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Rosser F, Forno E, Kurland KS, Han YY, Mair C, Acosta-Pérez E, Canino G, Celedón JC. Annual SO 2 exposure, asthma, atopy, and lung function in Puerto Rican children. Pediatr Pulmonol 2020; 55:330-337. [PMID: 31805225 PMCID: PMC7122992 DOI: 10.1002/ppul.24595] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/20/2019] [Indexed: 11/05/2022]
Abstract
BACKGROUND Long-term effects of sulfur dioxide (SO2 ) exposure on children, a vulnerable population, are largely unknown. Further, how long-term SO2 affects Puerto Rican children living in the island of Puerto Rico, a group with high asthma prevalence, is unclear. We evaluated the effects of annual average 1-hour daily maximum SO2 average on asthma, atopy, total immunoglobulin E (IgE), and lung function in Puerto Rican children. METHODS A cohort of 678 children (351 with asthma, 327 without asthma) was recruited in Puerto Rico from 2009 to 2010. Annual average 1-hour daily maximum SO2 exposure was interpolated utilizing publicly available monitoring data. Multivariable logistic and linear regression was used for the analysis of asthma, atopy (defined as an IgE ≥0.35 IU/mL to at least one of five common aero-allergens), total IgE, and lung function measures (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], and FEV1/FVC ratio). RESULTS Annual SO2 exposure (per 1 ppb) was significantly associated with asthma (odds ratio [OR] = 1.42; 95% confidence interval [CI] = 1.05-1.91) and atopy (OR = 1.35; 95% CI = 1.02-1.78). Such exposure was also significantly associated with lower FEV1/FVC in all children (β = -1.42; 95% CI = -2.78 to -0.08) and in children with asthma (β = -2.39; 95% CI= -4.31 to -0.46). Annual SO2 exposure was not significantly associated with total IgE, FEV1, or FVC. CONCLUSIONS Among Puerto Rican children in Puerto Rico, long-term SO2 exposure is linked to asthma and atopy. In these children, long-term SO2 exposure is also associated with reduced FEV1/FVC, particularly in those with asthma.
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Affiliation(s)
- Franziska Rosser
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kristen S Kurland
- H John Heinz III College and School of Architecture, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Edna Acosta-Pérez
- Behavioral Sciences Research Institute of Puerto Rico, University of Puerto Rico, San Juan, Puerto Rico
| | - Glorisa Canino
- Behavioral Sciences Research Institute of Puerto Rico, University of Puerto Rico, San Juan, Puerto Rico
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
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Guo P, Feng W, Zheng M, Lv J, Wang L, Liu J, Zhang Y, Luo G, Zhang Y, Deng C, Shi T, Liu P, Zhang L. Short-term associations of ambient air pollution and cause-specific emergency department visits in Guangzhou, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 613-614:306-313. [PMID: 28917169 DOI: 10.1016/j.scitotenv.2017.09.102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/23/2017] [Accepted: 09/11/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Evidence of association of ambient air pollution with cause-specific emergency department visits in China is still limited. This study aimed to investigate short-term associations between exposures to air pollutants and daily cause-specific emergency department visits using a large-scale multicenter database involving a total of 65 sentinel hospitals in Guangzhou, the most densely-populated city in south China, during 2013-2015. MATERIAL AND METHODS We obtained data on 162,771 emergency department visits from 65 hospitals from the Emergency Medical Command Center in Guangzhou between January 1, 2013 and December 31, 2015. Daily air pollution data on particulate matter (PM) of aerodynamic diameter<10 and 2.5μm (PM10, and PM2.5, respectively), sulfur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3) were collected from the Daily Quality Report of the Guangzhou Environmental Protection Bureau during the study period. Visits for neurologic, respiratory and circulatory diseases were assessed in relation to air pollutants using Poisson generalized additive models. RESULTS Mean daily number of emergency department visits for neurologic, respiratory and circulatory diseases was 89, 24 and 35, respectively. After adjustment for other pollutants (PM2.5, PM10, NO2 and O3), meteorological factors and time-varying confounders, a 7.98-μg/m3 (interquartile range) increment in 2-day moving average of same-day and previous-day SO2 concentrations was associated with the statistically significant increase of 4.89% (95% confidence interval: 2.86, 6.95) in neurologic emergency department visits; elevation in SO2 level (per 7.98μg/m3) was linked to a 5.19% (95% confidence interval: 2.03, 8.44) increase in circulatory emergency department visits. Most positive links were seen during the cold season. CONCLUSIONS The results of this study contribute to the evidence of the significant associations between SO2 and specific neurologic and circulatory conditions, and also provide insight into the planning of clinical services and emergency contingency response for air pollution exposures in Guangzhou.
