Primary prevention of asthma: from risk and protective factors to targeted strategies for prevention

Lancet. 2020 Sep 19;396(10254):854-866. doi: 10.1016/S0140-6736(20)31861-4. Epub 2020 Sep 7.

Abstract

Asthma is a complex disease that often starts in childhood. Genomic and environmental factors as well as aberrant immune maturation early in life can contribute to the onset of disease, with great disparity over time and geographical regions. Epidemiological studies have scrutinised environmental exposures and attempted to translate these exposures into prevention strategies. Some approaches for patients with asthma have been successful (eg, smoking ban, the Finnish Asthma Programme), and primary prevention of wheeze in pre-school children (age 0-5 years) by the supplementation of vitamin D or fish oil, or both, to pregnant women seems promising. Several recent prevention initiatives are based on strong asthma-protective environmental microbial exposures associated with traditional rural lifestyles. Preclinical studies with various bacterial lysates, bacterial and dietary metabolites, or helminthic compounds have yielded promising results that await translation into clinical practice. Given the immense societal and individual burden of asthma, there is an urgent need to further develop novel strategies to eradicate the disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Asthma / diet therapy
  • Asthma / epidemiology*
  • Asthma / immunology
  • Asthma / prevention & control*
  • Child, Preschool
  • Dietary Supplements / supply & distribution
  • Environmental Exposure / adverse effects
  • Female
  • Finland / epidemiology
  • Fish Oils / administration & dosage
  • Fish Oils / supply & distribution
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pregnancy
  • Prevalence
  • Primary Prevention / methods*
  • Protective Factors
  • Risk Factors
  • Smoking Prevention / methods
  • Vitamin D / administration & dosage
  • Vitamin D / supply & distribution

Substances

  • Fish Oils
  • Vitamin D