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Liu L, Liu Y, Zhang X, Yuan YL, Chen ZH, Chen-Yu Hsu A, Oliver BG, Xie M, Qin L, Li WM, Liu D, Wang G, Wood LG. Dyslipidemia Is Associated With Worse Asthma Clinical Outcomes: A Prospective Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:863-872.e8. [PMID: 36535523 DOI: 10.1016/j.jaip.2022.11.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/01/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Dyslipidemia has been widely documented to be associated with cardiovascular disease, and recent studies have found an association with asthma prevalence. However, longitudinal studies investigating the relationships between dyslipidemia, asthma phenotypes, and future asthma exacerbations (AEs) are lacking. OBJECTIVE To investigate the relationships between dyslipidemia, asthma phenotypes, and AEs. METHODS This study used an observational cohort study design with a 12-month follow-up. All subjects underwent serum lipid measurement, and they were then classified into 2 groups: the normal-lipidemia group and the dyslipidemia group. Demographic and clinical information and details regarding pulmonary function and asthma phenotypes at baseline were collected. All patients were followed up regularly to assess AEs. Associations of dyslipidemia with airway obstruction and asthma phenotypes were assessed at baseline, whereas dyslipidemia and AEs were assessed longitudinally. RESULTS A total of 477 patients with asthma were consecutively enrolled in this study. At baseline, the dyslipidemia group (n = 218) had a higher proportion of uncontrolled asthma, defined by the 6-item Asthma Control Questionnaire score (≥1.5). Furthermore, dyslipidemia was associated with severe asthma, nonallergic asthma, asthma with fixed airflow limitation, and older adult asthma phenotypes at baseline. In addition, dyslipidemia was associated with increased frequencies of severe AEs and moderate to severe AEs during the 12-month follow-up. In sensitivity analyses, after excluding the patients who were receiving statins, results did not differ significantly from those of the main analysis. CONCLUSIONS We identified the clinical relevance of dyslipidemia, which is associated with specific asthma phenotypes and increased AEs, independent of other components of metabolic syndrome. These findings highlight the importance of considering dyslipidemia as an "extrapulmonary trait" in asthma management.
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Affiliation(s)
- Lei Liu
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying Liu
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Zhang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Lai Yuan
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Respiratory Medicine, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou, Sichuan, China
| | - Zhi Hong Chen
- Shanghai Institute of Respiratory Disease, Respiratory Division of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Alan Chen-Yu Hsu
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, New South Wales, Australia
| | - Brian G Oliver
- School of Life Sciences, University of Technology Sydney, Ultimo, New South Wales, Australia; Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Min Xie
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Qin
- Department of Pulmonary and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Wei Min Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dan Liu
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Gang Wang
- Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, Sichuan, China; Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Lisa G Wood
- Center for Asthma and Respiratory Diseases, Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, New South Wales, Australia
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Farooq S, Khatri S. Life Course of Asthma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1426:43-76. [PMID: 37464116 DOI: 10.1007/978-3-031-32259-4_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Asthma is a heterogeneous chronic airway disease that can vary over a lifetime. Although broad categories of asthma by severity and type have been constructed, there remains a tremendous opportunity to discover an approach to managing asthma with additional factors in mind. Many in the field have suggested and are pursuing a novel paradigm shift in how asthma might be better managed, considering the life course of exposures, management priorities, and predicted trajectory of lung function growth. This approach will require a more holistic view of prenatal, postnatal, adolescence, hormonal and gender aspects, and the aging process. In addition, the environment, externally and internally, including in one's genetic code and epigenetic changes, are factors that affect how asthma progresses or becomes more stable in individuals. This chapter focuses on the various influences that may, to differing degrees, affect people with asthma, which can develop at any time in their lives. Shifting the paradigm of thought and strategies for care and advocating for public policies and health delivery that focus on this philosophy is paramount to advance asthma care for all.
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Affiliation(s)
- Sobia Farooq
- National Heart, Lung, and Blood Institute, CMO Division of Lung Diseases, Bethesda, MD, USA
| | - Sumita Khatri
- National Heart, Lung, and Blood Institute, CMO Division of Lung Diseases, Bethesda, MD, USA.
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Huang YJ, Chu YC, Chen CW, Yang HC, Huang HL, Hwang JS, Chen CH, Chan TC. Relationship among genetic variants, obesity traits and asthma in the Taiwan Biobank. BMJ Open Respir Res 2022; 9:9/1/e001355. [PMID: 36600406 PMCID: PMC9730389 DOI: 10.1136/bmjresp-2022-001355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Obesity and asthma impose a heavy health and economic burden on millions of people around the world. The complex interaction between genetic traits and phenotypes caused the mechanism between obesity and asthma is still vague. This study investigates the relationship among obesity-related polygenic risk score (PRS), obesity phenotypes and the risk of having asthma. METHODS This is a matched case-control study, with 4 controls (8288 non-asthmatic) for each case (2072 asthmatic). Data were obtained from the 2008-2015 Taiwan Biobank Database and linked to the 2000-2016 National Health Insurance Research Database. All participants were ≥30 years old with no history of cancer and had a complete questionnaire, as well as physical examination, genome-wide single nucleotide polymorphisms and clinical diagnosis data. Environmental exposure, PM2.5, was also considered. Multivariate adjusted ORs and 95% CIs were calculated using conditional logistic regression stratified by age and sex. Mediation analysis was also assessed, using a generalised linear model. RESULTS We found that the obese phenotype was associated with significantly increased odds of asthma by approximately 26%. Four obesity-related PRS, including body mass index (OR=1.07 (1.01-1.13)), waist circumference (OR=1.10 (1.04-1.17)), central obesity as defined by waist-to-height ratio (OR=1.09 (1.03-1.15)) and general-central obesity (OR=1.06 (1.00-1.12)), were associated with increased odds of asthma. Additional independent risk factors for asthma included lower educational level, family history of asthma, certain chronic diseases and increased PM2.5 exposure. Obesity-related PRS is an indirect risk factor for asthma, the link being fully mediated by the trait of obesity. CONCLUSIONS Obese phenotypes and obesity-related PRS are independent risk factors for having asthma in adults in the Taiwan Biobank. Overall, genetic risk for obesity increases the risk of asthma by affecting the obese phenotype.
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Affiliation(s)
- Ying-Jhen Huang
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City, Taiwan
| | - Yi-Chi Chu
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City, Taiwan
| | - Chia-Wei Chen
- Institute of Statistical Science, Academia Sinica, Taipei City, Taiwan
| | - Hsin-Chou Yang
- Institute of Statistical Science, Academia Sinica, Taipei City, Taiwan
| | - Hung-Ling Huang
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung City, Taiwan,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Jing-Shiang Hwang
- Institute of Statistical Science, Academia Sinica, Taipei City, Taiwan
| | - Chun-Houh Chen
- Institute of Statistical Science, Academia Sinica, Taipei City, Taiwan
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City, Taiwan,Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
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What is the impact of birth weight corrected for gestational age on later onset asthma: a meta-analysis. Allergy Asthma Clin Immunol 2022; 18:1. [PMID: 34983644 PMCID: PMC8725261 DOI: 10.1186/s13223-021-00633-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 11/26/2021] [Indexed: 12/01/2022] Open
Abstract
Background Asthma is a common multifactorial disease affecting millions worldwide. The Barker hypothesis postulates an association between later onset disease risk and energy exposure in utero. Birth weight corrected for gestational age is better for measuring the infant size, which reflects energy exposure in utero. Findings on asthma and birth weight corrected for gestational age have been inconclusive. We conducted a meta-analysis to further clarify the relationship between birth weight corrected for gestational age and later onset asthma. Methods A systematic literature search of the PubMed, Web of Science, MEDLINE, and Scopus databases up to January 2021 was conducted. The subject terms were used as follows: “asthma”, “allerg*”, “respiratory”, “birth weight”, “gestational age”, “birth outcomes”, “intrauterine growth retardation”, and “fetal growth restriction”. Results We included 12 articles with data from a total of 6,713,596 people. Compared with non-SGA infants, infants small for gestation age (SGA) were not associated with an increased risk of asthma (OR = 1.07; 95% CI 0.94–1.21). However, in the subgroup analysis, we found an increased risk of later onset asthma among SGA in studies conducted in Asia, with a large sample size, and defined asthma through medical records rather than questionnaires. Large for gestational age (LGA) was not associated with an increased risk of asthma when non-LGA or appropriated for gestational age (AGA) infants were used as the reference (OR = 1.02; 95% CI 0.90–1.16; OR = 1.01; 95% CI 0.88–1.15). Conclusion These results indicated that neither SGA nor LGA was associated with an increased risk of asthma. However, considering the limitations of the research, these results should be interpreted with caution.
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Kunøe A, Sevelsted A, Chawes BL, Stokholm J, Eliasen A, Krakauer M, Bønnelykke K, Bisgaard H. Associations between Inhaled Corticosteroid in the First 6 Years of Life and Obesity Related Traits. Am J Respir Crit Care Med 2021; 204:642-650. [PMID: 33975528 DOI: 10.1164/rccm.202009-3537oc] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale Infants and young children might be particularly susceptible to the potential clinical side effects of inhaled corticosteroids (ICS) on body mass index (BMI), adiposity rebound and body composition, but this has rarely been studied in long-term studies in this age-group. Objective To determine the association between ICS exposure in the first 6 years of life on BMI, adiposity rebound, body composition and blood lipid levels. Methods Children from the two Copenhagen Prospective Studies on Asthma in Childhood mother-child cohorts were included. ICS use was registered prospectively to age 6 and the cumulative dose was calculated. Multiple linear regression models were used for analysis. Measurements and Main Results A total of 932 (84%) of the 1111 children from the COPSAC cohorts had data on BMI, 786 (71%) had DXA scan data at age 6 years, and 815 (73%) had adiposity rebound age calculated. 291 children (31%) received a cumulative ICS dose > 10 weeks of standard treatment before age 6. ICS treatment during 0-6 years of age was associated with an increased BMI z-score; 0.05 SD [95% CI: 0.005 to 0.09] per one-year standard treatment, p=0.03, an earlier age at adiposity rebound; -0.18 year [95% CI: -0.28 to -0.08], p=0.0006, and a 2 % increased geometric mean android fat percentage, p=0.05. ICS exposure and DXA scan data were not associated. Conclusions ICS use in early childhood was associated with increased BMI z-score at age six, an earlier adiposity rebound and a trend of association with increased android body fat percentage.
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Affiliation(s)
- Asja Kunøe
- University of Copenhagen, 4321, COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, Kobenhavn, Denmark
| | - Astrid Sevelsted
- University of Copenhagen, 4321, COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, Kobenhavn, Denmark
| | - Bo L Chawes
- Brigham and Women's Hospital, 1861, Channing Division of Network Medicine, Boston, Massachusetts, United States.,University of Copenhagen, 4321, COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Kobenhavn, Denmark
| | - Jakob Stokholm
- University of Copenhagen, 4321, COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, Kobenhavn, Denmark
| | - Anders Eliasen
- University of Copenhagen, 4321, COPSAC Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, Kobenhavn, Denmark
| | - Martin Krakauer
- Gentofte University Hospital, 53147, Department of Clinical Physiology and Nuclear Medicine, Hellerup, Denmark
| | - Klaus Bønnelykke
- University of Copenhagen, 4321, Copenhagen Prospective Studies on Asthma in Childhood; The Danish Pediatric Asthma Center, Kobenhavn, Denmark
| | - Hans Bisgaard
- University of Copenhagen, 4321, COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, Kobenhavn, Denmark;
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Su KW, Chiu CY, Tsai MH, Liao SL, Chen LC, Hua MC, Yao TC, Huang JL, Yeh KW. Cord blood soluble Fas ligand linked to allergic rhinitis and lung function in seven-year-old children. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2021; 55:300-306. [PMID: 33879403 DOI: 10.1016/j.jmii.2021.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Serum or cord blood soluble Fas ligand (FasL) has been related to asthma, allergic rhinitis, and atopic dermatitis in cross-sectional and short-term follow-up studies. However, the association of cord blood soluble FasL with long-term allergic outcomes has seldom been investigated. METHODS The Prediction of Allergies in Taiwanese Children birth cohort study recruited healthy newborns upon delivery. At birth, blood was collected from the umbilical cords of these children, and the cord blood soluble Fas ligand levels were measured. At the age of seven years, the allergic outcome of each child was diagnosed by pediatric allergists and pulmonologists. Tests were conducted to measure the specific immunoglobulin E, fractional exhaled nitric oxide (FeNO), and pulmonary function levels of each child. RESULTS Cord blood soluble FasL levels were higher in seven-year-old children with allergic rhinitis (Odds ratio [OR] = 2.41, p = 0.012) and expiratory airway obstruction (the highest forced expiratory volume in 1 second/forced vital capacity < 90%, OR = 2.11, p = 0.022). The FeNO and Dermatophagoides pteronyssinus-specific immunoglobulin E levels of seven-year-old children were positively correlated with cord blood soluble FasL levels (p = 0.006 and 0.02, respectively). CONCLUSION In this birth cohort, the cord blood soluble FasL levels were associated with allergic rhinitis, obstructive-type lung function, FeNO, and house dust mite sensitization in 7-year-old children. The cord blood soluble FasL level might be used as a predictor for allergic diseases in children who are 7 years old.
