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Wang Y, Tzeng JY, Huang Y, Maguire R, Hoyo C, Allen TK. Duration of exposure to epidural anesthesia at delivery, DNA methylation in umbilical cord blood and their association with offspring asthma in Non-Hispanic Black women. ENVIRONMENTAL EPIGENETICS 2022; 9:dvac026. [PMID: 36694712 PMCID: PMC9854336 DOI: 10.1093/eep/dvac026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/16/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Epidural anesthesia is an effective pain relief modality, widely used for labor analgesia. Childhood asthma is one of the commonest chronic medical illnesses in the USA which places a significant burden on the health-care system. We recently demonstrated a negative association between the duration of epidural anesthesia and the development of childhood asthma; however, the underlying molecular mechanisms still remain unclear. In this study of 127 mother-child pairs comprised of 75 Non-Hispanic Black (NHB) and 52 Non-Hispanic White (NHW) from the Newborn Epigenetic Study, we tested the hypothesis that umbilical cord blood DNA methylation mediates the association between the duration of exposure to epidural anesthesia at delivery and the development of childhood asthma and whether this differed by race/ethnicity. In the mother-child pairs of NHB ancestry, the duration of exposure to epidural anesthesia was associated with a marginally lower risk of asthma (odds ratio = 0.88, 95% confidence interval = 0.76-1.01) for each 1-h increase in exposure to epidural anesthesia. Of the 20 CpGs in the NHB population showing the strongest mediation effect, 50% demonstrated an average mediation proportion of 52%, with directional consistency of direct and indirect effects. These top 20 CpGs mapped to 21 genes enriched for pathways engaged in antigen processing, antigen presentation, protein ubiquitination and regulatory networks related to the Major Histocompatibility Complex (MHC) class I complex and Nuclear Factor Kappa-B (NFkB) complex. Our findings suggest that DNA methylation in immune-related pathways contributes to the effects of the duration of exposure to epidural anesthesia on childhood asthma risk in NHB offspring.
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Affiliation(s)
- Yaxu Wang
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC 27607, USA
| | - Jung-Ying Tzeng
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC 27607, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27695-7633, USA
- Department of Statistics, North Carolina State University, Raleigh, NC 27607, USA
| | - Yueyang Huang
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC 27607, USA
| | - Rachel Maguire
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC 27695-7633, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Terrence K Allen
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC 27710, USA
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Brew BK, Lundholm C, Caffrey Osvald E, Chambers G, Öberg S, Fang F, Almqvist C. Early-Life Adversity Due to Bereavement and Inflammatory Diseases in the Next Generation: A Population Study in Transgenerational Stress Exposure. Am J Epidemiol 2022; 191:38-48. [PMID: 34550338 PMCID: PMC8751780 DOI: 10.1093/aje/kwab236] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/25/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022] Open
Abstract
Emerging evidence suggests that trauma experienced in childhood has negative transgenerational implications for offspring mental and physical health. We aimed to investigate whether early-life adversity experienced as bereavement is associated with chronic inflammatory health in offspring. The study population included 3 generations of Swedish families with a base population of 453,516 children (generation 3) born in 2001–2012. Exposure was defined as the middle generation’s (generation 2) experiencing bereavement in childhood due to the death of a parent (generation 1). Outcomes in generation 3 included 2 diagnoses of inflammatory diseases, including asthma, allergic diseases, eczema, and autoimmune diseases. Survival analysis was used to identify causal pathways, including investigation of mediation by generation 2 mood disorders and socioeconomic status (SES). We found that early-life bereavement experienced by women was associated with early-onset offspring asthma (hazard ratio = 1.15, 95% confidence interval: 1.08, 1.23); mediation analysis revealed that 28%–33% of the association may be mediated by SES and 9%–20% by mood disorders. Early-life bereavement experienced by men was associated with autoimmune diseases in offspring (hazard ratio = 1.31, 95% confidence interval: 1.06, 1.62), with no evidence of mediation. In conclusion, adversity experienced early in life may contribute to an increased risk of inflammatory diseases which is partly mediated by mood disorders and SES.
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Affiliation(s)
- Bronwyn K Brew
- Correspondence to Dr. Bronwyn K. Brew, Department of Medical Epidemiology and Biostatistics, Karolinska Institute, 12a Nobels vag, Solna, 171 77, Stockholm, Sweden (e-mail: )
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Huang Y, Tzeng JY, Maguire R, Hoyo C, Allen T. The association between neuraxial anesthesia and the development of childhood asthma - a secondary analysis of the newborn epigenetics study cohort. Curr Med Res Opin 2020; 36:1025-1032. [PMID: 32212939 PMCID: PMC7269869 DOI: 10.1080/03007995.2020.1747417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives: Childhood asthma is a common chronic illness that has been associated with mode of delivery. However, the effect of cesarean delivery alone does not fully account for the increased prevalence of childhood asthma. We tested the hypothesis that neuraxial anesthesia used for labor analgesia and cesarean delivery alters the risk of developing childhood asthma.Methods: Within the Newborn Epigenetics Study birth cohort, 196 mother and child pairs with entries in the electronic anesthesia records were included. From these records, data on maternal anesthesia type, duration of exposure, and drugs administered peripartum were abstracted and combined with questionnaire-derived prenatal risk factors and medical records and questionnaire-derived asthma diagnosis data in children. Logistic regression models were used to evaluate associations between type of anesthesia, duration of anesthesia, and the development of asthma in males and females.Results: We found that longer duration of epidural anesthesia was associated with a lower risk of asthma in male children (OR = 0.80; 95% CI = 0.66-0.95) for each hour of epidural exposure. Additionally, a unit increase in the composite dose of local anesthetics and opioid analgesics administered via the spinal route was associated with a lower risk of asthma in both male (OR = 0.59, 95% CI = 0.36-0.96) and female children (OR 0.26, 95% CI 0.09-0.82).Conclusion: Our data suggest that peripartum exposure to neuraxial anesthesia may reduce the risk of childhood asthma primarily in males. Larger human studies and model systems with longer follow-up are required to elucidate these findings.
