By Bo Chawes
Chairman: Lars K. Poulsen
Opponent: John Henderson
Opponent: Johan de Jongste
The objective of this thesis is to investigate the presence of early life disease activity prior to clinical symptoms to understand the etiology of childhood asthma and allergy. The thesis is built on seven studies (I-VII) originating from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000) birth cohort investigating markers of disease activity in asymptomatic neonates in relation to subsequent development of asthma, allergy, and their associated intermediate phenotypes.
First, it is explored how studies of biomarkers in cord blood (I-II), urine (III) and exhaled breath (IV-V) have established the theory of an early life low-grade disease activity preceding symptom penetrance. Thereafter, it is explored how studies of neonatal lung function and bronchial responsiveness (VI-VII) further corroborate this theory and suggest that systemic low-grade inflammation is part of the trajectory to develop asthma, allergy, and possibly several other common non-communicable diseases (NCDs). Last, it is discussed how these findings could be enforced and refined utilizing novel biomarker omics technologies, which might prepare the ground for improved prevention and treatment strategies to combat the asthma and allergy pandemic.