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. 2011 Jan 13;41(2):366–376. doi: 10.1093/ije/dyq239

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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2011; all rights reserved.

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

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Proposed effect of environmental and genetic risk factors and their interaction on lung development and evolution of wheeze phenotypes. The Figure illustrates how genetic background, environmental exposures (ETS, air pollution, infections, allergens, active smoking) and their interaction might influence lung growth and development from branching of the airways to alveolarization. We propose a direct effect of these exposures on lung development, and an indirect effect via changes in the balance between inflammation, injury and repair mechanisms, leading to remodelling. Differences in these pathways might lead to different phenotypes of wheezing disorders