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Affiliation(s)
- Yueyang Huang
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA
| | - Jung-Ying Tzeng
- Bioinformatics Research Center, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | - Rachel Maguire
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Cathrine Hoyo
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Terrence Allen
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA
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Azmeh R, Greydanus DE, Agana MG, Dickson CA, Patel DR, Ischander MM, Lloyd RD. Update in Pediatric Asthma: Selected Issues. Dis Mon 2019; 66:100886. [PMID: 31570159 DOI: 10.1016/j.disamonth.2019.100886] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Asthma is a complex condition that affects 14% of the world's children and the approach to management includes both pharmacologic as well as non-pharmacologic strategies including attention to complex socioeconomic status phenomena. After an historical consideration of asthma, allergic and immunologic aspects of asthma in children and adolescents are presented. Concepts of socioeconomic aspects of asthma are considered along with environmental features and complications of asthma disparities. Also reviewed are links of asthma with mental health disorders, sleep disturbances and other comorbidities. A stepwise approach to asthma management is discussed that includes pharmacologic and non-pharmacologic strategies in the pediatric population. The role of immunotherapy and use of various immunomodulators are considered as well.
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Affiliation(s)
- Roua Azmeh
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Marisha G Agana
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Cheryl A Dickson
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States; Health Equity and Community Affairs, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Mariam M Ischander
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Robert D Lloyd
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, United States
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Brew BK, Lundholm C, Viktorin A, Lichtenstein P, Larsson H, Almqvist C. Longitudinal depression or anxiety in mothers and offspring asthma: a Swedish population-based study. Int J Epidemiol 2019; 47:166-174. [PMID: 29040553 PMCID: PMC5837783 DOI: 10.1093/ije/dyx208] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2017] [Indexed: 12/15/2022] Open
Abstract
Background Previous research has found that maternal stress during pregnancy increases the risk of offspring asthma. However, whether this association is consistent with a causal interpretation has never been tested. The objective is to determine whether there is a critical exposure period for maternal depression or anxiety on offspring asthma or whether cumulative exposure is most important, and to investigate evidence of confounding. Methods The study population included all children born in Sweden from July 2006 to December 2009 (n = 360 526). Information about childhood asthma, maternal depression or anxiety (diagnosis or medication) and covariates was obtained from the Swedish national health registers. The associations between exposure periods (pre-conception, pregnancy, postnatal or current) and childhood asthma were estimated using structured life course approach hypothesis testing. Paternal and cousin analyses were used to test for evidence of confounding from shared genes and environment. Results For childhood asthma, cumulative exposure best described the effect of exposure to maternal depression or anxiety up to a maximum of any two exposure periods [adjusted odds ratio 1.44, 95% confidence interval (CI) 1.38, 1.52]. The hypotheses of a critical period were not supported. The paternal and cousin analyses indicated minimal influence from familial confounding. Conclusions These findings support an association between cumulative exposure to maternal depression or anxiety and asthma development in offspring. This association is unique for maternal depression or anxiety and not due to familial confounding. The clinical implication is that effective psychological management of women with chronic distress may reduce offspring asthma risk.
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Affiliation(s)
- Bronwyn K Brew
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Corresponding author. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden. E-mail:
| | - Cecilia Lundholm
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Viktorin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
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Sastre J, Crespo A, Fernandez-Sanchez A, Rial M, Plaza V, González FC, López JJ, Riaza MM, Orenes MM, Montaño PP, Toro MT, Balaguer CA, Girones MA, Martinez CB, Martín IF, Delgado PG, Calahorro MM, Carrasco GM, Pacheco RR, Tomás VV, Godoy MM, Yébenes JZ, Balza De Vallejo OV, Fernandez JA, Gonzalez TB, De Las Pozas GC, Donado CD, Angulo SD, Ortiz GG, Mañana BR, Gonzalez RB, Nieves EG, Torrado JM, Culla MD, Pla JJ, Bellfill RL, Velasco JM, Nogues EP, Ortun MR, Aguñin PR, Farre NS, Combas JV, Zubeldia IA, Hortigüela GB, Ayuso JC, Álvarez GG, Peña MH, Castro AL, Llorente PL, Martinez PM, Malanda NM, Gonzalez FG, Miguel TP, Hernandez M, Timon SJ, Carreño SP, Olbah MA, Muñoz AA, Mohedad JC, Fernandez DG, Camacho AL, Lopez CM, Gonzalez MM, Bernal SN, Pellon LF, Miguel EM, Portal FO, Rodríguez AS, Alapont MM, Raducan I, Segarra MS, Bonilla PG, Calderon PM, Rodriguez MM, Martinez RL, Pérez MM, Villarejo MM, Aparicio MB, Muíño Joga MD, Garcia-Boente LF, Paz VG, Barcala FG, Orjales RN, Castedo CR, Diaz MR, Fernandez AM, Español SA, San Francisco AR, Navarrete BA, Gomez De Cadiz LC, Rodriguez ME, Lopez JF, Jiménez ML, Caballero JL, Ceres MM, Costoya RM, García CM, Vilchez MR, Ortiz AR, Mazuecos JB, Castro AV, Arenaza BL, Mendizabal SL, Sampedro IP, Vazquez LV, De Sus JC, Villa JC, Pargada DF, Jarque JH, Patiño MC, Gomila AF, Pastrie FN, Lopez JA, Martinez PB, Ruiz De Lobera AV, Gonzalez FC, Carral CP, Racamonde AV, Del Pino MC, Sacanell JR, García IA, Mejias YA, Bausela BA, Cozar MA, Sanz PB, Bobolea I, Fernandez AB, De Santiago Delgado E, Campos RD, Uña JD, Vila AF, Cano MG, De Pedro JG, Galicia MG, De Olano