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Voorhies K, Sordillo JE, McGeachie M, Ampleford E, Wang AL, Lasky-Su J, Tantisira K, Dahlin A, Kelly RS, Ortega VE, Lutz SM, Wu AC. Age by Single Nucleotide Polymorphism Interactions on Bronchodilator Response in Asthmatics. J Pers Med 2021; 11:jpm11010059. [PMID: 33477890 PMCID: PMC7833432 DOI: 10.3390/jpm11010059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 12/15/2022] Open
Abstract
An unaddressed and important issue is the role age plays in modulating response to short acting β2-agonists in individuals with asthma. The objective of this study was to identify whether age modifies genetic associations of single nucleotide polymorphisms (SNPs) with bronchodilator response (BDR) to β2-agonists. Using three cohorts with a total of 892 subjects, we ran a genome wide interaction study (GWIS) for each cohort to examine SNP by age interactions with BDR. A fixed effect meta-analysis was used to combine the results. In order to determine if previously identified BDR SNPs had an age interaction, we also examined 16 polymorphisms in candidate genes from two published genome wide association studies (GWAS) of BDR. There were no significant SNP by age interactions on BDR using the genome wide significance level of 5 × 10−8. Using a suggestive significance level of 5 × 10−6, three interactions, including one for a SNP within PRAG1 (rs4840337), were significant and replicated at the significance level of 0.05. Considering candidate genes from two previous GWAS of BDR, three SNPs (rs10476900 (near ADRB2) [p-value = 0.009], rs10827492 (CREM) [p-value = 0.02], and rs72646209 (NCOA3) [p-value = 0.02]) had a marginally significant interaction with age on BDR (p < 0.05). Our results suggest age may be an important modifier of genetic associations for BDR in asthma.
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Affiliation(s)
- Kirsten Voorhies
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, USA; (K.V.); (J.E.S.); (S.M.L.)
| | - Joanne E. Sordillo
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, USA; (K.V.); (J.E.S.); (S.M.L.)
| | - Michael McGeachie
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (M.M.); (A.L.W.); (J.L.-S.); (K.T.); (A.D.); (R.S.K.)
| | - Elizabeth Ampleford
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (E.A.); (V.E.O.)
| | - Alberta L. Wang
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (M.M.); (A.L.W.); (J.L.-S.); (K.T.); (A.D.); (R.S.K.)
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (M.M.); (A.L.W.); (J.L.-S.); (K.T.); (A.D.); (R.S.K.)
| | - Kelan Tantisira
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (M.M.); (A.L.W.); (J.L.-S.); (K.T.); (A.D.); (R.S.K.)
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA 92093, USA
| | - Amber Dahlin
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (M.M.); (A.L.W.); (J.L.-S.); (K.T.); (A.D.); (R.S.K.)
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA; (M.M.); (A.L.W.); (J.L.-S.); (K.T.); (A.D.); (R.S.K.)
| | - Victor E. Ortega
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (E.A.); (V.E.O.)
| | - Sharon M. Lutz
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, USA; (K.V.); (J.E.S.); (S.M.L.)
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Ann C. Wu
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, USA; (K.V.); (J.E.S.); (S.M.L.)