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Affiliation(s)
- Kuan-Wen Su
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Yung Chiu
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Division of Pediatric Pulmonology, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Han Tsai
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Sui-Lin Liao
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Li-Chen Chen
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Pediatrics, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, Taiwan
| | - Man-Chin Hua
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Tsung-Chieh Yao
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jing-Long Huang
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Pediatrics, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, Taiwan
| | - Kuo-Wei Yeh
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Infant body mass index trajectories and asthma and lung function. J Allergy Clin Immunol 2021; 148:763-770. [PMID: 33662371 DOI: 10.1016/j.jaci.2021.02.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/10/2021] [Accepted: 02/19/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The impact of early rapid increase in body mass index (BMI) on asthma risk and subsequent lung function remains contentious, with limited prospective studies during a critical window for lung growth. OBJECTIVE Our aim was to investigate the associations between BMI trajectories in the first 2 years of life and adolescent asthma and lung function. METHODS Anthropometric data on 620 infants from the Melbourne Atopy Cohort Study were collected up to 18 times in the first 24 months of the study. BMI trajectories were developed by using group-based trajectory modeling. Associations between these trajectories and spirometry, fractional exhaled nitric oxide level, and current asthma status at 12 and/or 18 years of age were modeled by using multiple linear and logistic regression. RESULTS A total of 5 BMI trajectories were identified. Compared with those children with the "average" trajectory, the children belonging to the "early-low and catch-up" and "persistently high" BMI trajectories were at higher risk of asthma at the age of 18 years (odds ratios = 2.2 [95% CI = 1.0-4.8 and 2.4 [95% CI = 1.1-5.3], respectively). These trajectories were also associated with a lower ratio of FEV1 to forced vital capacity and a higher fractional exhaled nitric oxide levels at age 18 years. In addition, children belonging to the persistently low trajectory had lower FEV1 (β = -183.9 mL [95% CI = -340.9 to -26.9]) and forced vital capacity (β = -207.8 mL [95% CI = -393.6 to -22.0]) values at the age of 18 years. CONCLUSION In this cohort, the early-low and catch-up and persistently high trajectories were associated with asthma and obstructive lung function pattern in adolescence. Having a persistently low BMI at an early age was associated with a restrictive pattern. Thus, maintenance of normal growth patterns may lead to improved adolescent respiratory health.
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Salinas YD, Wang Z, DeWan AT. Discovery and Mediation Analysis of Cross-Phenotype Associations Between Asthma and Body Mass Index in 12q13.2. Am J Epidemiol 2021; 190:85-94. [PMID: 32700739 DOI: 10.1093/aje/kwaa144] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 12/20/2022] Open
Abstract
Twin studies suggest that shared genetics contributes to the comorbidity of asthma and obesity, but candidate-gene studies provide limited evidence of pleiotropy. We conducted genome-wide association analyses of asthma and body mass index (BMI; weight (kg)/height (m)2)) among 305,945 White British subjects recruited into the UK Biobank in 2006-2010. We searched for overlapping signals and conducted mediation analyses on genome-wide-significant cross-phenotype associations, assessing moderation by sex and age at asthma diagnosis, and adjusting for confounders of the asthma-BMI relationship. We identified a genome-wide-significant cross-phenotype association at rs705708 (asthma odds ratio = 1.05, 95% confidence interval: 1.03, 1.07; P = 7.20 × 10-9; and BMI β = -0.065, 95% confidence interval: -0.087, -0.042; P = 1.30 × 10-8). rs705708 resides on 12q13.2, which harbors 9 other asthma- and BMI-associated variants (all P < 5 × 10-5 for asthma; all but one P < 5 × 10-5 for BMI). Follow-up analyses of rs705708 show that most of the BMI association occurred independently of asthma, with consistent magnitude between men and women and persons with and without asthma, irrespective of age at diagnosis; the asthma association was stronger for childhood versus adult asthma; and both associations remained after confounder adjustment. This suggests that 12q13.2 displays pleiotropy for asthma and BMI. Upon further characterization, 12q13.2 might provide a target for interventions that simultaneously prevent or treat asthma and obesity.
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Lai L, Zhang T, Zeng X, Tan W, Cai L, Chen Y. Association between Physician-Diagnosed Asthma and Weight Status among Chinese Children: The Roles of Lifestyle Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051599. [PMID: 32121663 PMCID: PMC7084854 DOI: 10.3390/ijerph17051599] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 02/12/2020] [Accepted: 02/18/2020] [Indexed: 02/07/2023]
Abstract
Childhood asthma and obesity have posed a parallel epidemic over the past few decades. However, whether asthma diagnosis is associated with obesity, and what the roles of lifestyle factors play in this relationship, remained unclarified. This study aimed to investigate the association between asthma and weight status in Chinese children and explore the potential mediating and/or modifying roles of lifestyle factors in the association. In this cross-sectional study, 16,837 children aged 6–12 years were recruited from Guangzhou, China. Participants’ information on physician-diagnosed asthma was collected from parents, and data on physical activity, screen time, and sleeping were reported in a validated questionnaire. Height and weight were objectively measured, and weight status was classified by body mass index (BMI). Multiple logistic regression analysis and mediation analysis were used. Results showed that asthmatic children were at significantly higher risk of obesity (odds ratio (OR) 1.51, 95% confidence interval (CI) 1.03, 2.21) compared with non-asthmatic children. More importantly, this increased risk was even greater in children with moderate-to-vigorous physical activity <60 min/d and children with screen time >2 h/d (both Pinteraction < 0.05). Also, a positive relationship of asthma with overweight was found in children with screen time >2 h/d (OR 3.92, 95% CI 1.56, 9.88), while a negative association was observed between asthma and underweight in children aged 9–12 years (OR 0.23, 95% CI 0.06, 0.92). Mediation analysis indicated that these associations were not mediated by physical activity, screen time, or sleeping. The findings suggested that physician-diagnosed asthma was associated with higher risks of overweight and obesity, and these risks might be exacerbated by insufficient physical activity and prolonged screen time.
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Affiliation(s)
- Lijuan Lai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.L.); (X.Z.)
| | - Ting Zhang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China;
| | - Xia Zeng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.L.); (X.Z.)
| | - Weiqing Tan
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou 510020, China;
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.L.); (X.Z.)
- Correspondence: (Y.C.); (L.C.); Tel.: +86-020-8733-4627 (Y.C.); Fax: +86-020-8733-0446 (Y.C.)
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.L.); (X.Z.)
- Correspondence: (Y.C.); (L.C.); Tel.: +86-020-8733-4627 (Y.C.); Fax: +86-020-8733-0446 (Y.C.)
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Bédard A, Northstone K, Henderson AJ, Shaheen SO. Mediterranean diet during pregnancy and childhood respiratory and atopic outcomes: birth cohort study. Eur Respir J 2020; 55:1901215. [PMID: 31831586 PMCID: PMC7066469 DOI: 10.1183/13993003.01215-2019] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/29/2019] [Indexed: 01/12/2023]
Abstract
Evidence for associations between Mediterranean diet during pregnancy and childhood asthma, allergy and related outcomes is conflicting. Few cohorts have followed children to school age, and none have considered lung function.In the Avon Longitudinal Study of Parents and Children, we analysed associations between maternal Mediterranean diet score during pregnancy (estimated by a food frequency questionnaire, using an a priori defined score adapted to pregnant women; score ranging from 0 (low adherence) to 7 (high adherence)) and current doctor-diagnosed asthma, wheeze, eczema, hay fever, atopy and lung function in 8907 children at 7-9 years. Interaction between maternal Mediterranean diet and maternal smoking in pregnancy was investigated.The maternal Mediterranean diet score was not associated with asthma or other allergic outcomes. Weak positive associations were found between maternal Mediterranean diet score and childhood maximal mid-expiratory flow (forced expiratory flow at 25-75% of forced vital capacity (FEF25-75%)) after controlling for confounders. Higher Mediterranean diet scores were associated with increased FEF25-75% z-scores adjusted for age, height and sex (β 0.06, 95% CI 0.01-0.12; p=0.03, comparing a score of 4-7 versus a score of 0-3). Stratifying associations by maternal smoking during pregnancy showed that associations with FEF25-75% were only seen in children of never-/passive-smoking mothers, but no evidence for a statistically significant interaction was found.Results suggest adherence to a Mediterranean diet during pregnancy may be associated with increased small airway function in childhood, but we found no evidence for a reduced risk of asthma or other allergic outcomes.
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Affiliation(s)
- Annabelle Bédard
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A John Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Seif O Shaheen
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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11
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Associations between Neighborhood Walkability and Incident and Ongoing Asthma in Children. Ann Am Thorac Soc 2019; 15:728-734. [PMID: 29664674 DOI: 10.1513/annalsats.201708-693oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
RATIONALE Childhood asthma has shown variable associations with children's physical activity. Neighborhood walkability captures community features that promote walking and is protective against some chronic conditions, such as obesity and diabetes. OBJECTIVES We evaluated associations between home neighborhood walkability and incident and ongoing childhood asthma. METHODS In this population-based cohort study, we used prospectively collected administrative healthcare data for the Province of Ontario housed at the Institute for Clinical Evaluative Sciences. We followed an administrative data cohort of 326,383 Toronto children born between 1997 and 2003, inclusive, until ages 8-15 years. Home neighborhood walkability quintile was measured using a validated walkability index with four dimensions: population density, dwelling density, access to retail and services, and street connectivity. Incident asthma was defined by time of entry into the validated Ontario Asthma Surveillance Information System database, which requires two outpatient visits for asthma within two consecutive years or any hospitalization for asthma and follows children with asthma longitudinally starting at any age. Associations between walkability and incident asthma were examined using Cox proportional hazards models. Associations between ongoing asthma and walkability in each year of life were examined using generalized linear mixed models. RESULTS Twenty-one percent of children (n = 69,628) developed incident asthma and were followed longitudinally in the Ontario Asthma Surveillance Information System database. Low birth home neighborhood walkability was associated with an increased incidence of asthma (hazard ratio, 1.11; 95% confidence interval, 1.08-1.14). Among children with asthma, low walkability in a given year of a child`s life was associated with greater odds of ongoing asthma in the same year (odds ratio, 1.12; 95% confidence interval, 1.09-1.14). CONCLUSIONS Children living in neighborhoods with low walkability were at increased risk of incident and ongoing asthma. Neighborhood walkability improvement, such as by adding pedestrian paths to improve street connectivity, offers potential strategies to contribute to primary asthma prevention.
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12
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Dietary Acid Load: A Novel Nutritional Target in Overweight/Obese Children with Asthma? Nutrients 2019; 11:nu11092255. [PMID: 31546888 PMCID: PMC6770083 DOI: 10.3390/nu11092255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/10/2019] [Accepted: 09/12/2019] [Indexed: 01/16/2023] Open
Abstract
Obesity has been repeatedly linked to asthma, and several potential mechanisms have been proposed in the etiologies of the obese-asthma phenotype. Considering that lungs play an important role in systemic pH and acid–base regulation, are a key organ in asthma development, and that nutritional inadequacy of several nutrients and high dietary acid load can affect airway inflammation and reactivity, we aimed to test the hypothesis that dietary acid load may be associated with asthma in children. Data on 699 children (52% females), aged 7–12 years, were analyzed. Anthropometric measurements were performed to assess body mass index. Dietary acid load was calculated using potential renal acid load (PRAL) equations from a 24 h dietary recall administrated to children. Adjusted PRAL for total energy intake was applied with the use of the residual method. Lung function and airway reversibility were assessed with spirometry. Asthma was defined by a positive bronchodilation or self-reported medical diagnosis with reported symptoms (wheezing, dyspnea, or dry cough) in the past 12 months. After adjustment for energy intake, sex, age, parent’s education level, and physical activity, positive and significant associations were found between asthma and PRAL [odds ratio (OR) = 1.953, 95% CI = 1.024, 3.730) in overweight/obese children. Our findings suggest that dietary acid load might be a possible mechanism in overweight/obese-asthma phenotype development.
