The Role of Environmental Exposures in Pediatric Asthma Pathogenesis: A Contemporary Narrative Review
Luca Pecoraro, Anna Gloria Lanzilotti, Marta De Musso, Elisabetta Di Muri, Fernanda Tramacere, Emiliano Altavilla, Flavia Indrio
Abstract
Over several decades, childhood asthma has emerged as a significant global public health concern, with the highest prevalence reported in industrialized countries. The rapid rise in asthma incidence and loss of control when the diagnosis is established can be related to environmental and lifestyle changes, especially during early infancy. Current evidence indicates a potential link to an imbalance in immune system responses, influenced by tobacco smoke, traffic-related air pollution, outdoor and indoor allergens, gut microbiome, viral infection, obesity, sedentary lifestyle and dietary patterns. This narrative review aims to explore the landscape of contemporary environmental risk factors for childhood asthma, with a focus on their interplay and the relative importance.