- Division of General Pediatrics, Department of Pediatrics, Children’s Hospital, Boston, MA 02215, USA
- Correspondence: ; Tel.: +1-(617)-867-4823; Fax: +1-(617)-867-4276
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Israel E, Lasky-Su J, Markezich A, Damask A, Szefler SJ, Schuemann B, Klanderman B, Sylvia J, Kazani S, Wu R, Martinez F, Boushey HA, Chinchilli VM, Mauger D, Weiss ST, Tantisira KG. Genome-wide association study of short-acting β2-agonists. A novel genome-wide significant locus on chromosome 2 near ASB3. Am J Respir Crit Care Med 2015; 191:530-7. [PMID: 25562107 DOI: 10.1164/rccm.201408-1426oc] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE β2-Agonists are the most common form of treatment of asthma, but there is significant variability in response to these medications. A significant proportion of this responsiveness may be heritable. OBJECTIVES To investigate whether a genome-wide association study (GWAS) could identify novel pharmacogenetic loci in asthma. METHODS We performed a GWAS of acute bronchodilator response (BDR) to inhaled β2-agonists. A total of 444,088 single-nucleotide polymorphisms (SNPs) were examined in 724 individuals from the SNP Health Association Resource (SHARe) Asthma Resource Project (SHARP). The top 50 SNPs were carried forward to replication in a population of 444 individuals. MEASUREMENTS AND MAIN RESULTS The combined P value for four SNPs reached statistical genome-wide significance aftercorrecting for multiple comparisons. Combined P values for rs350729, rs1840321, rs1384918, and rs1319797 were 2.21 × 10(-10), 5.75 × 10(-8), 9.3 × 10(-8), and 3.95 × 10(-8), respectively. The significant variants all map to a novel genetic region on chromosome 2 near the ASB3 gene, a region associated with smooth muscle proliferation. As compared with the wild type, the presence of the minor alleles reduced the degree of BDR by 20% in the original population and by a similar percentage in the confirmatory population. CONCLUSIONS These GWAS findings for BDR in subjects with asthma suggest that a gene associated with smooth muscle proliferation may influence a proportion of the smooth muscle relaxation that occurs in asthma.
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Affiliation(s)
- Elliot Israel
- 1 Division of Pulmonary and Critical Care Medicine and
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Tarnoki DL, Medda E, Tarnoki AD, Bikov A, Lazar Z, Fagnani C, Stazi MA, Karlinger K, Garami Z, Berczi V, Horvath I. Modest genetic influence on bronchodilator response: a study in healthy twins. Croat Med J 2015; 56:152-8. [PMID: 25891875 PMCID: PMC4410177 DOI: 10.3325/cmj.2015.56.152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim To determine the reasons for large standard deviation of bronchodilator response (BDR) and establish whether there is a potential heritable component in healthy subjects. Methods 67 monozygotic and 42 dizygotic adult twin pairs were assessed for bronchodilator response (%change in FEV1 after inhaling 400 µg salbutamol). Univariate quantitative genetic modeling was performed. Results Multiple regression modeling showed a significant association between BDR and sex and baseline FEV1 (P < 0.05), while no association was found with smoking habits, body mass index, or age. Within pair correlation in monozygotic twins was modest (0.332), but higher than in dizygotic twins (0.258). Age-, sex-, and baseline FEV1-adjusted genetic effect accounted for 14.9% (95% confidence interval, CI 0%-53.1%) of the variance of BDR, shared environmental effect for 18.4% (95% CI 0%-46.8%), and unshared environmental effect for 66.8% (95% CI 46.8%-88.7%). Conclusion Our twin study showed that individual differences in BDR can be mostly explained by unshared environmental effects. In addition, it is the first study to show low, insignificant hereditary influences, independently from sex, age, and baseline FEV1.
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Affiliation(s)
- David Laszlo Tarnoki
- David Laszlo Tarnoki, Department of Radiology and Oncotherapy, Semmelweis University, 78/A Ulloi street, 1082 Budapest, Hungary,
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Yu Y, Wang L, Liu H, Zhang S, Walker SO, Bartell T, Wang X. Body mass index and waist circumference rather than body adiposity index are better surrogates for body adiposity in a Chinese population. Nutr Clin Pract 2015; 30:274-82. [PMID: 25616517 DOI: 10.1177/0884533614564468] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Several studies have found that body adiposity index (BAI) is a better index of body adiposity than body mass index (BMI) in African and Mexican American adults. This study aims to evaluate the ability of BAI to predict body adiposity in Chinese children and adults. MATERIALS AND METHODS In total, 2425 children and 5726 adults were recruited from rural China. All participants completed whole-body dual-energy X-ray absorptiometry (DXA) and anthropometric measures. The correlation of BMI, BAI, and waist circumference (WC) to DXA adiposity indexes was performed across sex-specific adult and age- and sex-specific child cohorts, using Spearman correlation and linear regression models, respectively. RESULTS Both BMI and WC had a higher correlation with all adiposity indexes (whole body fat, percent body fat [Bfat%], trunk fat, and percent trunk fat [Tfat%]) measured by DXA than did BAI in both adults and children. Meanwhile, most of the linear regression model associations for BMI with Bfat% and Tfat% had a greater adjusted R(2) than those for BAI among both children and adults. CONCLUSION This study indicates that BMI and WC are better tools than BAI for estimating whole body fat and central body fat in a Chinese population.