DG, Barbudo BH, Viña AL, Peña AL, Martin GM, De Francisco AM, Borque RM, Moro M, Prieto MR, Frutos MR, Jimenez BR, Rodríguez M, Ribate DR, Perez FR, Hornillos JR, López PS, Martinez FS, Garrido-Lestache JS, Gambasica ZV, Albelda CV, Ramirez JA, De Luiz Martínez G, Núñez IG, De Luna FL, Sáenz De Tejada EO, Galo AP, Martinez RR, Esojo MS, Espinosa RA, Inglés MA, Mora RB, Campos MF, Arellano MP, Puebla MA, Figueroa BG, Fernández SG, Rivera JO, Purroy AT, Garazo BP, Losada SV, Villamuza YG, Bonny JC, Sintes RA, Landin JC, Paz AC, Abelaira MC, Rio FI, Sanmartín AP, Picans I, Moreira AR, Romera RT, Aznar JI, Bellido FM, Hernandez MR, Perez RG, Flores HI, Gutierrez FA, Cimbollek S, De Luque Piñana V, Gallardo JM, Garcia VM, Cuevas JO, Crespo YP, Enriquez JQ, Dominguez PS, Elias ÒS, Pamplona MM, Lara MJ, De Gregorio AM, Martin MA, Canelles MB, Baixauli EB, Serra PC, Gregori MC, Rodriguez PC, De Las Marinas Alvarez M, Palacios MD, El-Qutob López D, Giner JG, Lara SH, Martínez GJ, Santafé JL, Bayo AL, Moragon EM, Sancho IM, Lacomba JM, Sendra EN, Seisdedos LN, Bertol BO, Iniesta AR, Cubillan JR, Sánchez-Toril López F, Vinuesa AS, Gomez AA, De Frutos Arribas J, Fernandez EM, Alonso AS, Sanz CC, Fuentes MD, Sotillos MG, Arazuri NS. Anxiety, Depression, and Asthma Control: Changes After Standardized Treatment. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1953-1959. [DOI: 10.1016/j.jaip.2018.02.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 01/28/2018] [Accepted: 02/01/2018] [Indexed: 11/28/2022]
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Miliku K, Azad MB. Breastfeeding and the Developmental Origins of Asthma: Current Evidence, Possible Mechanisms, and Future Research Priorities. Nutrients 2018; 10:E995. [PMID: 30061501 PMCID: PMC6115903 DOI: 10.3390/nu10080995] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/14/2018] [Accepted: 07/26/2018] [Indexed: 01/06/2023] Open
Abstract
Breastfeeding has many established health benefits, but its impact on asthma development is uncertain. Breastfeeding appears to have a positive and dose-dependent impact on respiratory health, particularly during early childhood and in high-risk populations; however, the strength and causality of these associations are unclear. It is challenging to compare results across studies due to methodological differences and biological variation. Resolving these inconsistencies will require well-designed, prospective studies that accurately capture asthma diagnoses and infant feeding exposures (including breastfeeding duration, exclusivity, and method of feeding), account for key confounders, evaluate dose effects, and consider effect modification and reverse causality. Mechanistic studies examining human milk bioactives and their impact on lung health and asthma development are beginning to emerge, and these will be important in establishing the causality and mechanistic basis of the observed associations between breastfeeding and asthma. In this review, we summarize current evidence on this topic, identify possible reasons for disagreement across studies, discuss potential mechanisms for a causal association, and provide recommendations for future research.
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Affiliation(s)
- Kozeta Miliku
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
| | - Meghan B Azad
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
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Choi H, Tabashidze N, Rossner P, Dostal M, Pastorkova A, Kong SW, Gmuender H, Sram RJ. Altered vulnerability to asthma at various levels of ambient Benzo[a]Pyrene by CTLA4, STAT4 and CYP2E1 polymorphisms. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 231:1134-1144. [PMID: 28807506 DOI: 10.1016/j.envpol.2017.07.057] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Within fossil- and solid-fuel dependent geographic locations, mechanisms of air pollution-induced asthma remains unknown. In particular, sources of greater genetic susceptibility to airborne carcinogen, namely, benzo[a]pyrene (B[a]P) has never been investigated beyond that of a few well known genes. OBJECTIVES To deepen our understanding on how the genotypic variations within the candidate genes contribute to the variability in the children's susceptibility to ambient B[a]P on doctor-diagnosed asthma. METHODS Clinically confirmed asthmatic versus healthy control children (aged, 7-15) were enrolled from historically polluted and rural background regions in Czech Republic. Contemporaneous ambient B[a]P concentration was obtained from the routine monitoring network. The sputum DNA was genotyped for 95 genes. B[a]P interaction with SNPs was studied by two-stage, semi-agnostic screening of 621 SNPs. RESULTS The median B[a]P within the highly polluted urban center was 8-times higher than that in the background region (7.8 vs. 1.1 ng/m3) during the period of investigation. Within the baseline model, which considered B[a]P exposure-only, the second tertile range was associated with a significantly reduced odds (aOR = 0.28) of asthma (95% CI, 0.16 to 0.50) compared to those at the lowest range. However, the highest range of B[a]P was associated with 3.18-times greater odds of the outcome (95% CI, 1.77 to 5.71). Within the gene-environment interaction models, joint occurrence of a high B[a]P exposure range and having a high-risk genotype at CTLA4 gene (rs11571316) was associated with 9-times greater odds (95% CI, 4.56-18.36) of the asthma diagnosis. Similarly, rs11571319 at CTLA4 and a high B[a]P exposure range was associated with a 8-times greater odds (95% CI, 3.95-14.27) of asthma diagnosis. Furthermore, having TG + GG genotypes on rs1031509 near STAT4 was associated with 5-times (95% CI, 3.03-8.55) greater odds of asthma diagnosis at the highest B[a]P range, compared to the odds at the reference range. Also CYP2E1 AT + TT genotypes (rs2070673) was associated with 5-times (95% CI, 3.1-8.8) greater odds of asthma diagnosis at the highest B[a]P exposure. CONCLUSIONS The children, who jointly experience a high B[a]P exposure (6.3-8.5 ng/m3) as well as susceptible genotypes in CTLA4 (rs11571316 and rs11571319), STAT4 (rs1031509), and CYP2E1 (rs2070673), respectively, are associated with a significantly greater odds of having doctor-diagnosed asthma, compared to those with neither risk factors.