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13
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Obesity and adiposity indicators in asthma and allergic rhinitis in children. Curr Opin Allergy Clin Immunol 2019; 19:7-11. [PMID: 30507714 DOI: 10.1097/aci.0000000000000504] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW The prevalence of obesity and allergic diseases, such as asthma and allergic rhinitis, is increasing worldwide not only in adults, but also in children. Experimental and clinical studies have demonstrated the effect of obesity not only on asthma, but also on other allergic diseases. RECENT FINDINGS Allergic diseases, such as asthma and allergic rhinitis, are common chronic inflammatory diseases of the airways. Obesity is an increasingly common pediatric disease and is a risk factor for the development of asthma in that obese patients with asthma tend to have more severe asthma that does not respond well to standard asthma therapy. On the contrary, children with asthma maybe at a high risk of obesity, suggesting that the relationship of asthma and obesity seems to be interrelated. The role of obesity on the development of allergic rhinitis is not well defined, whereas allergic rhinitis may have an impact on obesity. SUMMARY Childhood obesity is often considered to be less serious than obesity in adults because of the greater risk of complications in obese adults. In this review, we discuss the allergic confounders of obesity and the impact of allergic diseases on obesity. Proper control of the BMI within the normal range in children with allergic diseases is important.
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14
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Huang X, Mu X, Deng L, Fu A, Pu E, Tang T, Kong X. The etiologic origins for chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2019; 14:1139-1158. [PMID: 31213794 PMCID: PMC6549659 DOI: 10.2147/copd.s203215] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/18/2019] [Indexed: 12/27/2022] Open
Abstract
COPD, characterized by long-term poorly irreversible airway limitation and persistent respiratory symptoms, has resulted in enormous challenges to human health worldwide, with increasing rates of prevalence, death, and disability. Although its origin was thought to be in the interactions of genetic with environmental factors, the effects of environmental factors on the disease during different life stages remain little known. Without clear mechanisms and radical cure for it, early screening and prevention of COPD seem to be important. In this review, we will discuss the etiologic origins for poor lung function and COPD caused by specific adverse effects during corresponding life stages, as well as try to find new insights and potential prevention strategies for this disease.
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Affiliation(s)
- Xinwei Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China.,Medical School, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
| | - Xi Mu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
| | - Li Deng
- The Pathology Department, First People's Hospital of Yunnan Province, Kunming City, Yunnan Province, People's Republic of China
| | - Aili Fu
- Department of Oncology, Yunfeng Hospital, Xuanwei City, Yunnan Province, People's Republic of China
| | - Endong Pu
- Department of Thoracic Surgery, Yunfeng Hospital, Xuanwei City, Yunnan Province, People's Republic of China
| | - Tao Tang
- Medical School, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
| | - Xiangyang Kong
- Medical School, Kunming University of Science and Technology, Kunming City, Yunnan Province, People's Republic of China
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15
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Krajewska Wojciechowska J, Krajewski W, Zatoński T. The Association Between ENT Diseases and Obesity in Pediatric Population: A Systemic Review of Current Knowledge. EAR, NOSE & THROAT JOURNAL 2019; 98:E32-E43. [PMID: 30966807 DOI: 10.1177/0145561319840819] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Obesity in pediatric population is an important global problem. The prevalence of obesity in children is dramatically rising. According to World Health Organization, about 41 million children under the age of 5 years are obese or overweight worldwide. Overweight and obesity are well-known risk factors for a number of health disorders. Diseases commonly observed in this group of patients are metabolic disorders, type 2 diabetes mellitus, cardiovascular diseases, fatty liver disease, musculoskeletal problems, and many others. The main aim of this study was to present the current knowledge of the association between childhood obesity and common otorhinolaryngological disorders. It is suggested that obese children are more prone to suffer from otorhinolaryngological illnesses than the lean ones. Obesity may predispose to otorhinolaryngological diseases in various ways. It strongly interferes with the immune system (increases serum levels of interleukin 6, tumor necrosis factor, C-reactive protein, and leptin and reduces adiponectin concentration) affecting organs of the upper respiratory tract. Additionally, obesity induces mechanical disorders in the upper airways. According to our review, obesity predisposes to otitis media with effusion, acute otitis media, recurrent otitis media, obstructive sleep apnea, sensorineural hearing loss, adenotonsillar hypertrophy, and post-/perioperative complications after adenotonsillectomy. Obesity in children significantly correlates with both obstructive sleep apnea (OSA) and asthma and constitutes a significant component of "OSA, obesity, asthma" triad.
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Affiliation(s)
| | - Wojciech Krajewski
- 2 Department and Clinic of Urology, Medical University in Wrocław, Wrocław, Poland
| | - Tomasz Zatoński
- 1 Department and Clinic of Otolaryngology, Head and Neck Surgery, Medical University in Wrocław, Wrocław, Poland
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16
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Adeyeye TE, Yeung EH, McLain AC, Lin S, Lawrence DA, Bell EM. Wheeze and Food Allergies in Children Born via Cesarean Delivery: The Upstate KIDS Study. Am J Epidemiol 2019; 188:355-362. [PMID: 30475936 PMCID: PMC6357798 DOI: 10.1093/aje/kwy257] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 12/16/2022] Open
Abstract
We examined whether cesarean delivery (CD) increased the risk of wheeze or food allergy in early childhood compared with vaginal delivery and whether these associations were mediated by breastfeeding. The study population was the Upstate KIDS cohort (2008-2010) of mothers and infants from the State of New York (excluding New York City). Infant's wheeze was reported by questionnaire every 4-6 months until 3 years of age, as were food allergies beginning at 8 months. Modified Poisson regression was used to compare risks of the outcomes according to mode of delivery (MOD). Potential confounders were identified a priori using directed acyclic graphs. Emergency CD (n = 1,356) was associated with elevated risk of wheeze, adjusting for pregnancy complications, maternal atopy, gestational age, birth weight, and smoking during pregnancy (risk ratio = 2.47, 95% confidence interval: 1.31, 4.66), and an increased risk of food allergy, adjusting for maternal atopy, prepregnancy body mass index, smoking during pregnancy, and parity (risk ratio = 3.02, 95% confidence interval: 1.26, 7.25). Neither outcome was significantly associated with planned CD (n = 1,565 infants). Breastfeeding mediated the association between MOD and wheeze but not food allergy. Other factors not associated with early-life microbial transfer, but relating to the development of the outcomes, might contribute to the association between MOD and wheeze/food allergy.
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Affiliation(s)
- Temilayo E Adeyeye
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Albany, New York
- New York State Department of Health, Albany, New York
- Health Research Incorporated, Menands, New York
| | - Edwina H Yeung
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Albany, New York
| | - David A Lawrence
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Albany, New York
- New York State Department of Health, Albany, New York
- Health Research Incorporated, Menands, New York
| | - Erin M Bell
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Albany, New York
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17
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Peak flow variability in childhood and body mass index in adult life. J Allergy Clin Immunol 2018; 143:1224-1226.e9. [PMID: 30414860 DOI: 10.1016/j.jaci.2018.10.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 08/31/2018] [Accepted: 10/05/2018] [Indexed: 12/24/2022]
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18
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Liang L, Hur J, Kang JY, Rhee CK, Kim YK, Lee SY. Effect of the anti-IL-17 antibody on allergic inflammation in an obesity-related asthma model. Korean J Intern Med 2018; 33:1210-1223. [PMID: 29665658 PMCID: PMC6234391 DOI: 10.3904/kjim.2017.207] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 09/29/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS The co-occurrence of obesity aggravates asthma symptoms. Diet-induced obesity increases helper T cell (TH) 17 cell differentiation in adipose tissue and the spleen. The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor pravastatin can potentially be used to treat asthma in obese patients by inhibiting interleukin 17 (IL-17) expression. This study investigated the combined effects of pravastatin and anti-IL-17 antibody treatment on allergic inflammation in a mouse model of obesity-related asthma. METHODS High-fat diet (HFD)-induced obesity was induced in C57BL/6 mice with or without ovalbumin (OVA) sensitization and challenge. Mice were administered the anti-IL-17 antibody, pravastatin, or both, and pathophysiological and immunological responses were analyzed. RESULTS HFD exacerbated allergic airway inflammation in the bronchoalveolar lavage fluid of HFD-OVA mice as compared to OVA mice. Blockading of the IL-17 in the HFD-OVA mice decreased airway hyper-responsiveness (AHR) and airway inflammation compared to the HFD-OVA mice. Moreover, the administration of the anti-IL-17 antibody decreased the leptin/adiponectin ratio in the HFD-OVA but not the OVA mice. Co-administration of pravastatin and anti-IL-17 inhibited airway inflammation and AHR, decreased goblet cell numbers, and increased adipokine levels in obese asthmatic mice. CONCLUSION These results suggest that the IL-17-leptin/adiponectin axis plays a key role in airway inflammation in obesity-related asthma. Our findings suggest a potential new treatment for IL-17 as a target that may benefit obesity-related asthma patients who respond poorly to typical asthma medications.
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Affiliation(s)
- Lin Liang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jung Hur
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Ji Young Kang
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Young Kyoon Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Sook Young Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
- Correspondence to Sook Young Lee, M.D. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea Tel: +82-2-2258-6061 Fax: +82-2-2258-1219 E-mail:
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19
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Contreras ZA, Chen Z, Roumeliotaki T, Annesi-Maesano I, Baïz N, von Berg A, Bergström A, Crozier S, Duijts L, Ekström S, Eller E, Fantini MP, Kjaer HF, Forastiere F, Gerhard B, Gori D, Harskamp-van Ginkel MW, Heinrich J, Iñiguez C, Inskip H, Keil T, Kogevinas M, Lau S, Lehmann I, Maier D, van Meel ER, Mommers M, Murcia M, Porta D, Smit HA, Standl M, Stratakis N, Sunyer J, Thijs C, Torrent M, Vrijkotte TGM, Wijga AH, Berhane K, Gilliland F, Chatzi L. Does early onset asthma increase childhood obesity risk? A pooled analysis of 16 European cohorts. Eur Respir J 2018; 52:13993003.00504-2018. [PMID: 30209194 DOI: 10.1183/13993003.00504-2018] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/30/2018] [Indexed: 12/17/2022]
Abstract
The parallel epidemics of childhood asthma and obesity over the past few decades have spurred research into obesity as a risk factor for asthma. However, little is known regarding the role of asthma in obesity incidence. We examined whether early-onset asthma and related phenotypes are associated with the risk of developing obesity in childhood.This study includes 21 130 children born from 1990 to 2008 in Denmark, France, Germany, Greece, Italy, The Netherlands, Spain, Sweden and the UK. We followed non-obese children at 3-4 years of age for incident obesity up to 8 years of age. Physician-diagnosed asthma, wheezing and allergic rhinitis were assessed up to 3-4 years of age.Children with physician-diagnosed asthma had a higher risk for incident obesity than those without asthma (adjusted hazard ratio (aHR) 1.66, 95% CI 1.18-2.33). Children with active asthma (wheeze in the last 12 months and physician-diagnosed asthma) exhibited a higher risk for obesity (aHR 1.98, 95% CI 1.31-3.00) than those without wheeze and asthma. Persistent wheezing was associated with increased risk for incident obesity compared to never wheezers (aHR 1.51, 95% CI 1.08-2.09).Early-onset asthma and wheezing may contribute to an increased risk of developing obesity in later childhood.