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Affiliation(s)
- Yunxian Yu
- The Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, China
| | - Lijuan Wang
- The Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, China
| | - Hui Liu
- The Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, China
| | - Shanchun Zhang
- The Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, China
| | - Sheila O Walker
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Tami Bartell
- Smith Child Health Research Program, Ann and Robert H. Lurie Children's Hospital of Chicago Research Center, Chicago, Illinois
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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Park HW, Tantisira KG, Weiss ST. Pharmacogenomics in asthma therapy: where are we and where do we go? Annu Rev Pharmacol Toxicol 2014; 55:129-47. [PMID: 25292431 DOI: 10.1146/annurev-pharmtox-010814-124543] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The response to drug treatment in asthma is a complex trait and is markedly variable even in patients with apparently similar clinical features. Pharmaco-genomics, which is the study of variations of human genome characteristics as related to drug response, can play a role in asthma therapy. Both a traditional candidate-gene approach to conducting genetic association studies and genome-wide association studies have provided an increasing list of genes and variants associated with the three major classes of asthma medications: β2-agonists, inhaled corticosteroids, and leukotriene modifiers. Moreover, a recent integrative, systems-level approach has offered a promising opportunity to identify important pharmacogenomics loci in asthma treatment. However, we are still a long way away from making this discipline directly relevant to patients. The combination of network modeling, functional validation, and integrative omics technologies will likely be needed to move asthma pharmacogenomics closer to clinical relevance.
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Affiliation(s)
- Heung-Woo Park
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115; , ,
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Modeling and Optimization of Terbutaline Emitted from a Dry Powder Inhaler and Influence on Systemic Bioavailability Using Data Mining Technology. J Pharm Innov 2014. [DOI: 10.1007/s12247-014-9171-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Polygenic heritability estimates in pharmacogenetics: focus on asthma and related phenotypes. Pharmacogenet Genomics 2014; 23:324-8. [PMID: 23532052 DOI: 10.1097/fpc.0b013e3283607acf] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Although accurate measures of heritability are required to understand the pharmacogenetic basis of drug treatment response, these are generally not available, as it is unfeasible to give medications to individuals for which treatment is not indicated. Using a polygenic linear mixed modeling approach, we estimated lower bounds on the heritability of asthma and the heritability of two related drug-response phenotypes, bronchodilator response and airway hyperreactivity, using genome-wide single nucleotide polymorphism (SNP) data from existing asthma cohorts. Our estimate of the heritability for bronchodilator response is 28.5% (SE 16%, P=0.043) and airway hyperresponsiveness is 51.1% (SE 34%, P=0.064), whereas we estimate asthma genetic liability at 61.5% (SE 16%, P<0.001). Our results agree with the previously published estimates of the heritability of these traits, suggesting that the linear mixed modeling method is useful for computing the heritability of other pharmacogenetic traits. Furthermore, our results indicate that multiple SNP main effects, including SNPs as yet unidentified by genome-wide association study methods, together explain a sizable portion of the heritability of these traits.
