A joint project of GINA and GOLD. \u00a92016.https:\/\/goldcopd.org\/wp-content\/uploads\/2016\/04\/GOLD_ACOS_2015.pdf. 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