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Affiliation(s)
- Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Wenru Feng
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Murui Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Jiayun Lv
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Li Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Ju Liu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Yanhong Zhang
- Shantou University Medical College, Shantou 515041, China
| | - Gangfeng Luo
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Yanting Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Changyu Deng
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Tongxing Shi
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Pengda Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Lin Zhang
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
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Park HK. Air pollution and climate change: Effects on asthmatic patients. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.2.79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Liu P, Wang X, Fan J, Xiao W, Wang Y. Effects of Air Pollution on Hospital Emergency Room Visits for Respiratory Diseases: Urban-Suburban Differences in Eastern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13030341. [PMID: 27007384 PMCID: PMC4809004 DOI: 10.3390/ijerph13030341] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/11/2016] [Accepted: 03/14/2016] [Indexed: 11/16/2022]
Abstract
A study on the relationships between ambient air pollutants (PM2.5, SO2 and NO2) and hospital emergency room visits (ERVs) for respiratory diseases from 2013 to 2014 was performed in both urban and suburban areas of Jinan, a heavily air-polluted city in Eastern China. This research was analyzed using generalized additive models (GAM) with Poisson regression, which controls for long-time trends, the “day of the week” effect and meteorological parameters. An increase of 10 μg/m3 in PM2.5, SO2 and NO2 corresponded to a 1.4% (95% confidence interval (CI): 0.7%, 2.1%), 1.2% (95% CI: 0.5%, 1.9%), and 2.5% (95%: 0.8%, 4.2%) growth in ERVs for the urban population, respectively, and a 1.5% (95%: 0.4%, 2.6%), 0.8% (95%: −0.7%, 2.3%), and 3.1% (95%: 0.5%, 5.7%) rise in ERVs for the suburban population, respectively. It was found that females were more susceptible than males to air pollution in the urban area when the analysis was stratified by gender, and the reverse result was seen in the suburban area. Our results suggest that the increase in ERVs for respiratory illnesses is linked to the levels of air pollutants in Jinan, and there may be some urban-suburban discrepancies in health outcomes from air pollutant exposure.
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Affiliation(s)
- Peng Liu
- School of Environmental Science and Engineering, Shandong University, Jinan 250100, China.
| | - Xining Wang
- Shandong Center for Disease Control and Prevention, Jinan 250014, China.
| | - Jiayin Fan
- Shandong Experimental High School, Jinan 250001, China.
| | - Wenxin Xiao
- School of Foreign Languages and Literature, Shandong University, Jinan 250100, China.
| | - Yan Wang
- School of Environmental Science and Engineering, Shandong University, Jinan 250100, China.
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Ierodiakonou D, Zanobetti A, Coull BA, Melly S, Postma DS, Boezen HM, Vonk JM, Williams PV, Shapiro GG, McKone EF, Hallstrand TS, Koenig JQ, Schildcrout JS, Lumley T, Fuhlbrigge AN, Koutrakis P, Schwartz J, Weiss ST, Gold DR. Ambient air pollution, lung function, and airway responsiveness in asthmatic children. J Allergy Clin Immunol 2016; 137:390-9. [PMID: 26187234 PMCID: PMC4742428 DOI: 10.1016/j.jaci.2015.05.028] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 05/17/2015] [Accepted: 05/20/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Although ambient air pollution has been linked to reduced lung function in healthy children, longitudinal analyses of pollution effects in asthmatic patients are lacking. OBJECTIVE We sought to investigate pollution effects in a longitudinal asthma study and effect modification by controller medications. METHODS We examined associations of lung function and methacholine responsiveness (PC20) with ozone, carbon monoxide (CO), nitrogen dioxide, and sulfur dioxide concentrations in 1003 asthmatic children participating in a 4-year clinical trial. We further investigated whether budesonide and nedocromil modified pollution effects. Daily pollutant concentrations were linked to ZIP/postal code of residence. Linear mixed models tested associations of within-subject pollutant concentrations with FEV1 and forced vital capacity (FVC) percent predicted, FEV1/FVC ratio, and PC20, adjusting for seasonality and confounders. RESULTS Same-day and 1-week average CO concentrations were negatively associated with postbronchodilator percent predicted FEV1 (change per interquartile range, -0.33 [95% CI, -0.49 to -0.16] and -0.41 [95% CI, -0.62 to -0.21], respectively) and FVC (-0.19 [95% CI, -0.25 to -0.07] and -0.25 [95% CI, -0.43 to -0.07], respectively). Longer-term 4-month CO averages were negatively associated with prebronchodilator percent predicted FEV1 and FVC (-0.36 [95% CI, -0.62 to -0.10] and -0.21 [95% CI, -0.42 to -0.01], respectively). Four-month averaged CO and ozone concentrations were negatively associated with FEV1/FVC ratio (P < .05). Increased 4-month average nitrogen dioxide concentrations were associated with reduced postbronchodilator FEV1 and FVC percent predicted. Long-term exposures to sulfur dioxide were associated with reduced PC20 (percent change per interquartile range, -6% [95% CI, -11% to -1.5%]). Treatment augmented the negative short-term CO effect on PC20. CONCLUSIONS Air pollution adversely influences lung function and PC20 in asthmatic children. Treatment with controller medications might not protect but rather worsens the effects of CO on PC20. This clinical trial design evaluates modification of pollution effects by treatment without confounding by indication.