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Affiliation(s)
- Zuelma A Contreras
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zhanghua Chen
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Isabella Annesi-Maesano
- Dept of Epidemiology of Allergic and Respiratory Diseases, IPLESP, INSERM, UPMC, Medical School Saint-Antoine, Paris, France
| | - Nour Baïz
- Dept of Epidemiology of Allergic and Respiratory Diseases, IPLESP, INSERM, UPMC, Medical School Saint-Antoine, Paris, France
| | | | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.,Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Sarah Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Liesbeth Duijts
- Dept of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Dept of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Dept of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Esben Eller
- Dept of Dermatology and Allergy Center, Odense Research Centre for Anaphylaxis (ORCA), Odense, Denmark
| | - Maria P Fantini
- Dept of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Henrik Fomsgaard Kjaer
- Dept of Dermatology and Allergy Center, Odense Research Centre for Anaphylaxis (ORCA), Odense, Denmark
| | | | | | - Davide Gori
- Dept of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Margreet W Harskamp-van Ginkel
- Dept of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich (LMU), Munich, Germany
| | - Carmen Iñiguez
- Dept of Statistics and Operational Research, University of Valencia, Valencia, Spain.,Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, Southampton, UK
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Susanne Lau
- Dept of Paediatric Pneumology and Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Irina Lehmann
- Dept of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany
| | | | - Evelien R van Meel
- Dept of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Dept of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Monique Mommers
- Dept of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Mario Murcia
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Daniela Porta
- Dept of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Henriëtte A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Nikos Stratakis
- Dept of Social Medicine, University of Crete, Heraklion, Greece.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Carel Thijs
- Dept of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Tanja G M Vrijkotte
- Dept of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Alet H Wijga
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Kiros Berhane
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Frank Gilliland
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Leda Chatzi
- Dept of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.,Dept of Social Medicine, University of Crete, Heraklion, Greece.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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20
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Bédard A, Northstone K, Holloway JW, Henderson AJ, Shaheen SO. Maternal dietary antioxidant intake in pregnancy and childhood respiratory and atopic outcomes: birth cohort study. Eur Respir J 2018; 52:13993003.00507-2018. [PMID: 30093569 PMCID: PMC6383601 DOI: 10.1183/13993003.00507-2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/16/2018] [Indexed: 11/25/2022]
Abstract
Evidence for a possible protective effect of maternal dietary antioxidant intake during pregnancy on childhood asthma and other atopic outcomes is conflicting, and associations with childhood lung function have been little studied. In the Avon Longitudinal Study of Parents and Children, we analysed associations between maternal intake of fruits, vegetables, vitamins C and E, carotene, zinc, and selenium in pregnancy and current doctor-diagnosed asthma, atopy and lung function in 8915 children at age 7–9 years. Potential modification of associations by maternal smoking and common maternal antioxidant gene polymorphisms was explored to strengthen causal inference. After controlling for confounders, positive associations were observed between maternal intake of zinc and childhood forced expiratory volume in 1 s and forced vital capacity (difference in age-, height- and sex-adjusted sd units per quartile increase in maternal dietary zinc intake β 0.05 (95% CI 0.01–0.08); ptrend=0.01 and 0.05 (95% CI 0.02–0.09); ptrend=0.005, respectively). Weak evidence was found for an interaction between maternal zinc intake and maternal glutathione S-transferase GSTM1 genotype on childhood forced vital capacity (pinteraction=0.05); association among the GSTM1 null group β 0.11 (95% CI 0.05–0.17); ptrend=0.001. Our results suggest that a higher maternal intake of zinc during pregnancy may be associated with better lung function in the offspring. A higher maternal intake of zinc during pregnancy may improve lung function, and especially forced vital capacity, in the offspringhttp://ow.ly/oTt030l1rew
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Affiliation(s)
- Annabelle Bédard
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A John Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,These authors are joint senior authors
| | - Seif O Shaheen
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,These authors are joint senior authors
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21
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Matsumoto M, Konno S, Kimura H, Takei N, Kimura H, Shimizu K, Goudarzi H, Suzuki M, Hashino S, Nishimura M. Associations of Current Wheeze and Body Mass Index with Perennial and Seasonal Allergic Rhinitis in Young Adults. Int Arch Allergy Immunol 2018; 176:143-149. [PMID: 29768270 DOI: 10.1159/000488329] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/12/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The coexistence of asthma and allergic rhinitis (AR) and its distinct association with obesity have been reported. However, few studies have differentiated the two types of AR, i.e., perennial (PAR) and seasonal AR (SAR), with regard to their associations with asthma and obesity. The aim of this study was to evaluate the coexistence of current wheeze and two types of AR and the impact of body mass index (BMI) on these two conditions in Japanese young adults. METHODS First-year students from Hokkaido University were enrolled into this study from 2011 to 2016. A questionnaire survey including the prevalence of current wheeze, PAR, and SAR every year for 11,917 nonsmoking young adults was conducted. The difference in the impact of current wheeze and BMI on these two types of AR was separately evaluated. RESULTS Although both PAR and SAR were significantly associated with current wheeze, the impact of these two AR types on current wheeze was different (OR for PAR = 2.46 vs. OR for SAR = 1.29). When we classified all of the subjects into 4 groups with or/and without the two types of AR, the prevalence of current wheeze was significantly higher in subjects with PAR than in those without PAR (p < 0.001). However, the prevalence of current wheeze did not differ between subjects with or without SAR. Multinomial regression analyses showed that the association of wheeze with PAR and/or SAR was stronger compared to that of wheeze with SAR without PAR. The prevalence of PAR was not associated with BMI. Contrarily, a low BMI was significantly associated with a high SAR prevalence (p < 0.05). CONCLUSION Comparisons between PAR and SAR showed that the conditions are differentially associated with current wheeze and BMI.
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Affiliation(s)
- Munehiro Matsumoto
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hirokazu Kimura
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nozomu Takei
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroki Kimura
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kaoruko Shimizu
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Houman Goudarzi
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaru Suzuki
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Masaharu Nishimura
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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22
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Pinto LA, Guerra S, Anto JM, Postma D, Koppelman GH, de Jongste JC, Gehring U, Smit HA, Wijga AH. Increased risk of asthma in overweight children born large for gestational age. Clin Exp Allergy 2018; 47:1050-1056. [PMID: 28599075 DOI: 10.1111/cea.12961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/09/2017] [Accepted: 05/10/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Being born large for gestational age (LGA) is a marker of increased growth velocity in fetal life and a risk factor for childhood overweight. Both being born LGA and childhood overweight may influence the development of asthma, although the role of overweight in the association between LGA and childhood asthma is unclear. Importantly, recent studies have suggested that the association between overweight and asthma may be related to non-allergic pathways. If this also applies to the association between LGA and asthma, the association between being born LGA and asthma may be different for atopic and non-atopic children. OBJECTIVE We investigated the association of being LGA with the prevalence of asthma at age 8 in atopic and non-atopic children and the role of overweight in this association. METHODS Complete data on asthma, anthropometry and atopy at age of 8 years, and potential confounders were available for 1608 participants of the PIAMA birth cohort. Odds ratios for the association between LGA and asthma in atopic and non-atopic children were estimated by logistic regression analysis adjusting for potential confounders. Overweight was assessed as a potential modifier of the association between LGA and asthma. RESULTS Being born LGA was not significantly associated with asthma at age of 8 in atopic and non-atopic children. However, overweight at age of 8 years modified the association between asthma at age of 8 and LGA. In non-atopic children, children who were born LGA and were overweight at age of 8 years had a significantly increased odds of asthma compared to non-LGA, non-overweight children (adj OR 7.04; 95% CI 2.2-24). CONCLUSIONS We observed that non-atopic children born LGA, who were overweight by 8 years have an increased risk of asthma. If confirmed, these findings suggest that non-atopic children born LGA may be identified early in life as a high-risk group for asthma.
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Affiliation(s)
- L A Pinto
- ISGlobal, Centre for Research and Environmental Epidemiology (CREAL), Barcelona, Spain.,Centro Infant, Institute of Biomedical Research, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - S Guerra
- ISGlobal, Centre for Research and Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - J M Anto
- ISGlobal, Centre for Research and Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - D Postma
- Department of Pulmonology, GRIAC Research Institute, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - G H Koppelman
- Paediatric Pulmonology and Pediatric Allergology, Groningen Research Institute for Asthma and COPD, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J C de Jongste
- Department of Paediatrics, Division Paediatric Respiratory Medicine, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - U Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - H A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - A H Wijga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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23
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Wright LS, Rifas-Shiman SL, Oken E, Litonjua AA, Gold DR. Prenatal and Early Life Fructose, Fructose-Containing Beverages, and Midchildhood Asthma. Ann Am Thorac Soc 2018; 15:217-224. [PMID: 29219619 PMCID: PMC5802621 DOI: 10.1513/annalsats.201707-530oc] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 12/08/2017] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Cross-sectional studies have linked intake of high-fructose corn syrup-sweetened beverages with asthma in schoolchildren. OBJECTIVES To examine associations of maternal prenatal and early childhood intake of sugar-sweetened beverages and fructose with current asthma in midchildhood (median age, 7.7 yr). METHODS We assessed maternal pregnancy (first- and second-trimester average) and child (median age, 3.3 yr) intake of sugar-sweetened beverages and total fructose using food frequency questionnaires in 1,068 mother-child pairs from Project Viva, a prospective prebirth cohort. In a multivariable analysis, we examined associations of quartiles of maternal and child sugar-sweetened beverage, juice, and total fructose intake with child current asthma in midchildhood, assessed by questionnaire as ever having doctor-diagnosed asthma plus taking asthma medications or reporting wheezing in the past 12 months. RESULTS Higher maternal pregnancy sugar-sweetened beverage consumption (mean, 0.6 servings/d; range, 0-5) was associated with younger maternal age, nonwhite race/ethnicity, lower education and income, and higher prepregnancy body mass index. Adjusting for prepregnancy body mass index and other covariates, comparing quartile 4 with quartile 1, higher maternal pregnancy intake of sugar-sweetened beverages (odds ratio, 1.70; 95% confidence interval, 1.08-2.67) and total fructose (odds ratio, 1.58; 95% confidence interval, 0.98-2.53) were associated with greater odds of midchildhood current asthma (prevalence, 19%). Higher early childhood fructose intake (quartile 4 vs. quartile 1) was also associated with midchildhood current asthma in models adjusted for maternal sugar-sweetened beverages (odds ratio, 1.79; 95% confidence interval, 1.07-2.97) and after additional adjustment for midchildhood body mass index z-score (odds ratio, 1.77; 95% confidence interval, 1.06-2.95). CONCLUSIONS Higher sugar-sweetened beverage and fructose intake during pregnancy and in early childhood was associated with childhood asthma development independent of adiposity.
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Affiliation(s)
- Lakiea S. Wright
- Division of Rheumatology, Immunology, and Allergy
- Division of Immunology, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts; and
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Augusto A. Litonjua
- Channing Division of Network Medicine, and
- Division of Pulmonary and Critical Care, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Diane R. Gold
- Channing Division of Network Medicine, and
- Division of Pulmonary and Critical Care, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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24
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Okubo Y, Michihata N, Yoshida K, Morisaki N, Matsui H, Fushimi K, Yasunaga H. Impact of pediatric obesity on acute asthma exacerbation in Japan. Pediatr Allergy Immunol 2017; 28:763-767. [PMID: 29044803 DOI: 10.1111/pai.12801] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Asthma and obesity are common health problems in children. This study investigated the impact of obesity on children hospitalized with acute asthma exacerbation. METHODS We obtained the hospital discharge records of inpatients aged 3-8 years with a diagnosis of asthma using a national inpatient database in Japan. The patients were classified into underweight, normal weight, overweight, and obese groups using weight for height and body mass index for age provided by the World Health Organization. We compared 30-day re-admission, need for intensive care, mean total hospitalization costs, and length of hospital stay between the 4 groups using multivariable regression models. RESULTS Overall, 38 679 patients were identified, including 3177 underweight, 28 904 normal weight, 3334 overweight, and 3264 obese patients. The obese group showed significantly higher 30-day re-admission (adjusted odds ratio, 1.26; 95% confidence interval, 1.03-1.54) and longer length of stay (adjusted difference, 0.12 days; 95% confidence interval, 0.10-0.20 days) than the normal weight group. The threshold was a 91st percentile of weight for length or body mass index for the relationship with 30-day re-admission. No significant difference was observed between the 4 groups regarding the need for intensive care and total hospitalization costs. CONCLUSION These findings demonstrated that obesity was a risk factor for repeated admissions caused by asthma in children, indicating the importance for the prevention of pediatric obesity.
