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Distinct trajectories of lung function from childhood to mid-adulthood
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  • Published on:
    Bridging the gap between lung function trajectories and the clinic
    • Rachel M Scott, Respiratory academic clinical fellow Academic Respiratory Unit, University of Bristol, UK
    • Other Contributors:
      • Jack Grenville, Associate respiratory research fellow
      • George W Nava, Respiratory academic clinical fellow
      • James Dodd, Associate Professor in Respiratory Medicine

    We read with great interest this latest valuable addition by Zhang et al. to the growing evidence describing lung function trajectories. Although a relatively small cohort, this study has remarkable retention of participants with lung function measurements from the age of 3 to 45 years, bridging the existing gap in the literature between birth cohort and mid-adult life studies. The authors identify ten FEV1 trajectories, notably more than previous studies, by using a best fitting model with an upper limit of twelve trajectories. Trajectories which rise and fall are of interest as potential targets for public health intervention. Whilst the parallel course of most trajectories identified thus far by this and other cohorts do not inspire confidence in modifiability, their 10-class model does reveal additional decline and catch-up groups not identified by a 6-class model in the supplement. This raises the question as to whether there has been an oversimplification in lung function trajectory modelling in previous analyses, which select between just three and six classes[1–4].

    Our interest was particularly sparked by data in supplementary figure S8 where individual lung function trajectories are displayed by class, in which FEV1 in the ‘persistently low’ trajectory demonstrated considerable variability. For clinicians, this individual variability is the hallmark of asthma, especially when combined with the strong association of childhood airway hyper-responsiveness. Th...

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    Conflict of Interest:
    None declared.