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Affiliation(s)
- Hyunok Choi
- Departments of Environmental Health Sciences, Epidemiology, and Biostatistics University at Albany School of Public Health, One University Place, Room 153, Rensselaer, NY 12144-3456, USA.
| | - Nana Tabashidze
- Department of Genetic Ecotoxicology, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, v.v.i., Vídeňská 1083, 142 20, Prague 4, Czech Republic.
| | - Pavel Rossner
- Department of Genetic Ecotoxicology, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, v.v.i., Vídeňská 1083, 142 20, Prague 4, Czech Republic.
| | - Miroslav Dostal
- Department of Genetic Ecotoxicology, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, v.v.i., Vídeňská 1083, 142 20, Prague 4, Czech Republic.
| | - Anna Pastorkova
- Department of Genetic Ecotoxicology, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, v.v.i., Vídeňská 1083, 142 20, Prague 4, Czech Republic
| | - Sek Won Kong
- Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA.
| | - Hans Gmuender
- Genedata AG, Margarethenstrasse 38, CH-4053, Basel, Switzerland.
| | - Radim J Sram
- Department of Genetic Ecotoxicology, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, v.v.i., Vídeňská 1083, 142 20, Prague 4, Czech Republic.
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Rancière F, Bougas N, Viola M, Momas I. Early Exposure to Traffic-Related Air Pollution, Respiratory Symptoms at 4 Years of Age, and Potential Effect Modification by Parental Allergy, Stressful Family Events, and Sex: A Prospective Follow-up Study of the PARIS Birth Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:737-745. [PMID: 27219743 PMCID: PMC5381976 DOI: 10.1289/ehp239] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 11/10/2015] [Accepted: 05/09/2016] [Indexed: 05/06/2023]
Abstract
BACKGROUND The relation between traffic-related air pollution (TRAP) exposure and the incidence of asthma/allergy in preschool children has been widely studied, but results remain heterogeneous, possibly due to differences in methodology and susceptibility to TRAP. OBJECTIVES We aimed to study the relation of early TRAP exposure with the development of respiratory/allergic symptoms and asthma during preschool years, and to investigate parental allergy, "stressful" family events, and sex as possible effect modifiers. METHODS We examined data of 2,015 children from the PARIS birth cohort followed up with repeated questionnaires completed by parents until age 4 years. TRAP exposure in each child's first year of life was estimated by nitrogen oxides (NOx) air dispersion modeling, taking into account both home and day care locations. Association between TRAP exposure and patterns of wheezing, dry night cough, and rhinitis symptoms was studied using multinomial logistic regression models adjusted for potential confounders. Effect modification by parental history of allergy, stressful family events, and sex was investigated. RESULTS An interquartile range (26 μg/m3) increase in NOx levels was associated with an increased odds ratio (OR) of persistent wheezing at 4 years (adjusted OR = 1.27; 95% confidence interval: 1.09, 1.47). TRAP exposure was positively associated with persistent wheeze, dry cough, and rhinitis symptoms among children with a parental allergy, those experiencing stressful family events, and boys, but not in children whose parents did not have allergies or experience stressful events, or in girls (all interaction p-values < 0.2). CONCLUSIONS This study supports the hypothesis that not all preschool children are equal regarding TRAP health effects. Parental history of allergy, stressful family events, and male sex may increase their susceptibility to adverse respiratory effects of early TRAP exposure.
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Affiliation(s)
- Fanny Rancière
- Laboratoire Santé Publique et Environnement, EA4064, Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Cellule Cohorte, Direction de l’Action Sociale de l’Enfance et de la Santé, Mairie de Paris, Paris, France
- Address correspondence to F. Rancière, Université Paris Descartes, Faculté de Pharmacie de Paris, EA 4064, 4 avenue de l’Observatoire, 75270 Paris cedex 06, France. Telephone: 33 1 53 73 97 27. E-mail:
| | - Nicolas Bougas
- Laboratoire Santé Publique et Environnement, EA4064, Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Malika Viola
- Laboratoire Santé Publique et Environnement, EA4064, Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Isabelle Momas
- Laboratoire Santé Publique et Environnement, EA4064, Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Cellule Cohorte, Direction de l’Action Sociale de l’Enfance et de la Santé, Mairie de Paris, Paris, France
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Prenatal and postnatal stress and wheeze in Mexican children: Sex-specific differences. Ann Allergy Asthma Immunol 2016; 116:306-312.e1. [PMID: 26822280 DOI: 10.1016/j.anai.2015.12.025] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 12/18/2015] [Accepted: 12/22/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND Increasing evidence links early-life exposure to psychosocial stress with adverse childhood respiratory outcomes. The influence of exposure timing has not been completely elucidated. OBJECTIVE To examine the association between prenatal and postnatal maternal stress and wheeze in 417 children enrolled in a prospective birth cohort in Mexico City. METHODS Maternal negative life event (NLE) scores were ascertained in the second or third trimester of pregnancy and at the 48-month postnatal visit. Children's respiratory outcomes, caregiver report of ever wheeze, and wheeze in the past 12 months were obtained from the International Study of Asthma and Allergies in Childhood survey administered at 48 months. Associations between prenatal and postnatal NLE scores and wheeze were analyzed using a modified Poisson regression approach adjusting for covariates. RESULTS In separate models, higher maternal psychosocial stress during pregnancy (relative risk [RR], 1.12; 95% CI, 1.00-1.26) and postnatally (RR, 1.21; 95% CI, 1.08-1.35) were associated with increased risk of wheeze in the past 12 months with an evident exposure-response relationship. There was a significant interaction between postnatal stress and sex in relation to current wheeze. In a sex-stratified model, the association between postnatal stress and risk of wheeze in the past 12 months was stronger in girls (RR, 1.35; 95% CI, 1.13-1.61) than in boys (RR, 1.11; 95% CI, 0.97-1.27) (P for interaction = .04). CONCLUSION Prenatal and postnatal stress in mothers was associated with wheeze in preschool-aged children, and the effect of postnatal stress was stronger in girls. Understanding the temporal- and sex-specific effects of stress may better inform prevention strategies.