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Affiliation(s)
- Yusuke Okubo
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Epidemiology, UCLA Fielding School of Public Health, Tokyo, Japan
| | - Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichi Yoshida
- Division of Allergy, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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25
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Bédard A, Northstone K, Henderson AJ, Shaheen SO. Maternal intake of sugar during pregnancy and childhood respiratory and atopic outcomes. Eur Respir J 2017; 50:50/1/1700073. [PMID: 28679610 PMCID: PMC5540678 DOI: 10.1183/13993003.00073-2017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/05/2017] [Indexed: 11/17/2022]
Abstract
The possible role of maternal consumption of free sugar during pregnancy in the inception of respiratory and atopic diseases has not been studied. We aimed to study the relationship between maternal intake of free sugar during pregnancy and respiratory and atopic outcomes in the offspring in a population-based birth cohort, the Avon Longitudinal Study of Parents and Children. We analysed associations between maternal intake of free sugar in pregnancy (estimated by a food frequency questionnaire), and current doctor-diagnosed asthma, wheezing, hay fever, eczema, atopy, serum total IgE and lung function in children aged 7–9 years (n=8956 with information on maternal diet in pregnancy and at least one outcome of interest). After controlling for potential confounders, maternal intake of free sugar was positively associated with atopy (OR for highest versus lowest quintile of sugar intake 1.38, 95% CI 1.06–1.78; per quintile p-trend=0.006) and atopic asthma (OR 2.01, 95% CI 1.23–3.29; per quintile p-trend=0.004). These associations were not confounded by intake of sugar in early childhood, which was unrelated to these outcomes. Our results suggest that a higher maternal intake of free sugar during pregnancy is associated with an increased risk of atopy and atopic asthma in the offspring, independently of sugar intake in early childhood. Higher maternal intake of sugar in pregnancy may increase the risk of allergy and allergic asthma in the offspringhttp://ow.ly/zehc30bFswP
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Affiliation(s)
- Annabelle Bédard
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kate Northstone
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK.,Joint senior authors
| | - Seif O Shaheen
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Joint senior authors
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26
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Edwards MR, Saglani S, Schwarze J, Skevaki C, Smith JA, Ainsworth B, Almond M, Andreakos E, Belvisi MG, Chung KF, Cookson W, Cullinan P, Hawrylowicz C, Lommatzsch M, Jackson D, Lutter R, Marsland B, Moffatt M, Thomas M, Virchow JC, Xanthou G, Edwards J, Walker S, Johnston SL. Addressing unmet needs in understanding asthma mechanisms: From the European Asthma Research and Innovation Partnership (EARIP) Work Package (WP)2 collaborators. Eur Respir J 2017; 49:49/5/1602448. [PMID: 28461300 DOI: 10.1183/13993003.02448-2016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/13/2017] [Indexed: 12/27/2022]
Abstract
Asthma is a heterogeneous, complex disease with clinical phenotypes that incorporate persistent symptoms and acute exacerbations. It affects many millions of Europeans throughout their education and working lives and puts a heavy cost on European productivity. There is a wide spectrum of disease severity and control. Therapeutic advances have been slow despite greater understanding of basic mechanisms and the lack of satisfactory preventative and disease modifying management for asthma constitutes a significant unmet clinical need. Preventing, treating and ultimately curing asthma requires co-ordinated research and innovation across Europe. The European Asthma Research and Innovation Partnership (EARIP) is an FP7-funded programme which has taken a co-ordinated and integrated approach to analysing the future of asthma research and development. This report aims to identify the mechanistic areas in which investment is required to bring about significant improvements in asthma outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rene Lutter
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Benjamin Marsland
- University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | | | | | - Georgina Xanthou
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
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27
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Association between obesity and asthma - epidemiology, pathophysiology and clinical profile. Nutr Res Rev 2016; 29:194-201. [PMID: 27514726 DOI: 10.1017/s0954422416000111] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Obesity is a risk factor for asthma, and obese asthmatics have lower disease control and increased symptom severity. Several putative links have been proposed, including genetics, mechanical restriction of the chest and the intake of corticosteroids. The most consistent evidence, however, comes from studies of cytokines produced by the adipose tissue called adipokines. Adipokine imbalance is associated with both proinflammatory status and asthma. Although reverse causation has been proposed, it is now acknowledged that obesity precedes asthma symptoms. Nevertheless, prenatal origins of both conditions complicate the search for causality. There is a confirmed role of neuro-immune cross-talk mediating obesity-induced asthma, with leptin playing a key role in these processes. Obesity-induced asthma is now considered a distinct asthma phenotype. In fact, it is one of the most important determinants of asthma phenotypes. Two main subphenotypes have been distinguished. The first phenotype, which affects adult women, is characterised by later onset and is more likely to be non-atopic. The childhood obesity-induced asthma phenotype is characterised by primary and predominantly atopic asthma. In obesity-induced asthma, the immune responses are shifted towards T helper (Th) 1 polarisation rather than the typical atopic Th2 immunological profile. Moreover, obese asthmatics might respond differently to environmental triggers. The high cost of treatment of obesity-related asthma, and the burden it causes for the patients and their families call for urgent intervention. Phenotype-specific approaches seem to be crucial for the success of prevention and treatment.
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28
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Yiallouros PK, Kouis P, Kolokotroni O, Youhanna S, Savva SC, Dima K, Zerva A, Platt D, Middleton N, Zalloua P. Shared genetic variants between serum levels of high-density lipoprotein cholesterol and wheezing in a cohort of children from Cyprus. Ital J Pediatr 2016; 42:67. [PMID: 27411394 PMCID: PMC4944514 DOI: 10.1186/s13052-016-0276-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 07/03/2016] [Indexed: 02/07/2023] Open
Abstract
Background In a cohort of children in Cyprus, we recently reported low levels of high density lipoprotein cholesterol (HDL-C) to be associated with asthma. We examined whether genetic polymorphisms that were previously linked individually to asthma, obesity, or HDL-C are associated with both asthma and HDL-C levels in the Cyprus cohort. Methods We assessed genotypes frequencies in current-wheezers (n = 190) and non-asthmatic controls (n = 671) and HDL-C levels across several genotypes. Binary logistic regression models were used to assess the effect of genotypes on wheezing risk and examined whether this effect is carried out through changes of HDL–C. Results Of the 16 polymorphisms tested, two polymorphisms TNFa rs3093664 and PRKCA rs9892651 presented significant differences in genotype distribution among current-wheezers and controls. Higher HDL-C levels were noted in carriers of genotype GG of polymorphism TNFa rs3093664 that was protective for wheezing Vs AG and AA genotypes (65.3 Vs 51.8 and 53.3 mg/dl, p-value < 0.001 and p-value for trend = 0.028). In polymorphism PRKCA rs9892651, HDL-C levels were lower in carriers of CC and TC genotypes that were more frequent in current-wheezers Vs TT genotype (52.2 and 52.7 Vs 55.2 mg/dl, p-value = 0.042 and p-value for trend = 0.02). The association of TNFa rs3093664 with wheezing is partly mediated by its effect on HDL-C whereas association of PRKCA rs9892651 with wheezing appeared to be independent of HDL-C. Conclusions We found evidence that two SNPs located in different genetic loci, are associated with both wheezing and HDL-C levels, although more studies in other populations are needed to confirm our results. Electronic supplementary material The online version of this article (doi:10.1186/s13052-016-0276-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Panayiotis K Yiallouros
- Medical School, University of Cyprus, Nicosia, Cyprus.,Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Panayiotis Kouis
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.
| | - Ourania Kolokotroni
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.,Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.,St George University of London Medical School at the University of Nicosia, Nicosia, Cyprus
| | - Sonia Youhanna
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Savvas C Savva
- Research and Education Institute of Child Health, Nicosia, Cyprus
| | - Kleanthi Dima
- Department of Biochemistry, Attikon University Hospital, Athens, Greece
| | - Aikaterini Zerva
- Department of Biochemistry, Attikon University Hospital, Athens, Greece
| | - Danielle Platt
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Pierre Zalloua
- Lebanese American University, School of Medicine, Beirut, Lebanon
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29
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Okubo Y, Nochioka K, Hataya H, Sakakibara H, Terakawa T, Testa M. Burden of Obesity on Pediatric Inpatients with Acute Asthma Exacerbation in the United States. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 4:1227-1231. [PMID: 27372599 DOI: 10.1016/j.jaip.2016.06.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/25/2016] [Accepted: 06/07/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Obesity and asthma are common health problems in the United States. OBJECTIVE The objective of this study was to evaluate the clinical and economic burdens of obesity on hospitalized children with acute asthma exacerbation in 2012. METHODS Hospital discharge records of patients aged 2 to 18 years with a diagnosis of asthma were obtained from the 2012 Kids' Inpatient Database, wherein the data were compiled by the Agency for Healthcare Research and Quality. The discharge records were weighted to estimate the number of hospitalizations because of asthma exacerbations in the United States. To classify whether the patient was obese or not, we used the International Classification of Diseases, Ninth Revision, Clinical Modification code 278.0x. We compared the odds of using noninvasive or invasive mechanical ventilation, mean total charges for inpatient service, and length of hospital stay between obese and nonobese patients. RESULTS A total of 74,338 patient discharges were extracted. Of these, 3,494 discharges were excluded because of chronic medical conditions. Using discharge weight variables, we estimated a total of 100,157 hospitalizations with asthma exacerbations among children aged between 2 and 18 years in 2012. Obesity was significantly associated with higher odds of using mechanical ventilation (odds ratio 1.59, 95% CI 1.28-1.99), higher mean total hospital charges (adjusted difference: $1588, 95% CI $802-$2529), and longer mean length of hospital stay (0.24 days, 95% CI 0.17-0.32 days) compared with nonobesity. CONCLUSIONS These findings suggest that obesity is a significant risk factor of severe asthma exacerbation that requires mechanical ventilation, and obesity is an economically complicating factor.
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Affiliation(s)
- Yusuke Okubo
- Quantitative Methods, Harvard T.H. Chan School of Public Health, Boston, Mass; Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan.
| | - Kotaro Nochioka
- Quantitative Methods, Harvard T.H. Chan School of Public Health, Boston, Mass; Clinical Effectiveness, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Hiroshi Hataya
- Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Hiroshi Sakakibara
- Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Toshiro Terakawa
- Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Marcia Testa
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass
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30
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Melnik BC, John SM, Carrera-Bastos P, Schmitz G. Milk: a postnatal imprinting system stabilizing FoxP3 expression and regulatory T cell differentiation. Clin Transl Allergy 2016; 6:18. [PMID: 27175277 PMCID: PMC4864898 DOI: 10.1186/s13601-016-0108-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/19/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Breastfeeding has protective effects for the development of allergies and atopy. Recent evidence underlines that consumption of unboiled farm milk in early life is a key factor preventing the development of atopic diseases. Farm milk intake has been associated with increased demethylation of FOXP3 and increased numbers of regulatory T cells (Tregs). Thus, the questions arose which components of farm milk control the differentiation and function of Tregs, critical T cell subsets that promote tolerance induction and inhibit the development of allergy and autoimmunity. FINDINGS Based on translational research we identified at least six major signalling pathways that could explain milk's biological role controlling stable FoxP3 expression and Treg differentiation: (1) via maintaining appropriate magnitudes of Akt-mTORC1 signalling, (2) via transfer of milk fat-derived long-chain ω-3 fatty acids, (3) via transfer of milk-derived exosomal microRNAs that apparently decrease FOXP3 promoter methylation, (4) via transfer of exosomal transforming growth factor-β, which induces SMAD2/SMAD3-dependent FoxP3 expression, (5) via milk-derived Bifidobacterium and Lactobacillus species that induce interleukin-10 (IL-10)-mediated differentiation of Tregs, and (6) via milk-derived oligosaccharides that serve as selected nutrients for the growth of bifidobacteria in the intestine of the new born infant. CONCLUSION Accumulating evidence underlines that milk is a complex signalling and epigenetic imprinting network that promotes stable FoxP3 expression and long-lasting Treg differentiation, crucial postnatal events preventing atopic and autoimmune diseases.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Sedanstrasse 115, 49090 Osnabrück, Germany
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Sedanstrasse 115, 49090 Osnabrück, Germany
| | | | - Gerd Schmitz
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, University of Regensburg, Josef-Strauss-Allee 11, 93053 Regensburg, Germany
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31
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Vijayakanthi N, Greally JM, Rastogi D. Pediatric Obesity-Related Asthma: The Role of Metabolic Dysregulation. Pediatrics 2016; 137:peds.2015-0812. [PMID: 27244776 PMCID: PMC4845863 DOI: 10.1542/peds.2015-0812] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 12/15/2022] Open
Abstract
The burden of obesity-related asthma among children, particularly among ethnic minorities, necessitates an improved understanding of the underlying disease mechanisms. Although obesity is an independent risk factor for asthma, not all obese children develop asthma. Several recent studies have elucidated mechanisms, including the role of diet, sedentary lifestyle, mechanical fat load, and adiposity-mediated inflammation that may underlie the obese asthma pathophysiology. Here, we review these recent studies and emerging scientific evidence that suggest metabolic dysregulation may play a role in pediatric obesity-related asthma. We also review the genetic and epigenetic factors that may underlie susceptibility to metabolic dysregulation and associated pulmonary morbidity among children. Lastly, we identify knowledge gaps that need further exploration to better define pathways that will allow development of primary preventive strategies for obesity-related asthma in children.
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Affiliation(s)
| | - John M. Greally
- Departments of Pediatrics,,Genetics, and,Medicine, Albert Einstein College of Medicine, Bronx, New York
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Tian WH, Liu LF, Wang JY. Obesity risk class and asthma outpatient service utilization by the middle aged and elderly in Taiwan. Health Policy 2016; 120:552-60. [PMID: 27017050 DOI: 10.1016/j.healthpol.2016.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 01/29/2016] [Accepted: 03/07/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND According to the estimates of the World Health Organization (WHO), there were about 300 million people in the world suffering from asthma in 2005. Among the risk factors of asthma is obesity, which was found to be significantly associated with asthma in recent decades. OBJECTIVES In this study, we analyze the relationship between obesity risk class and asthma outpatient service utilization by the middle-aged and elderly in Taiwan. METHODS Adopting data from the 2005 Nation Health Interview Survey (NHIS) and National Health Insurance Research Database (NHIRD), we first utilize latent class analysis (LCA) to identify obesity risk classes. Next, we utilize a logit and a negative binominal model to analyze the relationship between each obesity risk class and asthma outpatient service utilization. RESULTS Results indicate that compared with the "overweight/obese with low consumption of vegetable/fruit and little exercise" class, the classes "normal-weight with high consumption of vegetable/fruit and moderate exercise" and "overweight/obese with high consumption of vegetable/fruit and moderate exercise" tend to have low probabilities and less number of visits of utilizing asthma outpatient services. CONCLUSIONS Our results may constitute useful references for clinicians and government policy makers formulating strategies for asthma management and prevention. Better informed strategies for asthma management could, in turn, increase the efficiency of asthmatic patients' care, which could provide efficient assistance to the target group based on the obesity risk classes.