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Himes BE, Jiang X, Hu R, Wu AC, Lasky-Su JA, Klanderman BJ, Ziniti J, Senter-Sylvia J, Lima JJ, Irvin CG, Peters SP, Meyers DA, Bleecker ER, Kubo M, Tamari M, Nakamura Y, Szefler SJ, Lemanske RF, Zeiger RS, Strunk RC, Martinez FD, Hanrahan JP, Koppelman GH, Postma DS, Nieuwenhuis MAE, Vonk JM, Panettieri RA, Markezich A, Israel E, Carey VJ, Tantisira KG, Litonjua AA, Lu Q, Weiss ST. Genome-wide association analysis in asthma subjects identifies SPATS2L as a novel bronchodilator response gene. PLoS Genet 2012; 8:e1002824. [PMID: 22792082 PMCID: PMC3390407 DOI: 10.1371/journal.pgen.1002824] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 05/24/2012] [Indexed: 01/25/2023] Open
Abstract
Bronchodilator response (BDR) is an important asthma phenotype that measures reversibility of airway obstruction by comparing lung function (i.e. FEV1) before and after the administration of a short-acting β2-agonist, the most common rescue medications used for the treatment of asthma. BDR also serves as a test of β2-agonist efficacy. BDR is a complex trait that is partly under genetic control. A genome-wide association study (GWAS) of BDR, quantified as percent change in baseline FEV1 after administration of a β2-agonist, was performed with 1,644 non-Hispanic white asthmatic subjects from six drug clinical trials: CAMP, LOCCS, LODO, a medication trial conducted by Sepracor, CARE, and ACRN. Data for 469,884 single-nucleotide polymorphisms (SNPs) were used to measure the association of SNPs with BDR using a linear regression model, while adjusting for age, sex, and height. Replication of primary P-values was attempted in 501 white subjects from SARP and 550 white subjects from DAG. Experimental evidence supporting the top gene was obtained via siRNA knockdown and Western blotting analyses. The lowest overall combined P-value was 9.7E-07 for SNP rs295137, near the SPATS2L gene. Among subjects in the primary analysis, those with rs295137 TT genotype had a median BDR of 16.0 (IQR = [6.2, 32.4]), while those with CC or TC genotypes had a median BDR of 10.9 (IQR = [5.0, 22.2]). SPATS2L mRNA knockdown resulted in increased β2-adrenergic receptor levels. Our results suggest that SPATS2L may be an important regulator of β2-adrenergic receptor down-regulation and that there is promise in gaining a better understanding of the biological mechanisms of differential response to β2-agonists through GWAS. Bronchodilator response (BDR) is an important asthma phenotype that measures reversibility of airway obstruction by comparing lung function before and after the administration of short-acting β2-agonists, common medications used for asthma treatment. We performed a genome-wide association study of BDR with 1,644 white asthmatic subjects from six drug clinical trials and attempted to replicate these findings in 1,051 white subjects from two independent cohorts. The most significant associated variant was near the SPATS2L gene. We knocked down SPATS2L mRNA in human airway smooth muscle cells and found that β2-adrenergic receptor levels increased, suggesting that SPATS2L may be a regulator of BDR. Our results highlight the promise of pursuing GWAS results that do not necessarily reach genome-wide significance and are an example of how results from pharmacogenetic GWAS can be studied functionally.
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Affiliation(s)
- Blanca E Himes
- Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America.
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Respiratory Symptoms Were Associated With Lower Spirometry Results During the First Examination of WTC Responders. J Occup Environ Med 2011; 53:49-54. [DOI: 10.1097/jom.0b013e3182028e5c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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de Matas M, Shao Q, Biddiscombe MF, Meah S, Chrystyn H, Usmani OS. Predicting the clinical effect of a short acting bronchodilator in individual patients using artificial neural networks. Eur J Pharm Sci 2010; 41:707-15. [PMID: 20932900 DOI: 10.1016/j.ejps.2010.09.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 09/16/2010] [Accepted: 09/28/2010] [Indexed: 11/25/2022]
Abstract
Artificial neural networks were used in this study to model the relationships between in vitro data, subject characteristics and in vivo outcomes from N=18 mild-moderate asthmatics receiving monodisperse salbutamol sulphate aerosols of 1.5, 3 and 6 μm mass median aerodynamic diameter in a cumulative dosing schedule of 10, 20, 40 and 100 μg. Input variables to the model were aerodynamic particle size (APS), body surface area (BSA), age, pre-treatment forced expiratory volume in one-second (FEV(1)), forced vital capacity, cumulative emitted drug dose and bronchodilator reversibility to a standard salbutamol sulphate 200 μg dose MDI (REV(%)). These factors were used by the model to predict the bronchodilator response at 10 (T10) and 20 (T20) min after receiving each of the 4 doses for each of the 3 different particle sizes. Predictability was assessed using data from selected patients in this study, which were set aside and not used in model generation. Models reliably predicted ΔFEV(1)(%) in individual subjects with non-linear determinants (R(2)) of ≥ 0.8. The average error between predicted and observed ΔFEV(1)(%) for individual subjects was <4% across the cumulative dosing regimen. Increases in APS and drug dose gave improved ΔFEV(1)(%). Models also showed trends towards improved responses in younger patients and those having greater REV(%), whilst BSA was also shown to influence clinical effect. These data show that APS can be used to discriminate predictably between aerosols giving different bronchodilator responses across a cumulative dosing schedule, whilst patient characteristics can be used to reliably estimate clinical response in individual subjects.