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Affiliation(s)
- Despo Ierodiakonou
- University of Groningen, Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, Groningen, The Netherlands.
| | - Antonella Zanobetti
- Environmental Epidemiology and Risk Program, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Steve Melly
- Environmental Epidemiology and Risk Program, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Dirkje S Postma
- Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, Groningen, The Netherlands; University of Groningen, Department of Pulmonology, University Medical Center Groningen, Groningen, The Netherlands
| | - H Marike Boezen
- University of Groningen, Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, Groningen, The Netherlands
| | - Judith M Vonk
- University of Groningen, Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands; Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, Groningen, The Netherlands
| | - Paul V Williams
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Wash
| | - Gail G Shapiro
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Wash
| | - Edward F McKone
- Department of Respiratory Medicine, St Vincent University Hospital, Dublin, Ireland
| | - Teal S Hallstrand
- Department of Pulmonary and Critical Care, School of Medicine, University of Washington, Seattle, Wash
| | - Jane Q Koenig
- Department of Environmental Health, School of Medicine, University of Washington, Seattle, Wash
| | | | - Thomas Lumley
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Anne N Fuhlbrigge
- Channing Laboratory, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Mass
| | - Petros Koutrakis
- Environmental Epidemiology and Risk Program, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Joel Schwartz
- Environmental Epidemiology and Risk Program, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Scott T Weiss
- Channing Laboratory, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Mass
| | - Diane R Gold
- Environmental Epidemiology and Risk Program, Harvard T.H. Chan School of Public Health, Boston, Mass; Channing Laboratory, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Mass.
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Reno AL, Brooks EG, Ameredes BT. Mechanisms of Heightened Airway Sensitivity and Responses to Inhaled SO2 in Asthmatics. ENVIRONMENTAL HEALTH INSIGHTS 2015; 9:13-25. [PMID: 25922579 PMCID: PMC4384764 DOI: 10.4137/ehi.s15671] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/14/2014] [Accepted: 12/16/2014] [Indexed: 05/29/2023]
Abstract
Sulfur dioxide (SO2) is a problematic inhalable air pollutant in areas of widespread industrialization, not only in the United States but also in countries undergoing rapid industrialization, such as China, and it can be a potential trigger factor for asthma exacerbations. It is known that asthmatics are sensitive to the effects of SO2; however, the basis of this enhanced sensitivity remains incompletely understood. A PubMed search was performed over the course of 2014, encompassing the following terms: asthma, airway inflammation, sulfur dioxide, IL-10, mouse studies, and human studies. This search indicated that biomarkers of SO2 exposure, SO2 effects on airway epithelial cell function, and animal model data are useful in our understanding of the body's response to SO2, as are SO2-associated amplification of allergic inflammation, and potential promotion of neurogenic inflammation due to chemical irritant properties. While definitive answers are still being sought, these areas comprise important foci of consideration regarding asthmatic responses to inhaled SO2. Furthermore, IL-10 deficiency associated with asthma may be another important factor associated with an inability to resolve inflammation and mitigate oxidative stress resulting from SO2 inhalation, supporting the idea that asthmatics are predisposed to SO2 sensitivity, leading to asthma exacerbations and airway dysfunction.
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Affiliation(s)
| | - Edward G Brooks
- University of Texas Health Science Center at San Antonio, Texas, USA
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7
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Vawda S, Mansour R, Takeda A, Funnell P, Kerry S, Mudway I, Jamaludin J, Shaheen S, Griffiths C, Walton R. Associations between inflammatory and immune response genes and adverse respiratory outcomes following exposure to outdoor air pollution: a HuGE systematic review. Am J Epidemiol 2014; 179:432-42. [PMID: 24243740 DOI: 10.1093/aje/kwt269] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Variants of inflammatory and immune response genes have been associated with adverse respiratory outcomes following exposure to air pollution. However, the genes involved and their associations are not well characterized, and there has been no systematic review. Thus, we conducted a review following the guidelines of the Human Genome Epidemiology Network. Six observational studies and 2 intervention studies with 14,903 participants were included (2001-2010). Six studies showed at least 1 significant gene-pollutant interaction. Meta-analysis was not possible due to variations in genes, pollutants, exposure estimates, and reported outcomes. The most commonly studied genes were tumor necrosis factor α (TNFA) (n = 6) and toll-like receptor 4 (TLR4) (n = 3). TNFA -308G>A modified the action of ozone and nitrogen dioxide on lung function, asthma risk, and symptoms; however, the direction of association varied between studies. The TLR4 single-nucleotide polymorphisms rs1927911, rs10759931, and rs6478317 modified the association of particulate matter and nitrogen dioxide with asthma. The transforming growth factor β1 (TGFB1) polymorphism -509C>T also modified the association of pollutants with asthma. This review indicates that genes controlling innate immune recognition of foreign material (TLR4) and the subsequent inflammatory response (TGFB1, TLR4) modify the associations of exposure to air pollution with respiratory function. The associations observed have biological plausibility; however, larger studies with improved reporting are needed to confirm these findings.