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Affiliation(s)
- Wei-Hua Tian
- Department of Economics, College of Social Science, National Cheng Kung University, Tainan 701, Taiwan.
| | - Li-Fan Liu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Jiu-Yao Wang
- Division of Allergy and Clinical Immunology, Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
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Kabeya Y, Kato K, Tomita M, Katsuki T, Oikawa Y, Shimada A. Higher Body Mass Index and Increased Prevalence of Paranasal Sinus Disease. J Epidemiol 2016; 26:258-63. [PMID: 26830349 PMCID: PMC4848324 DOI: 10.2188/jea.je20150134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background We hypothesized that higher body mass index (BMI) was associated with increased prevalence of paranasal sinus disease and examined the hypothesis in Japanese adults. Methods This was a cross-sectional study including 1350 Japanese adults aged 40 years or more who participated in a health check-up program focusing on brain diseases and metabolic syndrome. Participants were divided into quartiles of BMI levels. Paranasal sinus disease was confirmed by a head MRI scan. The association between BMI and paranasal sinus disease was examined using logistic regression analysis, which was adjusted for age, sex, waist:hip ratio, hemoglobin A1c, systolic blood pressure, smoking status, alcohol intake, and white blood cell count. Results Of the 1350 participants, 151 (11.2%) had paranasal sinus disease. In relation to those in the lowest quartile of BMI, the odds ratios of having the disease among those in the 2nd, 3rd, and 4th quartiles of BMI were 1.89 (95% confidence interval [CI], 1.03–3.48), 2.26 (95% CI, 1.20–4.23) and 2.26 (95% CI, 1.14–4.51), respectively. When BMI was analysed as a continuous variable, an increase of one unit in BMI was significantly associated with increased odds of having the disease, with an OR of 1.08 (95% CI, 1.01–1.16). Conclusions The present study suggests that patients with higher BMI are more likely to have paranasal sinus disease.
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Affiliation(s)
- Yusuke Kabeya
- Division of General Internal Medicine, Department of Internal Medicine, Tokai University Hachioji Hospital
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Nigro E, Matteis M, Roviezzo F, Mattera Iacono V, Scudiero O, Spaziano G, Tartaglione G, Urbanek K, Filosa R, Daniele A, D'Agostino B. Role of adiponectin in sphingosine-1-phosphate induced airway hyperresponsiveness and inflammation. Pharmacol Res 2015; 103:114-22. [PMID: 26462929 DOI: 10.1016/j.phrs.2015.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/24/2015] [Accepted: 10/05/2015] [Indexed: 12/15/2022]
Abstract
Epidemiological data suggest that obesity represent an important risk factor for asthma, but the link between excess fat and airway hyperresponsiveness (AHR) and inflammation is not fully understood. Recently, a key role in physiopathologic conditions of lungs has been given to adiponectin (Acrp30). Acrp30 is one of the most expressed adipokines produced and secreted by adipose tissue, showing an intriguing relationship with metabolism of sphingolipids. Sphingosine-1-phosphate (S1P) has been proposed as an important inflammatory mediator implicated in the pathogenesis of airway inflammation and asthma. In the present study we analyze the effects of recombinant Acrp30 administration in an experimental model of S1P-induced AHR and inflammation. The results show that S1P is able to reduce endogenous Acrp30 serum levels and that recombinant Acrp30 treatment significantly reduce S1P-induced AHR and inflammation. Moreover, we observed a reduction of Adiponectin receptors (AdipoR1, AdipoR2 and T-cadherin) expression in S1P treated mice. Treatment with recombinant Acrp30 was able to restore Acrp30 serum levels and adiponectin receptors expression. These results could indicate the ability of S1P to modulate the Acrp30 action, by modulating not only the serum levels of the protein, but also its receptors. Taken together, these data suggest that adiponectin could represent a possible biomarker in obesity-associated asthma.
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Affiliation(s)
- Ersilia Nigro
- CEINGE-Advanced Biotechnology s.c.ar.l, Naples, Italy
| | - Maria Matteis
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Fiorentina Roviezzo
- Department of Experimental Pharmacology, University Federico II of Naples, Naples, Italy
| | | | - Olga Scudiero
- CEINGE-Advanced Biotechnology s.c.ar.l, Naples, Italy; Department of Molecular Medicine and Medical Biotechnology, University Federico II of Naples, Naples, Italy
| | - Giuseppe Spaziano
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Gioia Tartaglione
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Konrad Urbanek
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Rosanna Filosa
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Aurora Daniele
- CEINGE-Advanced Biotechnology s.c.ar.l, Naples, Italy; Department of Environmental Sciences and Technologies Biological and Pharmaceutical, Second University of Naples, Caserta, Italy
| | - Bruno D'Agostino
- Department of Experimental Medicine, Second University of Naples, Naples, Italy.
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Strunk RC, Colvin R, Bacharier LB, Fuhlbrigge A, Forno E, Arbelaez AM, Tantisira KG. Airway Obstruction Worsens in Young Adults with Asthma Who Become Obese. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2015; 3:765-71.e2. [PMID: 26164807 PMCID: PMC4568157 DOI: 10.1016/j.jaip.2015.05.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 04/22/2015] [Accepted: 05/05/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Few studies have examined how developing obesity in early adulthood affects the course of asthma. OBJECTIVE We analyzed lung function and asthma impairment and risk among nonobese children with asthma, comparing those who were obese in young adulthood with those who remained nonobese. METHODS We carried out the post hoc analysis of 771 subjects with mild to moderate asthma who were not obese (pediatric definition, body mass index [BMI] < 95th percentile) when enrolled in the Childhood Asthma Management Program at ages 5-12 years. The subjects were then followed to age 20 years or more. For visits at ages 20 years or more, spirometry values as percent predicted and recent asthma symptom scores and prednisone exposure were compared between 579 subjects who were nonobese at all visits and 151 who were obese (adult definition of BMI ≥ 30 kg/m(2)) on at least 1 visit (median number of visits when obese = 4, IQR 2-7). RESULTS Compared with participants who were nonobese (BMI 23.4 ± 2.6 kg/m(2)), those who became obese (BMI 31.5 ± 3.8 kg/m(2)) had significant decreases in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) (P < .0003) and FEV1 (P = .001), without differences in FVC (P = .15) during visits at ages 20 years or more. For each unit increase of BMI, FEV1 percent predicted decreased by 0.29 (P = .0009). The relationship between BMI and lung function was not confounded by sex or BMI at baseline. Asthma impairment (symptom scores) and risk (prednisone use) did not differ between the 2 groups. CONCLUSION Becoming obese in early adulthood was associated with increased airway obstruction, without impact on asthma impairment or risk.
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Affiliation(s)
- Robert C Strunk
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Mo.
| | - Ryan Colvin
- Department of Pediatrics, Pediatric Computing Facility, Washington University School of Medicine, St. Louis, Mo
| | - Leonard B Bacharier
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Mo
| | - Anne Fuhlbrigge
- The Channing Division of Network Medicine and the Division of Pulmonary/Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Erick Forno
- Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh and University of Pittsburgh, Pittsburgh, Pa
| | - Ana Maria Arbelaez
- Division of Endocrinology, Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Mo
| | - Kelan G Tantisira
- The Channing Division of Network Medicine and the Division of Pulmonary/Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
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Vinding RK, Stokholm J, Chawes BLK, Bisgaard H. Blood lipid levels associate with childhood asthma, airway obstruction, bronchial hyperresponsiveness, and aeroallergen sensitization. J Allergy Clin Immunol 2015; 137:68-74.e4. [PMID: 26148797 DOI: 10.1016/j.jaci.2015.05.033] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 05/21/2015] [Accepted: 05/22/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND Studies of children's blood lipid profiles in relation to asthma are few, and the results are ambiguous. OBJECTIVE We sought to examine whether the lipid profile is associated with concurrent asthma, altered lung function, and allergic sensitization in children. METHODS High-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride levels were measured at ages 5 to 7 years in the Copenhagen Prospective Studies on Asthma in Childhood2000 at-risk birth cohort. Asthma and allergic rhinitis were diagnosed based on predefined algorithms at age 7 years along with assessments of lung function, bronchial responsiveness, fraction of exhaled nitric oxide (Feno), and allergic sensitization. Associations between lipid levels and clinical outcomes were adjusted for sex, passive smoking, and body mass index. RESULTS High levels of low-density lipoprotein cholesterol were associated with concurrent asthma (adjusted odds ratio [aOR], 1.93; 95% CI, 1.06-3.55; P = .03) and airway obstruction: 50% of forced expiratory flow (aβ coefficient, -0.13 L/s; 95% CI, -0.24 to -0.03 L/s; P = .01) and specific airway resistance (aβ coefficient, 0.06 kPa/s; 95% CI, 0.00-0.11 kPa/s; P = .05). High levels of high-density lipoprotein cholesterol were associated with improved specific airway resistance (aβ coefficient, -0.11 kPa/s; 95% CI, -0.21 to -0.02; P = .02), decreased bronchial responsiveness (aβ coefficient, 0.53 log-μmol; 95% CI, 0.00-1.60 log-μmol; P = .05), decreased risk of aeroallergen sensitization (aOR, 0.27; 95% CI, 0.01-0.70; P = .01), and a trend of reduced Feno levels (aβ coefficient, -0.22 log-ppb; 95% CI, -0.50 to 0.01 log-ppb; P = .06). High triglyceride levels were associated with aeroallergen sensitization (aOR, 2.01; 95% CI, 1.14-3.56; P = .02) and a trend of increased Feno levels (aβ coefficient, 0.14 log-ppb; 95% CI, -0.02 to 0.30 log-ppb; P = .08). CONCLUSION The blood lipid profile is associated with asthma, airway obstruction, bronchial responsiveness, and aeroallergen sensitization in 7-year-old children. These findings suggest that asthma and allergy are systemic disorders with commonalities with other chronic inflammatory disorders.
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Affiliation(s)
- Rebecca K Vinding
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Naestved Hospital, Næstved, Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Naestved Hospital, Næstved, Denmark
| | - Bo L K Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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Törmänen S, Lauhkonen E, Saari A, Koponen P, Korppi M, Nuolivirta K. Excess weight in preschool children with a history of severe bronchiolitis is associated with asthma. Pediatr Pulmonol 2015; 50:424-30. [PMID: 24753502 DOI: 10.1002/ppul.23053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 03/21/2014] [Indexed: 12/26/2022]
Abstract
BACKGROUND The relationship between excess weight gain and asthma in childhood remains inadequately defined. The aim of this study was to evaluate, as part of a prospective post-bronchiolitis follow-up, whether there is a link between earlier or current overweight or obesity and asthma or asthma symptoms at 5-7 years of age. METHODS In all, 151 former bronchiolitis patients were followed-up until the mean age of 6.45 years. At the control visit, the weights and heights were measured, and the asthma symptoms and medications for asthma were recorded. The weight status was expressed as body mass index (BMI) z-scores (zBMI). RESULTS There were 10 obese and 31 overweight (zBMI over national references) children. In adjusted analyses, presence of current asthma at 6-7 years of age (aOR 3.05, 95% CI 1.02-9.93) differed between overweight and normal weight children. Further, asthma ever, asthma at age 4-5 years, asthma at age 5-6 years, use of bronchodilators ever and use of ICSs during the last 12 months were more common in currently overweight than in normal weight children. Obesity was associated only with current asthma and asthma ever. Instead, there were no significant associations between birth weight, excess weight gain in infancy, or overweight at age 1.5 years, and later asthma, asthma symptoms or use of asthma medication. CONCLUSION Asthma was more common in currently overweight than in normal weight former bronchiolitis patients at preschool age and early school age.
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Hutchison AA, Leclerc F, Nève V, Pillow JJ, Robinson PD. The Respiratory System. PEDIATRIC AND NEONATAL MECHANICAL VENTILATION 2015. [PMCID: PMC7193717 DOI: 10.1007/978-3-642-01219-8_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This chapter addresses upper airway physiology for the pediatric intensivist, focusing on functions that affect ventilation, with an emphasis on laryngeal physiology and control in breathing. Effective control of breathing ensures that the airway is protected, maintains volume homeostasis, and provides ventilation. Upper airway structures are effectors for all of these functions that affect the entire airway. Nasal functions include air conditioning and protective reflexes that can be exaggerated and involve circulatory changes. Oral cavity and pharyngeal patency enable airflow and feeding, but during sleep pharyngeal closure can result in apnea. Coordination of breathing with sucking and nutritive swallowing alters during development, while nonnutritive swallowing at all ages limits aspiration. Laryngeal functions in breathing include protection of the subglottic airway, active maintenance of its absolute volume, and control of tidal flow patterns. These are vital functions for normal lung growth in fetal life and during rapid adaptations to breathing challenges from birth through adulthood. Active central control of breathing focuses on the coordination of laryngeal and diaphragmatic activities, which adapts according to the integration of central and peripheral inputs. For the intensivist, knowledge of upper airway physiology can be applied to improve respiratory support. In a second part the mechanical properties of the respiratory system as a critical component of the chain of events that result in translation of the output of the respiratory rhythm generator to ventilation are described. A comprehensive understanding of respiratory mechanics is essential to the delivery of optimized and individualized mechanical ventilation. The basic elements of respiratory mechanics will be described and developmental changes in the airways, lungs, and chest wall that impact on measurement of respiratory mechanics with advancing postnatal age are reviewed. This will be follwowed by two sections, the first on respiratory mechanics in various neonatal pathologies and the second in pediatric pathologies. The latter can be classified in three categories. First, restrictive diseases may be of pulmonary origin, such as chronic interstitial lung diseases or acute lung injury/acute respiratory distress syndrome, which are usually associated with reduced lung compliance. Restrictive diseases may also be due to chest wall abnormalities such as obesity or scoliosis (idiopathic or secondary to neuromuscular diseases), which are associated with a reduction in chest wall compliance. Second, obstructive diseases are represented by asthma and wheezing disorders, cystic fibrosis, long term sequelae of neonatal lung disease and bronchiolitis obliterans following hematopoietic stem cell transplantation. Obstructive diseases are defined by a reduced FEV1/VC ratio. Third, neuromuscular diseases, mainly represented by DMD and SMA, are associated with a decrease in vital capacity linked to respiratory muscle weakness that is better detected by PImax, PEmax and SNIP measurements.