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Coogan PF, Castro-Webb N, Yu J, O'Connor GT, Palmer JR, Rosenberg L. Neighborhood and Individual Socioeconomic Status and Asthma Incidence in African American Women. Ethn Dis 2016; 26:113-22. [PMID: 26843804 DOI: 10.18865/ed.26.1.113] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Individual socioeconomic status (SES) has been associated with asthma incidence but whether neighborhood SES has an influence is unknown. We assessed the contributions of neighborhood socioeconomic status (SES), neighborhood housing density, neighborhood racial composition, and individual SES to the development of adult-onset asthma in Black women, accounting for other known or suspected risk factors. DESIGN AND PARTICIPANTS Prospective cohort study conducted among 47,779 African American women followed with biennial health questionnaires from 1995 to 2011. METHODS AND MAIN OUTCOME MEASURES Incident asthma was defined as new self-report of doctor-diagnosed asthma with concurrent use of asthma medication. We assessed neighborhood SES, indicated by census variables representing income, education, and wealth, and housing density and % African American population, as well as individual SES, indicated by highest education of participant/spouse. Cox proportional hazards models were used to derive multivariable hazard ratios (HRs) and 95% CIs for the association of individual SES and neighborhood variables with asthma incidence. RESULTS During a 16-year follow-up period, 1520 women reported incident asthma. Neighborhood factors were not associated with asthma incidence after control for individual SES, body mass index, and other factors. Compared with college graduates, the multivariable HR for asthma was 1.13 (95% CI 1.00-1.28) for women with some college education and 1.23 (95% CI 1.05-1.44) for women with no more than a high school education. CONCLUSIONS Individual SES, but not neighborhood SES or other neighborhood factors, was associated with the incidence of adult-onset asthma in this population of African American women.
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Affiliation(s)
| | | | - Jeffrey Yu
- Boston University, Slone Epidemiology Center
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Grizenko N, Osmanlliu E, Fortier MÈ, Joober R. Increased Risk of Asthma in Children with ADHD: Role of Prematurity and Maternal Stress during Pregnancy. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2015; 24:109-115. [PMID: 26379722 PMCID: PMC4558981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 07/17/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE ADHD and asthma are prevalent conditions in childhood, with complex pathophysiology involving genetic-environmental interplay. The study objective is to examine the prevalence of asthma in our ADHD population and explore factors that may increase the risk of developing asthma in children with ADHD. METHODS We retrospectively analyzed the presence of maternal stress during pregnancy and history of asthma in 201 children diagnosed with ADHD. RESULTS Chi-square analysis indicated significant higher presence of asthma in our ADHD sample compared to Quebec children, χ(2)(1, N = 201) = 15.37, P<0.001. Only prematurity and stress during pregnancy significantly predicted asthma in a logistic regression model, χ(2)(2)=23.70, P<0.001, with odds ratios of 10.6 (95% CI: 2.8-39.5) and 3.2 (95% CI: 1.4-7.3), respectively. CONCLUSION Children with ADHD have a higher prevalence of asthma than the general Quebec pediatric population. Children with ADHD born prematurely and/or those whose mothers experienced stress during pregnancy have a significantly increased risk of developing asthma. The study highlights the importance of potentially offering social and psychological support to mothers who experienced stress during pregnancy and/or are at risk of delivering prematurely.
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Affiliation(s)
- Natalie Grizenko
- Department of Psychiatry, McGill University and Division of Child and Adolescent Psychiatry, Montreal, Quebec
- Douglas Mental Health University Institute, Montreal, Quebec
| | - Esli Osmanlliu
- Department of Pediatrics, McGill University, Montreal, Quebec
| | | | - Ridha Joober
- Douglas Mental Health University Institute, Montreal, Quebec
- Department of Human Genetics, McGill University, Montreal, Quebec
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13
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Araújo-Martins J, Carreiro Martins P, Viegas J, Aelenei D, Cano M, Teixeira J, Paixão P, Papoila A, Leiria-Pinto P, Pedro C, Rosado-Pinto J, Annesi-Maesano I, Neuparth N. Environment and Health in Children Day Care Centres (ENVIRH) - Study rationale and protocol. REVISTA PORTUGUESA DE PNEUMOLOGIA 2014; 20:311-323. [PMID: 32288977 PMCID: PMC7110969 DOI: 10.1016/j.rppnen.2014.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 02/01/2014] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Indoor air quality (IAQ) is considered an important determinant of human health. The association between exposure to volatile organic compounds, particulate matter, house dust mite, molds and bacteria in day care centers (DCC) is not completely clear. The aim of this project was to study these effects. METHODS – STUDY DESIGN This study comprised two phases. Phase I included an evaluation of 45 DCCs (25 from Lisbon and 20 from Oporto, targeting 5161 children). In this phase, building characteristics, indoor CO2 and air temperature/relative humidity, were assessed. A children's respiratory health questionnaire derived from the ISAAC (International Study on Asthma and Allergies in Children) was also distributed. Phase II encompassed two evaluations and included 20 DCCs selected from phase I after a cluster analysis (11 from Lisbon and 9 from Oporto, targeting 2287 children). In this phase, data on ventilation, IAQ, thermal comfort parameters, respiratory and allergic health, airway inflammation biomarkers, respiratory virus infection patterns and parental and child stress were collected. RESULTS In Phase I, building characteristics, occupant behavior and ventilation surrogates were collected from all DCCs. The response rate of the questionnaire was 61.7% (3186 children).Phase II included 1221 children. Association results between DCC characteristics, IAQ and health outcomes will be provided in order to support recommendations on IAQ and children's health. A building ventilation model will also be developed. DISCUSSION This paper outlines methods that might be implemented by other investigators conducting studies on the association between respiratory health and indoor air quality at DCC.