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Kim KH, Jahan SA, Kabir E. A review on human health perspective of air pollution with respect to allergies and asthma. ENVIRONMENT INTERNATIONAL 2013; 59:41-52. [PMID: 23770580 DOI: 10.1016/j.envint.2013.05.007] [Citation(s) in RCA: 183] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/10/2013] [Accepted: 05/11/2013] [Indexed: 05/27/2023]
Abstract
The increase in cases of asthma and allergies has become an important health issue throughout the globe. Although these ailments were not common diseases a few short decades ago, they are now affecting a large part of the population in many regions. Exposure to environmental (both outdoor and indoor) pollutants may partially account for the prevalence of such diseases. In this review, we provide a multidisciplinary review based on the most up-to-date survey of literature regarding various types of airborne pollutants and their associations with asthma-allergies. The major pollutants in this respect include both chemical (nitrogen dioxide, ozone, sulfur dioxide, particulate matter, and volatile organic compounds) and biophysical parameters (dust mites, pet allergens, and mold). The analysis was extended further to describe the development of these afflictions in the human body and the subsequent impact on health. This publication is organized to offer an overview on the current state of research regarding the significance of air pollution and its linkage with allergy and asthma.
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Affiliation(s)
- Ki-Hyun Kim
- Department of Environment & Energy, Sejong University, Seoul 143-747, Republic of Korea.
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9
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Howden R, Kleeberger SR. Genetic and Environmental Influences on Gas Exchange. Compr Physiol 2012; 2:2595-614. [DOI: 10.1002/cphy.c110060] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Johns DO, Svendsgaard D, Linn WS. Analysis of the concentration-respiratory response among asthmatics following controlled short-term exposures to sulfur dioxide. Inhal Toxicol 2011; 22:1184-93. [PMID: 21126154 DOI: 10.3109/08958378.2010.535220] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Some of the most compelling evidence of sulfur dioxide (SO(2))-induced respiratory morbidity is derived from a large body of studies involving controlled short-term exposures among groups of asthmatic volunteers. These studies were extensively cited in the recently completed review of the primary National Ambient Air Quality Standards for SO(2). Although it is clear from these investigations that exposure to SO(2) may result in a significant increase in bronchoconstriction, there is uncertainty regarding the range of concentrations over which this respiratory response occurs. The objective of this study was to better characterize the concentration-response relationship between SO(2) and measures of bronchoconstriction using individual subject lung function response data. In reviewing studies of asthmatics exposed to SO(2) during 5- to 10-min periods of elevated ventilation, we observed clear and consistent evidence of an increase in the bronchoconstrictive response to SO(2) with increasing exposure concentrations between 0.2 and 1.0 ppm. In a subsequent analysis of individual subject data, it was found that those asthmatics experiencing SO(2)-induced respiratory effects at relatively high exposure concentrations are also more likely than nonresponders to experience similar effects after exposure to lower SO(2) concentrations (≤0.4 ppm). Although the clinical significance of these effects is unsettled, the findings provide additional support to epidemiologic evidence of an association between ambient SO(2) concentration and various measures of respiratory morbidity in the general population.
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Affiliation(s)
- Douglas O Johns
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
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Johns DO, Linn WS. A review of controlled human SO₂ exposure studies contributing to the US EPA integrated science assessment for sulfur oxides. Inhal Toxicol 2011; 23:33-43. [PMID: 21222560 DOI: 10.3109/08958378.2010.539290] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Laboratory studies involving intentional and highly controlled exposures to air pollutants among groups of human volunteers provide valuable information related to the potential health effects of pollutants regulated under the US Clean Air Act. These controlled human exposure studies often provide biological plausibility for the associations between air-pollutant concentration and a given health endpoint observed in epidemiologic investigations. In some cases, results from human laboratory studies provide evidence of a relevant health effect at ambient or near-ambient concentrations and thus directly support the selection of air quality standard levels. In the recently completed review of the US National Ambient Air Quality Standards (NAAQS) for sulfur dioxide (SO₂), the US Environmental Protection Agency (EPA) concluded that short-term exposures to SO₂ are causally associated with an increase in respiratory morbidity. This determination was based in large part on findings from laboratory studies of controlled exposures to SO₂ among small groups of asthmatic individuals. The purpose of this review is to concisely present an overview of the evidence from controlled human exposure studies of SO₂-induced respiratory health effects following short-term exposures. While the majority of these studies were conducted over 20 years ago, the findings and insights gained from this work continues to play an integral role in evaluating the respiratory effects of ambient exposures to SO₂.