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Sharma S, Zhou X, Thibault DM, Himes BE, Liu A, Szefler SJ, Strunk R, Castro M, Hansel NN, Diette GB, Vonakis BM, Adkinson NF, Avila L, Soto-Quiros M, Barraza-Villareal A, Lemanske RF, Solway J, Krishnan J, White SR, Cheadle C, Berger AE, Fan J, Boorgula MP, Nicolae D, Gilliland F, Barnes K, London SJ, Martinez F, Ober C, Celedón JC, Carey VJ, Weiss ST, Raby BA. A genome-wide survey of CD4(+) lymphocyte regulatory genetic variants identifies novel asthma genes. J Allergy Clin Immunol 2014; 134:1153-62. [PMID: 24934276 PMCID: PMC4253878 DOI: 10.1016/j.jaci.2014.04.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 04/01/2014] [Accepted: 04/15/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Genome-wide association studies have yet to identify the majority of genetic variants involved in asthma. We hypothesized that expression quantitative trait locus (eQTL) mapping can identify novel asthma genes by enabling prioritization of putative functional variants for association testing. OBJECTIVE We evaluated 6706 cis-acting expression-associated variants (eSNPs) identified through a genome-wide eQTL survey of CD4(+) lymphocytes for association with asthma. METHODS eSNPs were tested for association with asthma in 359 asthmatic patients and 846 control subjects from the Childhood Asthma Management Program, with verification by using family-based testing. Significant associations were tested for replication in 579 parent-child trios with asthma from Costa Rica. Further functional validation was performed by using formaldehyde-assisted isolation of regulatory elements (FAIRE) quantitative PCR and chromatin immunoprecipitation PCR in lung-derived epithelial cell lines (Beas-2B and A549) and Jurkat cells, a leukemia cell line derived from T lymphocytes. RESULTS Cis-acting eSNPs demonstrated associations with asthma in both cohorts. We confirmed the previously reported association of ORMDL3/GSDMB variants with asthma (combined P = 2.9 × 10(-8)). Reproducible associations were also observed for eSNPs in 3 additional genes: fatty acid desaturase 2 (FADS2; P = .002), N-acetyl-α-D-galactosaminidase (NAGA; P = .0002), and Factor XIII, A1 (F13A1; P = .0001). Subsequently, we demonstrated that FADS2 mRNA is increased in CD4(+) lymphocytes in asthmatic patients and that the associated eSNPs reside within DNA segments with histone modifications that denote open chromatin status and confer enhancer activity. CONCLUSIONS Our results demonstrate the utility of eQTL mapping in the identification of novel asthma genes and provide evidence for the importance of FADS2, NAGA, and F13A1 in the pathogenesis of asthma.
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Affiliation(s)
- Sunita Sharma
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass.
| | - Xiaobo Zhou
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Derek M Thibault
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
| | - Blanca E Himes
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
| | - Andy Liu
- Department of Pediatrics, National Jewish Health, Denver, Colo
| | | | - Robert Strunk
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Mo
| | - Mario Castro
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Mo
| | - Nadia N Hansel
- Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Gregory B Diette
- Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Becky M Vonakis
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - N Franklin Adkinson
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | | | | | - Albino Barraza-Villareal
- National Institute of Public Health of Mexico, Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico
| | - Robert F Lemanske
- Division of Allergy and Immunology, Department of Medicine, University of Wisconsin, Madison, Wis
| | - Julian Solway
- Department of Pediatrics, University of Chicago, Chicago, Ill
| | - Jerry Krishnan
- Department of Medicine, University of Illinois Hospital and Health Sciences System, Chicago, Ill
| | - Steven R White
- Department of Pediatrics, University of Chicago, Chicago, Ill
| | - Chris Cheadle
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Alan E Berger
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Jinshui Fan
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | | | - Dan Nicolae
- Department of Human Genetics, University of Chicago, Chicago, Ill
| | - Frank Gilliland
- Division of Environmental and Occupational Health, Department of Medicine, University of Southern California, Los Angeles, Calif
| | - Kathleen Barnes
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Stephanie J London
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
| | | | - Carole Ober
- Department of Human Genetics, University of Chicago, Chicago, Ill
| | - Juan C Celedón
- Division of Pulmonary Medicine, Allergy and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
| | - Vincent J Carey
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass
| | - Benjamin A Raby
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass
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Early weight gain and the development of asthma and atopy in children. Curr Opin Allergy Clin Immunol 2014; 14:126-30. [PMID: 24451911 DOI: 10.1097/aci.0000000000000037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW To provide perspective to the most recent evidence regarding the association between early weight gain in infancy and the development of asthma and atopy during childhood, and highlight the potential mechanisms involved. RECENT FINDINGS Recently, several birth cohort studies involving more than 25 000 children have found a consistent association between early weight gain in the first 2 years of life and incident asthma during school age. Methodology differs substantially between the studies and complicates the establishment of definite conclusions. Specific mechanisms for this association have been proposed, including impairment in lung development and elevated levels of growth factors and cytokines associated with airway inflammation and remodeling. A limited number of studies indicate that early weight gain in infancy is also associated with recurrent wheezing during preschool age but not with the development of atopy. SUMMARY A consistent association between early weight gain in infancy and incident asthma during school age has been observed in several cohort studies. The identification of this modifiable risk factor for the development of asthma opens the possibility of preventive intervention. Additional studies are necessary to clarify the involved mechanisms and some pending questions, such as the influence of early weight gain in asthma phenotypes and severity.
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Mathews JA, Wurmbrand AP, Ribeiro L, Neto FL, Shore SA. Induction of IL-17A Precedes Development of Airway Hyperresponsiveness during Diet-Induced Obesity and Correlates with Complement Factor D. Front Immunol 2014; 5:440. [PMID: 25309539 PMCID: PMC4164008 DOI: 10.3389/fimmu.2014.00440] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 08/30/2014] [Indexed: 12/31/2022] Open
Abstract
Obesity is a risk factor for the development of asthma. Obese mice exhibit innate airway hyperresponsiveness (AHR), a characteristic feature of asthma, and IL-17A is required for development of AHR in obese mice. The purpose of this study was to examine the temporal association between the onset of AHR and changes in IL-17A during the development of obesity by high-fat feeding in mice. At weaning, C57BL/6J mice were placed either on mouse chow or on a high-fat diet (HFD) and examined 9, 12, 15, 18, or 24 weeks later. Airway responsiveness to aerosolized methacholine (assessed via the forced oscillation technique) was greater in mice fed HFD versus chow for 24 weeks but not at earlier time points. Bronchoalveolar lavage and serum IL-17A were not affected by either the type or duration of diet, but increased pulmonary IL17a mRNA abundance was observed in HFD versus chow fed mice after both 18 and 24 weeks. Flow cytometry also confirmed an increase in IL-17A(+) γδ T cells and IL-17A(+) CD4(+) T (Th17) cells in lungs of HFD versus chow fed mice. Pulmonary expression of Cfd (complement factor D, adipsin), a gene whose expression can be reduced by IL-17A, decreased after both 18 and 24 weeks in HFD versus chow fed mice. Furthermore, pulmonary Cfd mRNA abundance correlated with elevations in pulmonary Il17a mRNA expression and with AHR. Serum levels of TNFα, MIP-1α, and MIP-1β, and classical markers of systemic inflammation of obesity were significantly greater in HFD than chow fed mice after 24 weeks, but not earlier. In conclusion, our data indicate that pulmonary rather than systemic IL-17A is important for obesity-related AHR and suggest that changes in pulmonary Cfd expression contribute to these effects of IL-17A. Further, the observation that increases in Il17a preceded the development of AHR by several weeks suggests that IL-17A interacts with other factors to promote AHR. The observation that the onset of the systemic inflammation of obesity coincided temporally with the development of AHR suggest that systemic inflammation may be one of these factors.
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Affiliation(s)
- Joel A Mathews
- Molecular and Integrative Physiological Sciences Program, Department of Environmental Health, Harvard School of Public Health , Boston, MA , USA
| | - Allison P Wurmbrand
- Molecular and Integrative Physiological Sciences Program, Department of Environmental Health, Harvard School of Public Health , Boston, MA , USA
| | - Luiza Ribeiro
- Molecular and Integrative Physiological Sciences Program, Department of Environmental Health, Harvard School of Public Health , Boston, MA , USA
| | - Felippe Lazar Neto
- Molecular and Integrative Physiological Sciences Program, Department of Environmental Health, Harvard School of Public Health , Boston, MA , USA
| | - Stephanie A Shore
- Molecular and Integrative Physiological Sciences Program, Department of Environmental Health, Harvard School of Public Health , Boston, MA , USA
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Danielewicz H. What the Genetic Background of Individuals with Asthma and Obesity Can Reveal: Is β2-Adrenergic Receptor Gene Polymorphism Important? PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2014; 27:104-110. [PMID: 25276484 DOI: 10.1089/ped.2014.0360] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/16/2014] [Indexed: 12/31/2022]
Abstract
The goal of this review was to evaluate the association of β2-adrenergic receptor (ADRB2) gene polymorphisms with asthma and obesity. Asthma is the most common pediatric inflammatory disorder. The prevalence, severity, and hospitalization index for asthma have increased markedly in the last several decades. Interestingly, asthma is often diagnosed along with obesity. Genetic factors are essential for both conditions, and some of the candidate pleiotropic genes thought to be involved in the development of these diseases are ADRB2, vitamin D receptor (VDR), leptin (LEP), protein kinase C alpha (PRKCA), and tumor necrosis factor alpha (TNFα). The ADRB2 has been studied in multiple populations and more than 80 polymorphisms, mainly single-nucleotide polymorphisms, have been identified. For nonsynonymous Arg16Gly, Gln27Glu, and Thr164Ile, functional effects have been shown. In vivo, these polymorphisms have been evaluated to determine their association with both obesity and asthma, but the results are inconsistent and depend on the population studied or how the disease was defined. Currently, there are only few reports describing the genetic background for the comorbidity of asthma and obesity.