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Affiliation(s)
- J. Araújo-Martins
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - P. Carreiro Martins
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - J. Viegas
- Laboratório Nacional de Engenharia Civil, Avenida do Brasil, 101, 1700-066 Lisbon, Portugal
| | - D. Aelenei
- Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus da Caparica, 2829-516 Caparica, Portugal
| | - M.M. Cano
- Instituto Nacional de Saúde Dr. Ricardo Jorge – Lisboa, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
| | - J.P. Teixeira
- Instituto Nacional de Saúde Dr. Ricardo Jorge – Porto, Rua Alexandre Herculano, 321, 4000-055 Oporto, Portugal
| | - P. Paixão
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - A.L. Papoila
- Departamento de Bioestatística e Informática, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Ceaul, Portugal
- Centro de Investigação, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - P. Leiria-Pinto
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - C. Pedro
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - J. Rosado-Pinto
- Hospital da Luz, Avenida Lusíada, 100, 1500-650 Lisbon, Portugal
| | - I. Annesi-Maesano
- INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe EPAR (Epidemiology of Allergic and Respiratory Diseases), F-75013 Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe EPAR, F-75013 Paris, France
| | - N. Neuparth
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
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14
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Araújo-Martins J, Carreiro Martins P, Viegas J, Aelenei D, Cano MM, Teixeira JP, Paixão P, Papoila AL, Leiria-Pinto P, Pedro C, Rosado-Pinto J, Annesi-Maesano I, Neuparth N. Environment and Health in Children Day Care Centres (ENVIRH) - Study rationale and protocol. REVISTA PORTUGUESA DE PNEUMOLOGIA 2014; 20:311-23. [PMID: 24746462 PMCID: PMC7126211 DOI: 10.1016/j.rppneu.2014.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/06/2014] [Accepted: 02/01/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Indoor air quality (IAQ) is considered an important determinant of human health. The association between exposure to volatile organic compounds, particulate matter, house dust mite, molds and bacteria in day care centers (DCC) is not completely clear. The aim of this project was to study these effects. METHODS - STUDY DESIGN This study comprised two phases. Phase I included an evaluation of 45 DCCs (25 from Lisbon and 20 from Oporto, targeting 5161 children). In this phase, building characteristics, indoor CO2 and air temperature/relative humidity, were assessed. A children's respiratory health questionnaire derived from the ISAAC (International Study on Asthma and Allergies in Children) was also distributed. Phase II encompassed two evaluations and included 20 DCCs selected from phase I after a cluster analysis (11 from Lisbon and 9 from Oporto, targeting 2287 children). In this phase, data on ventilation, IAQ, thermal comfort parameters, respiratory and allergic health, airway inflammation biomarkers, respiratory virus infection patterns and parental and child stress were collected. RESULTS In Phase I, building characteristics, occupant behavior and ventilation surrogates were collected from all DCCs. The response rate of the questionnaire was 61.7% (3186 children). Phase II included 1221 children. Association results between DCC characteristics, IAQ and health outcomes will be provided in order to support recommendations on IAQ and children's health. A building ventilation model will also be developed. DISCUSSION This paper outlines methods that might be implemented by other investigators conducting studies on the association between respiratory health and indoor air quality at DCC.
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Affiliation(s)
- J Araújo-Martins
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal.
| | - P Carreiro Martins
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - J Viegas
- Laboratório Nacional de Engenharia Civil, Avenida do Brasil, 101, 1700-066 Lisbon, Portugal
| | - D Aelenei
- Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus da Caparica, 2829-516 Caparica, Portugal
| | - M M Cano
- Instituto Nacional de Saúde Dr. Ricardo Jorge - Lisboa, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
| | - J P Teixeira
- Instituto Nacional de Saúde Dr. Ricardo Jorge - Porto, Rua Alexandre Herculano, 321, 4000-055 Oporto, Portugal
| | - P Paixão
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - A L Papoila
- Departamento de Bioestatística e Informática, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Ceaul, Portugal; Centro de Investigação, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - P Leiria-Pinto
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - C Pedro
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - J Rosado-Pinto
- Hospital da Luz, Avenida Lusíada, 100, 1500-650 Lisbon, Portugal
| | - I Annesi-Maesano
- INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR (Epidemiology of Allergic and Respiratory Diseases), F-75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, F-75013 Paris, France
| | - N Neuparth
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
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Zhou C, Baïz N, Banerjee S, Charpin DA, Caillaud D, de Blay F, Raherison C, Lavaud F, Annesi-Maesano I. The relationships between ambient air pollutants and childhood asthma and eczema are modified by emotion and conduct problems. Ann Epidemiol 2014; 23:778-83. [PMID: 24404567 DOI: 10.1016/j.annepidem.2013.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE This study examined the hypothesis that emotion and conduct problems (ECPs) may modify the relationships between ambient air pollutants and childhood asthma and eczema. METHODS In the cross-sectional study, 4209 French schoolchildren (aged 10e12 years) were investigated between March 1999 and October 2000. Ambient air pollutants exposures were estimated with dispersion modeling. Health outcomes and ECPs were evaluated by validated questionnaires, completed by the parents. Marginal models were used to analyze the relationships of exposures to ambient air pollutants and/or ECPs to asthma phenotypes and current eczema, adjusting for potential confounders. RESULTS In our population, interactions were found between ECPs and exposures to ambient air pollutants (benzene, carbon monoxide, nitrogen dioxide, nitrogen oxides, particulate matter with an aerodynamic diameter below 10 mm, volatile organic compounds) (P < .20). In addition, ECPs were related to current wheezing (adjusted prevalence odds ratio [aOR], 2.35; 95% confidence interval [CI], 1.59e3.47), current doctor-diagnosed asthma (aOR, 1.82; 95% CI, 1.25e2.66), and current eczema (aOR, 2.21; 95% CI, 1.61e3.02). Children with ECPs had 1.17e1.51 times higher aORs for the associations between ambient air pollutants and asthma phenotypes and current eczema than those without ECPs. CONCLUSIONS ECPs may modify the relationships between ambient air pollutants and childhood asthma and eczema.