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Affiliation(s)
- Douglas O Johns
- National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
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Fisk MZ, Steigerwald MD, Smoliga JM, Rundell KW. Asthma in swimmers: a review of the current literature. PHYSICIAN SPORTSMED 2010; 38:28-34. [PMID: 21150139 DOI: 10.3810/psm.2010.12.1822] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Asthma is common in many types of athletes, but its prevalence appears to be particularly high in swimmers. Long-term and acute exposure to swimming pool disinfectants has been shown to increase asthma risk in swimmers through inducing oxidative stress, which results in inflammation of the pulmonary epithelium and subsequent airway remodeling. Individuals with specific genotypes are more likely to develop asthma when exposed to inhaled irritants. Therefore, it is important for physicians to be knowledgeable about the risks associated with asthma in swimmers, as well as the diagnostic techniques and practices to reduce asthma symptoms.
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van Thriel C, Schäper M, Kleinbeck S, Kiesswetter E, Blaszkewicz M, Golka K, Nies E, Raulf-Heimsoth M, Brüning T. Sensory and pulmonary effects of acute exposure to sulfur dioxide (SO2). Toxicol Lett 2010; 196:42-50. [DOI: 10.1016/j.toxlet.2010.03.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Revised: 03/16/2010] [Accepted: 03/25/2010] [Indexed: 02/06/2023]
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14
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Castro-Giner F, Künzli N, Jacquemin B, Forsberg B, de Cid R, Sunyer J, Jarvis D, Briggs D, Vienneau D, Norback D, González JR, Guerra S, Janson C, Antó JM, Wjst M, Heinrich J, Estivill X, Kogevinas M. Traffic-related air pollution, oxidative stress genes, and asthma (ECHRS). ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1919-24. [PMID: 20049212 PMCID: PMC2799467 DOI: 10.1289/ehp.0900589] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 07/23/2009] [Indexed: 05/20/2023]
Abstract
BACKGROUND Traffic-related air pollution is related with asthma, and this association may be modified by genetic factors. OBJECTIVES We investigated the role of genetic polymorphisms potentially modifying the association between home outdoor levels of modeled nitrogen dioxide and asthma. METHODS Adults from 13 cities of the second European Community Respiratory Health Survey (ECRHS II) were included (n = 2,920), for whom both DNA and outdoor NO(2) estimates were available. Home addresses were geocoded and linked to modeled outdoor NO(2) estimates, as a marker of local traffic-related pollution. We examined asthma prevalence and evaluated polymorphisms in genes involved in oxidative stress pathways [gluthatione S-transferases M1 (GSTM1), T1 (GSTT1), and P1 (GSTP1) and NAD(P)H:quinine oxidoreductase (NQO1)], inflammatory response [tumor necrosis factor alpha (TNFA)], immunologic response [Toll-like receptor 4 (TLR4)], and airway reactivity [adrenergic receptor beta2 (ADRB2)]. RESULTS The association between modeled NO(2) and asthma prevalence was significant for carriers of the most common genotypes of NQO1 rs2917666 [odds ratio (OR) = 1.54; 95% confidence interval (CI), 1.10-2.24], TNFA rs2844484 (OR = 2.02; 95% CI, 1.30-3.27). For new-onset asthma, the effect of NO(2) was significant for the most common genotype of NQO1 rs2917666 (OR = 1.52; 95% CI, 1.09-2.16). A significant interaction was found between NQO1 rs2917666 and NO(2) for asthma prevalence (p = 0.02) and new-onset asthma (p = 0.04). CONCLUSIONS Genetic polymorphisms in the NQO1 gene are related to asthma susceptibility among persons exposed to local traffic-related air pollution. This points to the importance of antioxidant pathways in the protection against the effects of air pollution on asthma.
