Chapter 8 - Epigenetics and environmental programing of lung disease

Abstract

The developmental origins of lung disease describe the connections between environmental stressors and the development of lung disease in the short and long term. Environmental stressors include organic and inorganic exposures, as well as more general environmental stress including prenatal nutrition and oxygen. The basic tenant is that lung disease following an early-life environmental exposure is the result of a change in the normal trajectory of lung growth and development, as well as reprogramming of the lung response to injurious stimuli. The result is alterations in lung structure, function, and reactivity, which in turn result in failure to achieve optimal lung function, onset of lung disease, and exacerbated response to additional lung injury. Epigenetic mechanisms are involved, and likely drive the cellular memory and organ reprogramming that is required to manifest disease long after exposure. The Developmental Origins of Lung Disease field is evolving rapidly and focuses in now turning to the questions important to translate knowledge into meaningful interventions. These important and still somewhat unanswered questions include insight into vulnerable windows, an understanding of cause-and-effect relationships, and identification of gene pathways affected by environmental stimuli that may be amenable to modulation in therapeutics.