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16
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Coogan PF, Yu J, O'Connor GT, Brown TA, Palmer JR, Rosenberg L. Depressive symptoms and the incidence of adult-onset asthma in African American women. Ann Allergy Asthma Immunol 2014; 112:333-8.e1. [PMID: 24440322 DOI: 10.1016/j.anai.2013.12.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/11/2013] [Accepted: 12/31/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Some evidence suggests that depression may increase the risk of adult-onset asthma. No data are available for African American women, in whom the prevalence of depression and asthma is high. OBJECTIVE To conduct prospective analyses of the relation of depressive symptoms to asthma incidence in the Black Women's Health Study, a prospective cohort of US black women followed since 1995 with mailed biennial questionnaires. METHODS Of 31,848 participants followed from 1999 to 2011, 771 reported incident asthma. Depressive symptoms were ascertained on 1999 and 2005 follow-up questionnaires with the Center for Epidemiological Studies-Depression Scale (CES-D). Participants rated the frequency of 20 symptoms. A score was calculated by summing the responses to all questions. Cox regression models were used to derive incidence rate ratios and 95% confidence intervals for 4 categories of the CES-D score in relation to incident asthma, adjusted for body mass index, smoking, and other covariates. RESULTS The multivariable incidence rate ratio in the highest category of CES-D score (≥ 33) compared with the lowest (<16) was 2.08 (95% confidence interval 1.58-2.74), with a significant trend (P < .0001). The incidence rate ratio was higher in women who took antidepressants, were current or former smokers, were not obese, and were at least 40 years old, although there were no statistically significant interactions. CONCLUSION A positive association was observed between CES-D score and the incidence of adult-onset asthma. If the hypothesis is confirmed, depression could contribute substantially to the burden of asthma in adults.
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Affiliation(s)
- Patricia F Coogan
- Slone Epidemiology Center at Boston University, Boston, Massachusetts.
| | - Jeffrey Yu
- Slone Epidemiology Center at Boston University, Boston, Massachusetts
| | | | - Timothy A Brown
- Center for Anxiety and Related Disorders, Boston University, Boston, Massachusetts
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston, Massachusetts
| | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston, Massachusetts
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Liu X, Olsen J, Agerbo E, Yuan W, Cnattingius S, Gissler M, Li J. Psychological stress and hospitalization for childhood asthma-a nationwide cohort study in two Nordic countries. PLoS One 2013; 8:e78816. [PMID: 24205324 PMCID: PMC3808299 DOI: 10.1371/journal.pone.0078816] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 09/16/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Exposures to psychological stress in early life may contribute to the development or exacerbation of asthma. We undertook a cohort study based on data from several population-based registers in Denmark and Sweden to examine whether bereavement in childhood led to increased asthma hospitalization. METHODS All singleton children born in Denmark during 1977-2008 and in Sweden during 1973-2006 were included in the study (N=5,202,576). The children were followed from birth to the date of first asthma hospitalization, emigration, death, their 18(th) birthday, or the end of study (31 December 2007 in Sweden and 31 December 2008 in Denmark), whichever came first. All the children were assigned to the non-bereaved group until they lost a close relative (mother, father or a sibling), from when they were included in the bereaved group. We evaluated the hazard ratio (HR) of first hospitalization for asthma in bereaved children using Cox proportional hazards regression models, compared to those who were in the non-bereaved group. We also did a sub-analysis on the association between bereavement and first asthma medication. RESULTS A total of 147,829 children were hospitalized for asthma. The overall adjusted HR of asthma hospitalization in bereaved children was 1.10 (95% confidence interval (CI): 1.04-1.16), compared to non-bereaved children. The risk of asthma hospitalization was increased in those who lost a close relative at age of 14-17 years (HR=1.54, 95% CI: 1.23-1.92), but not in younger age groups. The association between bereavement and asthma hospitalization did not change over time since bereavement. In the sub-analysis in singleton live births during 1996-2008 recorded in the DMBR, bereavement was associated with a lower use of asthma medication (HR=0.87, 95% CI: 0.80-0.95). CONCLUSIONS Our data suggests that psychological stress following bereavement in late adolescence is associated with an increased risk of asthma hospitalization or lowers the threshold for asthma hospitalization.
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Affiliation(s)
- Xiaoqin Liu
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Epidemiology and Social Science on Reproductive Health, Shanghai Institute of Planned Parenthood Research, WHO Collaborating Center for Research in Human Reproduction, National Population & Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai, China
- * E-mail:
| | - Jørn Olsen
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Esben Agerbo
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- CIRRAU-Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Wei Yuan
- Department of Epidemiology and Social Science on Reproductive Health, Shanghai Institute of Planned Parenthood Research, WHO Collaborating Center for Research in Human Reproduction, National Population & Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai, China
| | - Sven Cnattingius
- Clinical Epidemiology Unit, Department of Medicin Solna, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Mika Gissler
- THL (Terveyden ja hyvinvoinnin laitos) National Institute for Health and Welfare, Information Department, Helsinki, Finland
- NHV (Nordisk högskola för folkhälsovetenskap) Nordic School of Public Health, Gothenburg, Sweden
| | - Jiong Li
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
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18
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Asthma and wheezing are associated with depression and anxiety in adults: an analysis from 54 countries. Pulm Med 2013; 2013:929028. [PMID: 23577252 PMCID: PMC3613067 DOI: 10.1155/2013/929028] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 02/03/2013] [Indexed: 11/18/2022] Open
Abstract
Background. Asthma and depression are important public-health concerns worldwide. While some epidemiologic studies have shown asthma and wheezing to be associated with depression and anxiety, the patterns are unclear at the multinational level due to the lack of cross-study comparability. Our study examined the associations of self-reported asthma diagnosis and current wheezing with self-reported depression diagnosis and 30-day anxiety using an international survey. Methods. Using the 2002 World Health Survey, a standardized international survey conducted by the WHO, we estimated the associations between diagnosed asthma and current wheezing with diagnosed depression and 30-day anxiety via multiple logistic regressions for 54 countries worldwide. Results. Diagnosed depression and 30-day anxiety were associated with diagnosed asthma in 65% and 40% of the countries, respectively. Diagnosed depression and 30-day anxiety were associated with current wheezing in 83% and 82% of the countries, respectively. Conclusions. The association between asthma and depression was generally seen at the global level. These results indicated the importance of addressing the asthma-depression comorbidity as public-health and clinical management priorities, in order to improve the overall health of the countries.