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Affiliation(s)
- Francesc Castro-Giner
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research, Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Nino Künzli
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research, Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Bénédicte Jacquemin
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Institut national de la santé et de la recherche médicale, U780, Epidemiology and Biostatistics, Villejuif, France
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Rafael de Cid
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
- Genes and Disease Program, Center for Genomic Regulation, Barcelona, Spain
| | - Jordi Sunyer
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research, Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
- Department of Health and Experimental Sciences, University Pompeu Fabra, Barcelona, Spain
| | - Deborah Jarvis
- Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute and
| | - David Briggs
- Epidemiology and Public Health, Imperial College, London, United Kingdom
| | - Danielle Vienneau
- Epidemiology and Public Health, Imperial College, London, United Kingdom
| | - Dan Norback
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
| | - Juan R. González
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research, Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Stefano Guerra
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research, Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Christer Janson
- Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
| | - Josep-Maria Antó
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research, Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
- Department of Health and Experimental Sciences, University Pompeu Fabra, Barcelona, Spain
| | - Matthias Wjst
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Munich, Germany
| | - Joachim Heinrich
- Institute of Epidemiology, Helmholtz Zentrum München, Munich, Germany
| | - Xavier Estivill
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
- Genes and Disease Program, Center for Genomic Regulation, Barcelona, Spain
- Department of Health and Experimental Sciences, University Pompeu Fabra, Barcelona, Spain
| | - Manolis Kogevinas
- Centre for Research in Environmental Epidemiology, Barcelona, Spain
- Municipal Institute of Medical Research, Hospital del Mar, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
- National School of Public Health, Athens, Greece
- Address correspondence to M. Kogevinas, Centre for Research in Environmental Epidemiology, 88 Dr Aiguader Rd., Barcelona 08003, Spain. Telephone: 34-93-316-0673. Fax: 34-93-316-05-75. E-mail:
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15
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Ciencewicki J, Trivedi S, Kleeberger SR. Oxidants and the pathogenesis of lung diseases. J Allergy Clin Immunol 2008; 122:456-68; quiz 469-70. [PMID: 18774381 DOI: 10.1016/j.jaci.2008.08.004] [Citation(s) in RCA: 245] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Revised: 08/05/2008] [Accepted: 08/07/2008] [Indexed: 12/31/2022]
Abstract
The increasing number of population-based and epidemiologic associations between oxidant pollutant exposures and cardiopulmonary disease exacerbation, decrements in pulmonary function, and mortality underscores the important detrimental effects of oxidants on public health. Because inhaled oxidants initiate a number of pathologic processes, including inflammation of the airways, which may contribute to the pathogenesis and/or exacerbation of airways disease, it is critical to understand the mechanisms through which exogenous and endogenous oxidants interact with molecules in the cells, tissues, and epithelial lining fluid of the lung. Furthermore, it is clear that interindividual variation in response to a given exposure also exists across an individual lifetime. Because of the potential impact that oxidant exposures may have on reproductive outcomes and infant, child, and adult health, identification of the intrinsic and extrinsic factors that may influence susceptibility to oxidants remains an important issue. In this review, we discuss mechanisms of oxidant stress in the lung, the role of oxidants in lung disease pathogenesis and exacerbation (eg, asthma, chronic obstructive pulmonary disease, and acute respiratory distress syndrome), and the potential risk factors (eg, age, genetics) for enhanced susceptibility to oxidant-induced disease.
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Affiliation(s)
- Jonathan Ciencewicki
- Laboratory of Respiratory Biology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
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16
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Abstract
In the last decades, many studies have shown an increase in the prevalence of allergic rhinitis and asthma mainly in urban communities, especially in industrialized countries. Airborne pollutants such as diesel exhaust particles, ozone, nitrogen dioxide and sulphur dioxide have been implicated in the initiation and exacerbation of allergic airway diseases. Epidemiologic studies have shown clear associations between air pollution and allergic diseases, in vivo and in vitro studies have provided biologic link and potential molecular mechanisms. Particulate and gaseous pollutants can act both on the upper and lower airways to initiate and exacerbate cellular inflammation through interaction with the innate immune system. As a consequence, increased non-specific airway hyper-responsiveness and airway resistance have been observed in man. Diesel exhaust particles can both induce and exacerbate in vivo allergic responses. They can also modify the immune system's handling of the allergen. The effects of gaseous pollutants on immune responses to allergens are not fully understood. We review the different mechanisms involved in the enhancement of allergic inflammation by urban air pollutants, including effects on cytokine and chemokine production, as well as activation of different immune cells. We discuss the hypothesis that pollutants' effects on the immune system involve hierarchical oxidative stress. Susceptibility genes to air pollution inducing allergic diseases are also discussed.
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Affiliation(s)
- Marcel Bonay
- Inserm U700 et Service de Physiologie-Explorations fonctionnelles, Université Paris 7 et Hôpital Bichat-Claude-Bernard, AP-HP, 46, rue Henri Huchard, 75018 Paris, France.