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Affiliation(s)
- Marcel de Matas
- Institute of Pharmaceutical Innovation, University of Bradford, Richmond Rd, West Yorkshire, Bradford BD7 1DP, UK.
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Asano K, Yamada-Yamasawa W, Kudoh H, Matsuzaki T, Nakajima T, Hakuno H, Hiraoka R, Fukunaga K, Oguma T, Sayama K, Yamaguchi K, Nagabukuro A, Harada Y, Ishizaka A. Association between beta-adrenoceptor gene polymorphisms and relative response to beta 2-agonists and anticholinergic drugs in Japanese asthmatic patients. Respirology 2010; 15:849-54. [PMID: 20546196 DOI: 10.1111/j.1440-1843.2010.01786.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Whether beta(2)-adrenoceptor gene (ADRB2) polymorphisms are associated with airway responsiveness to beta(2)-agonist medications remains controversial, partly due to factors that may confound pharmacogenetic associations, including age, cigarette smoking and airway remodelling. To overcome these problems, we performed an analysis using parameters that reflected the specific bronchodilator response to beta(2)-agonists. METHODS The increases in FEV(1) after inhalation of procaterol hydrochloride (Delta FEV(1) procaterol) or oxitropium bromide (Delta FEV(1) oxitropium), and after sequential inhalation of procaterol and oxitropium (total airway reversibility), were measured in 81 Japanese patients with moderate to severe asthma. Approximately 3 kb of the DNA sequence of the coding and 5'-flanking regions of ADRB2 were genotyped by direct sequencing and PCR-restriction fragment length polymorphism assay. RESULTS The mean age of the participants was 54 years, and 38 (47%) were smokers. Although Delta FEV(1) procaterol and Delta FEV(1) oxitropium adjusted for predicted FEV(1) were not associated with ADRB2 polymorphisms, the ratio of Delta FEV(1) procaterol to total airway reversibility was significantly associated with the ADRB2 A46G genotype (P < 0.05). Patients who were homozygous for the A46 allele (arginine at amino acid 16) were more responsive than carriers of the G46 (glycine 16) allele (P = 0.008). Multivariate linear regression analysis showed that Delta FEV(1) procaterol was correlated with the number of A46 alleles (P = 0.014), and also with total airway reversibility (P < 0.001) and smoking index in current smokers (P = 0.009). CONCLUSIONS The ADRB2 A46G polymorphism was associated with a relatively greater bronchodilator responsiveness to beta(2)-agonists even in elderly asthmatic patients and smokers.
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Affiliation(s)
- Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
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Himes BE, Wu AC, Duan QL, Klanderman B, Litonjua AA, Tantisira K, Ramoni MF, Weiss ST. Predicting response to short-acting bronchodilator medication using Bayesian networks. Pharmacogenomics 2009; 10:1393-412. [PMID: 19761364 DOI: 10.2217/pgs.09.93] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIMS Bronchodilator response tests measure the effect of beta(2)-agonists, the most commonly used short-acting reliever drugs for asthma. We sought to relate candidate gene SNP data with bronchodilator response and measure the predictive accuracy of a model constructed with genetic variants. MATERIALS & METHODS Bayesian networks, multivariate models that are able to account for simultaneous associations and interactions among variables, were used to create a predictive model of bronchodilator response using candidate gene SNP data from 308 Childhood Asthma Management Program Caucasian subjects. RESULTS The model found that 15 SNPs in 15 genes predict bronchodilator response with fair accuracy, as established by a fivefold cross-validation area under the receiver-operating characteristic curve of 0.75 (standard error: 0.03). CONCLUSION Bayesian networks are an attractive approach to analyze large-scale pharmacogenetic SNP data because of their ability to automatically learn complex models that can be used for the prediction and discovery of novel biological hypotheses.
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Affiliation(s)
- Blanca E Himes
- Harvard-MIT Division of Health Sciences and Technology, MA, USA.
