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Understanding the aetiology of lung function impairment: the crucial role of age of onset
  1. Xander Bertels,
  2. Lies Lahousse
  1. Bioanalysis, Ghent University, Ghent, Belgium
  1. Correspondence to Dr Lies Lahousse, Bioanalysis, Ghent University, Ghent 9000, Belgium; lies.lahousse{at}

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During the last two decades, a paradigm shift in the aetiology of impaired lung function has been unfolding. Here, chronic obstructive pulmonary disease (COPD) is no longer exclusively the result of exposure-related accelerated lung function decline, but may also be a direct consequence of impaired lung growth or early-life lung function deficits. Several epidemiological studies have now demonstrated that reduced peak lung function in early adulthood is indeed associated with COPD later in life, despite normal age-related lung function decline.1 Recently, an additional trajectory of lung function catch-up has been observed in children, showing potential plasticity of lung function during development and raising hope for more prevention and early intervention strategies.2 However, the dynamics and progression patterns of lung function over the life-course are complex, and trajectories leading to other patterns of impaired lung function such as preserved ratio impaired spirometry (PRISm) are poorly explored.3 Therefore, well-powered studies exploring lung function trajectories over time, in real life populations, are highly needed. Such studies are not only essential to retrieve early markers of impaired lung growth or …

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  • Contributors XB and LL contributed equally.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests LL reports consulting fees of AstraZeneca and lecture honoraria of IPSA and Chiesi, all paid to her institution and outside this editorial. XB reports no competing interests.

  • Provenance and peer review Commissioned; internally peer reviewed.

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