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Kelsay K, Leung DYM, Mrazek DA, Klinnert MD. Prospectively assessed early life experiences in relation to cortisol reactivity in adolescents at risk for asthma. Dev Psychobiol 2013; 55:133-44. [PMID: 22314999 PMCID: PMC8609772 DOI: 10.1002/dev.21006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 12/08/2011] [Indexed: 12/26/2022]
Abstract
Altered cortisol reactivity in individuals with asthma likely increases the risk of inflammation in the face of stress. Understanding antecedents of cortisol reactivity enhances knowledge of factors affecting asthma. Forty-eight subjects genetically predisposed for asthma, recruited from a study that assessed them from birth, completed a laboratory stress procedure and self-report measures at ages 17-19 years. Observation and parent reports from age 0 to 2 years were used to create a parent child relationship risk variable and to define criteria for a cumulative risk variable. In repeated measures analysis of 46 adolescents, those who had experienced early parent child relationship problems, specifically insecure attachment, had an attenuated cortisol stress response, even after controlling for concurrent psychological function and recent stressors (F = 4.6, p < .005). Cortisol stress response was not related to asthma status. This study supports a relationship between the parent child relationship during the first 2 years of life and later cortisol response to stress in youth at genetic risk for asthma.
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Affiliation(s)
- Kim Kelsay
- Department of Psychiatry, University of Colorado, Denver, CO, USA.
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de Marco R, Pesce G, Girardi P, Marchetti P, Rava M, Ricci P, Marcon A. Foetal exposure to maternal stressful events increases the risk of having asthma and atopic diseases in childhood. Pediatr Allergy Immunol 2012; 23:724-9. [PMID: 22957808 DOI: 10.1111/j.1399-3038.2012.01346.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The natural history of asthma and atopic diseases begins in utero. Studies investigating the influence of foetal exposure to maternal stressful life events during pregnancy (SLEP) on asthma and atopic diseases are lacking. AIM To test whether the children of mothers who had experienced SLEP are at an increased risk for asthma, atopic eczema and allergic rhinitis. METHODS The association between maternal SLEP (at least one among: divorce, mourning or loss of the job) and the occurrence of asthma and atopic diseases in childhood was studied in a population (n = 3854) of children, aged 3-14 yrs, living in Northern Italy. The parents filled in a standardized questionnaire about the children's health and the events occurred to their mothers during pregnancy. RESULTS Three hundred and thirty-three (9%) of the mothers experienced SLEP. Their children had a statistically significantly higher lifetime prevalence of wheezing (31.6% vs. 23.1%), asthma (8.9% vs. 5.6%), allergic rhinitis (10.9% vs. 7.3%) and atopic eczema (29.7% vs. 21.1%) than those of mothers without SLEP. After adjusting for potential confounders, the foetal exposure to SLEP was positively associated with wheezing (OR: 1.41, 95% CI: 1.03-1.94), asthma (OR: 1.71, 95% CI: 1.02-2.89), allergic rhinitis (OR: 1.75, 95% CI: 1.08-2.84) and atopic eczema (OR: 1.53, 95% CI: 1.11-2.10). CONCLUSION The children of mothers who had experienced SLEP were at a moderately increased risk of having wheezing, asthma, eczema and allergic rhinitis during their childhood. Maternal stress during pregnancy might enhance the expression of asthma and atopic phenotypes in children.
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Affiliation(s)
- Roberto de Marco
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Italy.
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Vangeepuram N, Galvez MP, Teitelbaum SL, Brenner B, Wolff MS. The association between parental perception of neighborhood safety and asthma diagnosis in ethnic minority urban children. J Urban Health 2012; 89:758-68. [PMID: 22669642 PMCID: PMC3462829 DOI: 10.1007/s11524-012-9679-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Low-income populations, minorities, and children living in inner cities have high rates of asthma. Recent studies have emphasized the role of psychosocial stress in development of asthma. Residence in unsafe neighborhoods is one potential source of increased stress. The study objective was to examine the association between parental perception of neighborhood safety and asthma diagnosis among inner city, minority children. Cross-sectional data from a community-based study of 6-8-year-old New York City children were used. Asthma was defined as parental report of physician-diagnosed asthma and at least one asthma-related symptom. Parental perceptions of neighborhood safety were assessed with a questionnaire. Associations between perceived neighborhood safety and asthma were examined using chi-squared tests. Multivariate logistic regression analyses were then performed. Five hundred four children were included with 79% female, 26.5% non-Hispanic Black, and 73.5% Hispanic. Asthma was present in 23.8% of children. There was an inverse association between feeling safe walking in the neighborhood and asthma with 45.7% of parents of asthmatic children reporting they felt safe compared to 60.9% of parents of non-asthmatic children (p = 0.006). Fewer parents of asthmatic children than of non-asthmatic children reported that their neighborhood was safe from crime (21.7% versus 33.9%, p = 0.018). In multivariate analyses adjusting for race/ethnicity, age, gender, socioeconomic status, number of smokers in the home and breastfeeding history, parents reporting feeling unsafe walking in the neighborhood were more likely to have a child diagnosed with asthma (OR = 1.89, 95%CI 1.13-3.14). Psychosocial stressors such as living in unsafe neighborhoods may be associated with asthma diagnosis in urban ethnic minority children. Addressing the increased asthma burden in certain communities may require interventions to decrease urban stressors.
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Affiliation(s)
- N Vangeepuram
- Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
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