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Abstract
Asthma is the most common chronic disease of childhood in the United States, affecting nearly 6.5 million children. The prevalence and severity of childhood asthma have continued to increase over the past 2 decades, despite major advances in the recognition and treatment of this condition. Representing a heterogeneous collection of airway diseases, asthma has multiple pathologic processes resulting from the interactions of genetic susceptibility and environmental exposures. Preventing and treating airway disease in children will require new research approaches to understanding these complex interactions.
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Affiliation(s)
- David A Schwartz
- National Institute of Environmental Health Sciences, PO Box 12233, Research Triangle Park, NC 27709, USA.
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14
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Hizawa N, Makita H, Nasuhara Y, Betsuyaku T, Itoh Y, Nagai K, Hasegawa M, Nishimura M. β 2 -Adrenergic Receptor Genetic Polymorphisms and Short-term Bronchodilator Responses in Patients With COPD. Chest 2007; 132:1485-92. [PMID: 17890463 DOI: 10.1378/chest.07-1103] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND COPD is characterized by a persistent airflow limitation that is not fully reversible; thus, the reversibility of airflow limitations in response to a bronchodilator is an important component of COPD. Several studies have established that two common nonsynonymous polymorphisms in the beta2-adrenergic receptor gene (ADRB2), Arg16Gly and Gln27Glu, have important effects in modulating responses to beta2-agonists; however, the effects of these polymorphisms on responses to beta2-agonists in patients with COPD is unknown. OBJECTIVE To examine whether different genotypes at these two polymorphisms are related to differential responses to inhaled beta2-agonists in patients with COPD. DESIGN AND PARTICIPANTS A total of 246 patients with COPD who were participants in a longitudinal study of COPD (ie, the Hokkaido COPD cohort study) were studied. We compared short-term bronchodilator responses (BDRs) to salbutamol according to ADRB2 genotypes at codons 16 and 27. RESULTS The presence of the Arg16 allele was associated with lower BDRs to beta2-agonist inhalation. The mean (+/-SD) log (postbronchodilator FEV1-prebronchodilator FEV1) values of Gly16 homozygotes (n=65), Arg16Gly16 heterozygotes (n=106), and Arg16 homozygotes (n=75) were 2.19+/-0.43, 2.09+/-0.42, and 2.01+/-0.42, respectively (p<0.05). The genetic effects of the Arg16Gly polymorphism were independent of the severity of airflow limitation, age, and smoking status. The most common Arg16-Gln27 haplotype was also significantly associated with decreased BDRs to salbutamol (p<0.01). CONCLUSION The genetic effects of ADRB2 gene polymorphisms may explain some of the variability in response to therapeutic doses of a short-acting beta2-agonists in patients with COPD.
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Affiliation(s)
- Nobuyuki Hizawa
- Department of Pulmonary Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
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de Matas M, Shao Q, Richardson CH, Chrystyn H. Evaluation of in vitro in vivo correlations for dry powder inhaler delivery using artificial neural networks. Eur J Pharm Sci 2007; 33:80-90. [PMID: 18035525 DOI: 10.1016/j.ejps.2007.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Accepted: 10/10/2007] [Indexed: 10/22/2022]
Abstract
The aim of these experiments was to investigate the use of artificial neural networks (ANNs) for generating models able to predict the relative lung bioavailability and clinical effect of salbutamol when delivered to healthy volunteers and asthmatic patients from dry powder inhalers (DPIs). ANN software was used to model in vitro, demographic and in vivo data from human subjects for four different DPI formulations containing salbutamol sulfate. In 12 volunteers, a model linking the in vitro aerodynamic characteristics of the emitted dose and volunteer body surface area with the urinary excretion of drug and its metabolite in the 24h period after inhalation was established. In 11 mild asthmatics, a predictive model correlating in vitro data, baseline lung function, body surface area and age with post-treatment improvements in forced expiratory volume in 1s (FEV1) was also generated. Models validated using unseen data from individual subjects receiving the different DPI formulations were shown to give predictions of in vivo performance. The squared correlation coefficients (R2) for plots comparing predicted and observed in vivo outcomes were 0.83 and 0.84 for urinary excretion and lung function data, respectively. It can therefore be concluded that ANN models have the potential to predict the in vivo performance of DPIs in individual subjects.
