• Gabrielle Y Liu and Ravi Kalhan.
• Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: gabrielle.liu@northwestern.edu.
• Chest. 2021 Sep 1; 160 (3): 879-889.

AbstractPrimary prevention and interception of chronic lung disease are essential in the effort to reduce the morbidity and mortality caused by respiratory conditions. In this review, we apply a life course approach that examines exposures across the life span to identify risk factors that are associated with not only chronic lung disease but also an intermediate phenotype between ideal lung health and lung disease, termed "impaired respiratory health." Notably, risk factors such as exposure to tobacco smoke and air pollution, as well as obesity and physical fitness, affect respiratory health across the life course by being associated with both abnormal lung growth and lung function decline. We then discuss the importance of disease interception and identifying those at highest risk of developing chronic lung disease. This work begins with understanding and detecting impaired respiratory health, and we review several promising molecular biomarkers, predictive symptoms, and early imaging findings that may lead to a better understanding of this intermediate phenotype.Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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