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17
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Castro-Giner F, Kauffmann F, de Cid R, Kogevinas M. Gene-environment interactions in asthma. Occup Environ Med 2006; 63:776-86, 761. [PMID: 17050746 PMCID: PMC2077993 DOI: 10.1136/oem.2004.019216] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- F Castro-Giner
- Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research (IMIM), Barcelona, Spain
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18
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Abstract
PURPOSE OF REVIEW The gene that encodes the beta2-adrenergic receptor (ADRB2) is one of the most studied candidate genes in asthma. This review examines recent articles of the relationship between ADRB2 polymorphisms and asthma. RECENT FINDINGS Candidate gene association studies of ADRB2 and asthma have been dominated by analyses of the two common non-synonymous coding single nucleotide polymorphisms, Arg16Gly and Glu27Gly. Published studies have yielded inconsistent results. Three recent meta-analyses on the effects of these two polymorphisms have found no associations with asthma, although there were suggestions of associations with other asthma-related phenotypes, such as nocturnal asthma and asthma severity. Other recent studies have investigated other single nucleotide polymorphisms in this gene (i.e. single nucleotide polymorphisms in the promoter region and other single nucleotide polymorphisms in the coding region). These analyses have investigated the association between these single nucleotide polymorphisms (and haplotypes of these polymorphisms) and asthma-related phenotypes such as lung function, airways hyperresponsiveness, and response to a bronchodilator, and have suggested that certain regions of the gene may be associated with different phenotypes. Results from these studies, however, have also been inconsistent. SUMMARY Polymorphisms of ADRB2 are not major risk factors for the development of asthma. These polymorphisms are likely to be important, however, in determining drug response. Future studies need to fully characterize all of the variation in the gene and perform comprehensive association studies. Finally, interactions between ADRB2 and other genes in the beta-agonist pathway are an important and active area of research that will shed more light on inter-individual differences in drug response.
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Affiliation(s)
- Augusto A Litonjua
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02115, USA.
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19
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Just J, Nisakinovic L, Laoudi Y, Grimfeld A. [Air pollution and asthma in children]. Arch Pediatr 2006; 13:1055-60. [PMID: 16697622 DOI: 10.1016/j.arcped.2006.03.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2005] [Accepted: 03/16/2006] [Indexed: 10/24/2022]
Abstract
The prevalence of asthma and allergic diseases has increased world-wide during the last quarter of the 20th century, particularly among children and adolescents. No change common to all sites where asthma has increased throughout the world has been identified, suggesting that this 'epidemic' phenomenon is likely due to multiple factors. The following have been most discussed: exposure to indoor and outdoor allergens, modification of the patterns of respiratory infections, decreasing trends of physical activity, evolution in the make-up of environmental irritants, including tobacco smoke and urban air toxicants. In this review, we point out the role of exposure to air pollutants, in addition to and in combination with other asthma enhancers or precipitators. Whereas concentrations of the 'classical' air quality indicators (SO2, CO) have more or less steadily decreased, asthma prevalence augmented in developed countries during the same period. However, the nature of the air pollution mix has deeply evolved, and should also be considered. Ambient air concentrations of industrial and house heating combustion sources of pollutants in the city have substantially decreased, but by contrast the concentrations of various ultrafine particles have increased. Now, there is in vitro and in vivo evidence that exposure to urban air particles, and particularly to diesel exhausts, elicits chronic oxidative stress and repeated inflammatory responses, so that they may enhance allergic inflammation and airway hyper-responsiveness. Several epidemiological studies suggested an association between traffic density close to places of children's residence and prevalence of respiratory symptoms, and more specifically of asthma or allergic rhinitis symptoms in them. Chronic exposure during infancy to traffic-related pollutants may accelerate or even provoke, among genetically sensitive subjects, disruption of the normal regulatory and repair processes eventually contributing to the increase of asthma incidence.
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Affiliation(s)
- J Just
- Service de pneumologie et allergologie pédiatriques, hôpital d'enfants Armand-Trousseau, APHP, 26, avenue du Docteur-Arnold-Netter, 75571 Paris cedex 12 et université Pierre et Marie-Curie Paris-VI, France
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20
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Yang IA, Holz O, Jörres RA, Magnussen H, Barton SJ, Rodríguez S, Cakebread JA, Holloway JW, Holgate ST. Association of tumor necrosis factor-alpha polymorphisms and ozone-induced change in lung function. Am J Respir Crit Care Med 2004; 171:171-6. [PMID: 15486341 DOI: 10.1164/rccm.200402-194oc] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Ozone is a major air pollutant with adverse health effects which exhibit marked inter-individual variability. In mice, regions of genetic linkage with ozone-induced lung injury include the tumor necrosis factor-alpha (TNF), lymphotoxin-alpha (LTA), Toll-like receptor 4 (TLR4), superoxide dismutase (SOD2), and glutathione peroxidase (GPX1) genes. We genotyped polymorphisms in these genes in 51 individuals who had undergone ozone challenge. Mean change in FEV1 with ozone challenge, as a percentage of baseline, was -3% in TNF -308G/A or A/A individuals, compared with -9% in G/G individuals (p = 0.024). When considering TNF haplotypes, the smallest change in FEV1 with ozone exposure was associated with the TNF haplotype comprising LTA +252G/TNF -1031T/TNF -308A/TNF -238G. This association remained statistically significant after correction for age, sex, disease, and ozone concentration (p = 0.047). SOD2 or GPX1 genotypes were not associated with lung function, and the TLR4 polymorphism was too infrequent to analyze. The results of this study support TNF as a genetic factor for susceptibility to ozone-induced changes in lung function in humans, and has potential implications for stratifying health risks of air pollution.