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Affiliation(s)
- Marcel de Matas
- Institute of Pharmaceutical Innovation, University of Bradford, Bradford BD7 1DP, UK.
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Teerlink CC, Hegewald MJ, Cannon-Albright LA. A genealogical assessment of heritable predisposition to asthma mortality. Am J Respir Crit Care Med 2007; 176:865-70. [PMID: 17690335 DOI: 10.1164/rccm.200703-448oc] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
RATIONALE Asthma is a multifactorial disease; genetic factors have been suggested but have not been well defined. OBJECTIVES This study examined evidence for a heritable component to asthma mortality using a unique data resource consisting of Utah death certificates linked to a genealogy of Utah. METHODS Cases were defined as individuals whose death certificate listed asthma as a cause of death in a registry of all Utah deaths since 1904 (n = 1,553). The genealogical index of familiality analysis was used to compare the average relatedness of asthma deaths to the expected relatedness in the Utah population. Relative risks for asthma death in relatives of individuals who died of asthma are provided for close and distant relatives. MEASUREMENTS AND MAIN RESULTS The genealogical index of familiality identified a significantly higher average relatedness in cases (P < 0.001), even when close relationships were ignored. In addition, a significantly increased risk of dying of asthma was observed in first-degree relatives of cases (relative risk = 1.69, P < 0.001) and in second-degree relatives of cases (relative risk = 1.34, P = 0.003). CONCLUSIONS These results support a heritable contribution to asthma mortality.
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Affiliation(s)
- Craig C Teerlink
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah 84112-5750, USA.
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17
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Yu Y, Kumar R, Venners S, Pongracic J, Wang B, Yang J, Li Z, Wang L, Liu X, Tang G, Xing H, Xu X, Wang X. Age and gender specific lung function predictive equations provide similar predictions for both a twin population and a general population from age 6 through adolescence. Pediatr Pulmonol 2007; 42:631-9. [PMID: 17534976 DOI: 10.1002/ppul.20631] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There have been numerous studies of asthma in twins, but no study has evaluated whether lung function predictive models yield similar results between twin and general populations. We sought to evaluate this in late childhood and adolescent subjects. METHODS We generated cross-sectional, sex- and age-specific regression models of FEV(1), and FVC, in a community-based cohort of 3140 healthy, non-smoking Chinese twins using generalized estimating equations to adjust for correlations within twin pairs. We applied the model to a healthy non-smoking general population cohort of 2187 subjects from the same region, and compared %predicted FEV(1) and FVC values between the two populations. RESULTS Stratified by age and sex, the associations of height with FEV(1) or FVC varied by age group. During the adolescent growth spurt (age 13 for girls and ages 14-16 for boys), the associations of height with FEV(1) or FVC were nonlinear and greater than that seen at other ages. During adolescence, FEV(1) and FVC for a given height increased with age. The percent predicted values of FEV(1) and FVC in the twin population were similar to that of the general population. CONCLUSIONS Twin and general populations have similar patterns of lung function change over middle childhood and adolescence. Similar equations may be used to estimate percent predicted values. Finally, a single prediction equation cannot completely describe patterns of lung function from childhood through adolescence due to puberty related changes.
