Download PDFPDF
Original research
Distinct trajectories of lung function from childhood to mid-adulthood
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g.
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests


  • A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
  • We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
  • Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
  • By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

  • 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...

    Show More
    Conflict of Interest:
    None declared.