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Affiliation(s)
- Hanna Danielewicz
- 1st Department of Pediatrics, Allergy and Cardiology, Wroclaw Medical University , Wrocław, Poland
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43
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Melnik BC. The potential mechanistic link between allergy and obesity development and infant formula feeding. Allergy Asthma Clin Immunol 2014; 10:37. [PMID: 25071855 PMCID: PMC4112849 DOI: 10.1186/1710-1492-10-37] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 07/15/2014] [Indexed: 12/14/2022] Open
Abstract
This article provides a new view of the cellular mechanisms that have been proposed to explain the links between infant formula feeding and the development of atopy and obesity. Epidemiological evidence points to an allergy- and obesity-preventive effect of breastfeeding. Both allergy and obesity development have been traced back to accelerated growth early in life. The nutrient-sensitive kinase mTORC1 is the master regulator of cell growth, which is predominantly activated by amino acids. In contrast to breastfeeding, artificial infant formula feeding bears the risk of uncontrolled excessive protein intake overactivating the infant's mTORC1 signalling pathways. Overactivated mTORC1 enhances S6K1-mediated adipocyte differentiation, but negatively regulates growth and differentiation of FoxP3(+) regulatory T-cells (Tregs), which are deficient in atopic individuals. Thus, the "early protein hypothesis" not only explains increased mTORC1-mediated infant growth but also the development of mTORC1-driven diseases such as allergy and obesity due to a postnatal deviation from the appropriate axis of mTORC1-driven metabolic and immunologic programming. Remarkably, intake of fresh unpasteurized cow's milk exhibits an allergy-preventive effect in farm children associated with increased FoxP3(+) Treg numbers. In contrast to unprocessed cow's milk, formula lacks bioactive immune-regulatory microRNAs, such as microRNA-155, which plays a major role in FoxP3 expression. Uncontrolled excessive protein supply by formula feeding associated with the absence of bioactive microRNAs and bifidobacteria in formula apparently in a synergistic way result in insufficient Treg maturation. Treg deficiency allows Th2-cell differentiation promoting the development of allergic diseases. Formula-induced mTORC1 overactivation is thus the critical mechanism that explains accelerated postnatal growth, allergy and obesity development on one aberrant pathway.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Sedanstrasse 115, DE-49090 Osnabrück, Germany
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44
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Rosser FJ, Forno E, Cooper PJ, Celedón JC. Asthma in Hispanics. An 8-year update. Am J Respir Crit Care Med 2014; 189:1316-27. [PMID: 24881937 PMCID: PMC4098086 DOI: 10.1164/rccm.201401-0186pp] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/05/2014] [Indexed: 01/25/2023] Open
Abstract
This review provides an update on asthma in Hispanics, a diverse group tracing their ancestry to countries previously under Spanish rule. A marked variability in the prevalence and morbidity from asthma remains among Hispanic subgroups in the United States and Hispanic America. In the United States, Puerto Ricans and Mexican Americans have high and low burdens of asthma, respectively (the "Hispanic Paradox"). This wide divergence in asthma morbidity among Hispanic subgroups is multifactorial, likely reflecting the effects of known (secondhand tobacco smoke, air pollution, psychosocial stress, obesity, inadequate treatment) and potential (genetic variants, urbanization, vitamin D insufficiency, and eradication of parasitic infections) risk factors. Barriers to adequate asthma management in Hispanics include economic and educational disadvantages, lack of health insurance, and no access to or poor adherence with controller medications such as inhaled corticosteroids. Although considerable progress has been made in our understanding of asthma in Hispanic subgroups, many questions remain. Studies of asthma in Hispanic America should focus on environmental or lifestyle factors that are more relevant to asthma in this region (e.g., urbanization, air pollution, parasitism, and stress). In the United States, research studies should focus on risk factors that are known to or may diverge among Hispanic subgroups, including but not limited to epigenetic variation, prematurity, vitamin D level, diet, and stress. Clinical trials of culturally appropriate interventions that address multiple aspects of asthma management in Hispanic subgroups should be prioritized for funding. Ensuring high-quality healthcare for all remains a pillar of eliminating asthma disparities.
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Affiliation(s)
- Franziska J. Rosser
- Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Philip J. Cooper
- Laboratorio de Investigaciones FEPIS, Quinindé, Esmeraldas Province, Ecuador; and
- Institute of Infection and Immunity, St. George’s University of London, London, United Kingdom
| | - Juan C. Celedón
- Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania
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45
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Watson PE, McDonald BW. Subcutaneous body fat in pregnant New Zealand women: association with wheeze in their infants at 18 months. Matern Child Health J 2014; 17:959-67. [PMID: 23010863 DOI: 10.1007/s10995-012-1124-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
To investigate the association of subcutaneous body fat levels in pregnant women with wheezing in their 18 month old infants. A prospective study of European and Polynesian volunteers (n = 369) recruited from northern New Zealand were visited in months 4 and 7 of pregnancy when height, weight, and triceps, biceps and costal skinfolds were measured, and questionnaires determining personal details administered; and again visited 18 months after birth when infants were measured and questions on infant feeding and wheeze administered. At 18 months 32 % of infants had wheezed in the past 12 months. Increased wheeze was associated with maternal asthma, eczema or allergy (p = 0.001); receiving family welfare payments (p = 0.010); and being Polynesian (p = 0.021); while exclusive breastfeeding to 2 months (p = 0.045) was associated with decreased wheeze. Individual month 4 and month 7 mean triceps, biceps and costal skinfolds were all greater in mothers of wheezers compared to nonwheezers, biceps and costal skinfolds significantly so (p = 0.002, p = 0.005 at month 7). The sum of these skinfolds at month 4, at month 7, and the difference between these sums, were all significantly associated with increased risk of infant wheeze at 18 months when considered alone (p = 0.037, p = 0.001 and p = 0.015) or in combination. Prevalence of infant wheeze was 22.7 % for mothers with lower quartile month 7 skinfolds, compared to 45.0 % for mothers with upper quartile. After adjusting for significant covariates the difference in skinfolds had the strongest association (p = 0.003) followed by sum at month 4 (p = 0.074 or 0.003 depending on whether Polynesian ethnicity was included in the model). The sum of skinfolds declined between month 4 and month 7 in 34 % of women. Prevalence of wheeze was 19.2 % where the difference in mothers' skinfolds between month 4 and month 7 decreased by 10 mm or more and 41.7 % where the difference increased by 10 mm or more. Mean month 4 weights, BMI and sum of skinfolds were below average in the latter group. As the sum of month 4 or month 7 maternal skinfolds increased the prevalence of infant wheeze increased. In addition as the change in skinfolds between month 4 and month 7 became more positive the prevalence of infant wheeze increased. This study suggests for the first time that changes in subcutaneous fat during pregnancy are associated with prevalence of infant wheeze.
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Yoo JK, Shin JY, You JS, Jeong SI, Song JS, Yang S, Hwang IT, Lee HB, Baek HS. Serum leptin levels correlate with bronchial hyper-responsiveness to mannitol in asthmatic children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2014. [DOI: 10.4168/aard.2014.2.1.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jung-Kyung Yoo
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Jae Young Shin
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Jueng-Sup You
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Soo-In Jeong
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Joon-Sup Song
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Seong Yang
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Il-Tae Hwang
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Ha-Baik Lee
- Department of Pediatrics, Hanyang University Medical Center, Seoul, Korea
| | - Hey-Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
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47
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Jung SH, Kwon JM, Shim JW, Kim DS, Jung HL, Park MS, Park SH, Lee J, Lee WY, Shim JY. Effects of diet-induced mild obesity on airway hyperreactivity and lung inflammation in mice. Yonsei Med J 2013; 54:1430-7. [PMID: 24142648 PMCID: PMC3809850 DOI: 10.3349/ymj.2013.54.6.1430] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Obesity has been suggested to be linked to asthma. However, it is not yet known whether obesity directly leads to airway hyperreactivity (AHR) or obesity-induced airway inflammation associated with asthma. We investigated obesity- related changes in adipokines, AHR, and lung inflammation in a murine model of asthma and obesity. MATERIALS AND METHODS We developed mouse models of chronic asthma via ovalbumin (OVA)-challenge and of obesity by feeding a high-fat diet, and then performed the methacholine bronchial provocation test, and real-time PCR for leptin, leptin receptor, adiponectin, adiponectin receptor (adipor1 and 2), vascular endothelial growth factor (VEGF), transforming growth factor (TGF) β, and tumor necrosis factor (TNF) α in lung tissue. We also measured cell counts in bronchoalveolar lavage fluid. RESULTS Both obese and lean mice chronically exposed to OVA developed eosinophilic lung inflammation and AHR to methacholine. However, obese mice without OVA challenge did not develop AHR or eosinophilic inflammation in lung tissue. In obese mice, lung mRNA expressions of leptin, leptin receptor, VEGF, TGF, and TNF were enhanced, and adipor1 and 2 expressions were decreased compared to mice in the control group. On the other hand, there were no differences between obese mice with or without OVA challenge. CONCLUSION Diet-induced mild obesity may not augment AHR or eosinophilic lung inflammation in asthma.
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Affiliation(s)
- Sun Hee Jung
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 110-746, Korea.
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48
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Abstract
Obesity currently affects about one-third of the U.S. population, while another one-third is overweight. The importance of obesity for certain conditions such as heart disease and type 2 diabetes is well appreciated. The effects of obesity on the respiratory system have received less attention and are the subject of this article. Obesity alters the static mechanical properties of the respiratory system leading to a reduction in the functional residual capacity (FRC) and the expiratory reserve volume (ERV). There is substantial variability in the effects of obesity on FRC and ERV, at least some of which is related to the location rather than the total mass of adipose tissue. Obesity also results in airflow obstruction, which is only partially attributable to breathing at low lung volume, and can also promote airway hyperresponsiveness and asthma. Hypoxemia is common is obesity and correlates well with FRC, as well as with measures of abdominal obesity. However, obese subjects are usually eucapnic, indicating that hypoventilation is not a common cause of their hypoxemia. Instead, hypoxemia results from ventilation-perfusion mismatch caused by closure of dependent airways at FRC. Many obese subjects complain of dyspnea either at rest or during exertion, and the dyspnea score also correlates with reductions in FRC and ERV. Weight reduction should be encouraged in any symptomatic obese individual, since virtually all of the respiratory complications of obesity improve with even moderate weight loss.
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Melén E, Granell R, Kogevinas M, Strachan D, Gonzalez JR, Wjst M, Jarvis D, Ege M, Braun-Fahrländer C, Genuneit J, Horak E, Bouzigon E, Demenais F, Kauffmann F, Siroux V, Michel S, von Berg A, Heinzmann A, Kabesch M, Probst-Hensch NM, Curjuric I, Imboden M, Rochat T, Henderson J, Sterne JAC, McArdle WL, Hui J, James AL, William Musk A, Palmer LJ, Becker A, Kozyrskyj AL, Chan-Young M, Park JE, Leung A, Daley D, Freidin MB, Deev IA, Ogorodova LM, Puzyrev VP, Celedón JC, Brehm JM, Cloutier MM, Canino G, Acosta-Pérez E, Soto-Quiros M, Avila L, Bergström A, Magnusson J, Söderhäll C, Kull I, Scholtens S, Marike Boezen H, Koppelman GH, Wijga AH, Marenholz I, Esparza-Gordillo J, Lau S, Lee YA, Standl M, Tiesler CMT, Flexeder C, Heinrich J, Myers RA, Ober C, Nicolae DL, Farrall M, Kumar A, Moffatt MF, Cookson WOCM, Lasky-Su J. Genome-wide association study of body mass index in 23 000 individuals with and without asthma. Clin Exp Allergy 2013; 43:463-74. [PMID: 23517042 DOI: 10.1111/cea.12054] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 09/28/2012] [Accepted: 10/22/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND Both asthma and obesity are complex disorders that are influenced by environmental and genetic factors. Shared genetic factors between asthma and obesity have been proposed to partly explain epidemiological findings of co-morbidity between these conditions. OBJECTIVE To identify genetic variants that are associated with body mass index (BMI) in asthmatic children and adults, and to evaluate if there are differences between the genetics of BMI in asthmatics and healthy individuals. METHODS In total, 19 studies contributed with genome-wide analysis study (GWAS) data from more than 23 000 individuals with predominantly European descent, of whom 8165 are asthmatics. RESULTS We report associations between several DENND1B variants (P = 2.2 × 10(-7) for rs4915551) on chromosome 1q31 and BMI from a meta-analysis of GWAS data using 2691 asthmatic children (screening data). The top DENND1B single nucleotide polymorphisms(SNPs) were next evaluated in seven independent replication data sets comprising 2014 asthmatics, and rs4915551 was nominally replicated (P < 0.05) in two of the seven studies and of borderline significance in one (P = 0.059). However, strong evidence of effect heterogeneity was observed and overall, the association between rs4915551 and BMI was not significant in the total replication data set, P = 0.71. Using a random effects model, BMI was overall estimated to increase by 0.30 kg/m(2) (P = 0.01 for combined screening and replication data sets, N = 4705) per additional G allele of this DENND1BSNP. FTO was confirmed as an important gene for adult and childhood BMI regardless of asthma status. CONCLUSIONS AND CLINICAL RELEVANCE DENND1B was recently identified as an asthma susceptibility gene in a GWAS on children, and here, we find evidence that DENND1B variants may also be associated with BMI in asthmatic children. However, the association was overall not replicated in the independent data sets and the heterogeneous effect of DENND1B points to complex associations with the studied diseases that deserve further study.
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Affiliation(s)
- E Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Obesity and asthma: physiological perspective. J Allergy (Cairo) 2013; 2013:198068. [PMID: 23970905 PMCID: PMC3732624 DOI: 10.1155/2013/198068] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 05/27/2013] [Accepted: 07/03/2013] [Indexed: 12/19/2022] Open
Abstract
Obesity induces some pertinent physiological changes which are conducive to either development of asthma or cause of poorly controlled asthma state. Obesity related mechanical stress forces induced by abdominal and thoracic fat generate stiffening of the lungs and diaphragmatic movements to result in reduction of resting lung volumes such as functional residual capacity (FRC). Reduced FRC is primarily an outcome of decreased expiratory reserve volume, which pushes the tidal breathing more towards smaller high resistance airways, and consequentially results in expiratory flow limitation during normal breathing in obesity. Reduced FRC also induces plastic alteration in the small collapsible airways, which may generate smooth muscle contraction resulting in increased small airway resistance, which, however, is not picked up by spirometric lung volumes. There is also a possibility that chronically reduced FRC may generate permanent adaptation in the very small airways; therefore, the airway calibres may not change despite weight reduction. Obesity may also induce bronchodilator reversibility and diurnal lung functional variability. Obesity is also associated with airway hyperresponsiveness; however, the mechanism of this is not clear. Thus, obesity has effects on lung function that can generate respiratory distress similar to asthma and may also exaggerate the effects of preexisting asthma.
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