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Affiliation(s)
- Ian A Yang
- Asthma Genetics Laboratory, Human Genetics Division, University of Southampton, United Kingdom.
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21
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Small KM, McGraw DW, Liggett SB. Pharmacology and physiology of human adrenergic receptor polymorphisms. Annu Rev Pharmacol Toxicol 2003; 43:381-411. [PMID: 12540746 DOI: 10.1146/annurev.pharmtox.43.100901.135823] [Citation(s) in RCA: 219] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Adrenergic receptors are expressed on virtually every cell type in the body and are the receptors for epinephrine and norepinephrine within the sympathetic nervous system. They serve critical roles in maintaining homeostasis in normal physiologic settings as well as pathologic states. These receptors are also targets for therapeutically administered agonists and antagonists. Recent studies have shown that at least seven adrenergic receptor subtypes display variation in amino acid sequence in the human population due to common genetic polymorphisms. Variations in potential regulatory domains in noncoding sequence are also present. Here, we review the consequences of these polymorphisms in terms of signaling, human physiology and disease, and response to therapy.
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Affiliation(s)
- Kersten M Small
- Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA.
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22
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Hakonarson H, Halapi E. Genetic analyses in asthma: current concepts and future directions. AMERICAN JOURNAL OF PHARMACOGENOMICS : GENOMICS-RELATED RESEARCH IN DRUG DEVELOPMENT AND CLINICAL PRACTICE 2003; 2:155-66. [PMID: 12383022 DOI: 10.2165/00129785-200202030-00001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Asthma is a complex genetic disorder with a heterogeneous phenotype, largely attributed to the interactions among many genes and between these genes and the environment. Numerous loci and candidate genes have been reported to show linkage and association of asthma and the asthma-associated phenotypes, atopy, elevated immunoglobulin E (IgE) levels, and bronchial hyper-responsiveness to alleles of microsatellite markers and single nucleotide polymorphisms (SNPs) within specific cytokine/chemokine, and IgE regulating genes. While many studies reporting these observations are compelling, only one asthma gene conferring high risk has been mapped. In this review, we present studies that support linkage and/or associations to the various genetic loci and genes in asthma. The first genome-wide scan for linkage to quantitative traits underlying asthma identified linkage on chromosome 4q, 6, 7, 11q, 13q and 16. A genome scan in American families from three racial groups revealed linkage to chromosome 2q, 5q, 6p, 12q, 13q and 14q. A two-stage scan in Hutterite families from the US found linkage on chromosome 5q, 12q, 19q and 21q. A screen in German families identified linkage to asthma on chromosome 2q, 6p, 9 and 12q and a two-stage genome scan in French families found replicated linkage on chromosomes 1p, 12q and 17q. A study of asthma in Finland showed linkage to high IgE on 7q14. Apart from a European linkage study of 199 families with atopic dermatitis, which demonstrated significant linkage to chromosome 3q21, three other studies have reported linkage results of genome-wide significance, including a linkage study in 175 Icelandic asthma families (14q24), a study in 533 Chinese families with bronchial hyper-responsiveness (chromosome 2) and a study in 47 Japanese families with mite-sensitive atopic asthma (5q31), suggesting that these regions may harbor genes contributing to the development of asthma and allergies. While significant progress has been made in the field of asthma genetics in the past decade, the clinical implications of the genes and genetic variations within the numerous candidate asthma genes that have been found to associate with the expression of the asthmatic phenotype, remain undetermined.
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Affiliation(s)
- Hakon Hakonarson
- Division of Respiratory and Pharmacogenomics Research, deCODE Genetics, Inc., Reykjavik, Iceland
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23
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Applying statistical approaches in the dissection of genes versus environment for asthma and allergic disease. Curr Opin Allergy Clin Immunol 2001. [DOI: 10.1097/00130832-200110000-00008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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