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Affiliation(s)
- Yunxian Yu
- Mary Ann and J Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL 60614, USA
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18
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Hersh CP, Soto-Quirós ME, Avila L, Lake SL, Liang C, Fournier E, Spesny M, Sylvia JS, Lazarus R, Hudson T, Verner A, Klanderman BJ, Freimer NB, Silverman EK, Celedón JC. Genome-wide linkage analysis of pulmonary function in families of children with asthma in Costa Rica. Thorax 2006; 62:224-30. [PMID: 17099076 PMCID: PMC2117166 DOI: 10.1136/thx.2006.067934] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Although asthma is highly prevalent among certain Hispanic subgroups, genetic determinants of asthma and asthma-related traits have not been conclusively identified in Hispanic populations. A study was undertaken to identify genomic regions containing susceptibility loci for pulmonary function and bronchodilator responsiveness (BDR) in Costa Ricans. METHODS Eight extended pedigrees were ascertained through schoolchildren with asthma in the Central Valley of Costa Rica. Short tandem repeat (STR) markers were genotyped throughout the genome at an average spacing of 8.2 cM. Multipoint variance component linkage analyses of forced expiratory volume in 1 second (FEV(1)) and FEV(1)/ forced vital capacity (FVC; both pre-bronchodilator and post-bronchodilator) and BDR were performed in these eight families (pre-bronchodilator spirometry, n = 640; post-bronchodilator spirometry and BDR, n = 624). Nine additional STR markers were genotyped on chromosome 7. Secondary analyses were repeated after stratification by cigarette smoking. RESULTS Among all subjects, the highest logarithm of the odds of linkage (LOD) score for FEV(1) (post-bronchodilator) was found on chromosome 7q34-35 (LOD = 2.45, including the additional markers). The highest LOD scores for FEV(1)/FVC (pre-bronchodilator) and BDR were found on chromosomes 2q (LOD = 1.53) and 9p (LOD = 1.53), respectively. Among former and current smokers there was near-significant evidence of linkage to FEV(1)/FVC (post-bronchodilator) on chromosome 5p (LOD = 3.27) and suggestive evidence of linkage to FEV(1) on chromosomes 3q (pre-bronchodilator, LOD = 2.74) and 4q (post-bronchodilator, LOD = 2.66). CONCLUSIONS In eight families of children with asthma in Costa Rica, there is suggestive evidence of linkage to FEV(1) on chromosome 7q34-35. In these families, FEV(1)/FVC may be influenced by an interaction between cigarette smoking and a locus (loci) on chromosome 5p.
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Affiliation(s)
- Craig P Hersh
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
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Weiss ST, Litonjua AA, Lange C, Lazarus R, Liggett SB, Bleecker ER, Tantisira KG. Overview of the pharmacogenetics of asthma treatment. THE PHARMACOGENOMICS JOURNAL 2006; 6:311-26. [PMID: 16568148 DOI: 10.1038/sj.tpj.6500387] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Asthma affects approximately 300 million individuals worldwide. Medications comprise a substantial portion of asthma expenditures. Despite the availability of three primary therapeutic classes of medications, there are a significant number of nonresponders to therapy. Available data, as well as previous pharmacogenetic studies, suggest that genetics may contribute as much as 60-80% to the interindividual variability in treatment response. In this methodologic review, after providing a broad overview of the asthma pharmacogenetics literature to date, we describe the application of a novel family-based screening algorithm to the analysis of pharmacogenetic data and highlight our approach to identifying and verifying loci influencing asthma treatment response. This approach seeks to address issues related to multiple comparisons, statistical power, population stratification, and failure to replicate from which previous population-based or case-control pharmacogenetic association studies may suffer. Identification of such replicable loci is the next step towards the goal of 'individualized therapy' for asthma.
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MESH Headings
- Adrenergic beta-Agonists/pharmacology
- Adrenergic beta-Agonists/therapeutic use
- Algorithms
- Animals
- Anti-Asthmatic Agents/pharmacology
- Anti-Asthmatic Agents/therapeutic use
- Arachidonate 5-Lipoxygenase/genetics
- Arachidonate 5-Lipoxygenase/metabolism
- Asthma/drug therapy
- Asthma/genetics
- Asthma/metabolism
- Glucocorticoids/pharmacology
- Glucocorticoids/therapeutic use
- Humans
- Leukotriene Antagonists/pharmacology
- Leukotriene Antagonists/therapeutic use
- Pharmacogenetics
- Phenotype
- Polymorphism, Single Nucleotide
- Practice Guidelines as Topic
- Randomized Controlled Trials as Topic
- Receptors, Adrenergic, beta/drug effects
- Receptors, Adrenergic, beta/genetics
- Receptors, Adrenergic, beta/metabolism
- Receptors, Corticotropin-Releasing Hormone/drug effects
- Receptors, Corticotropin-Releasing Hormone/genetics
- Receptors, Corticotropin-Releasing Hormone/metabolism
- Treatment Outcome
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Affiliation(s)
- S T Weiss
- Channing Laboratory, Brigham and Women's Hospital, Boston, MA 02115, USA
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Hao K, Chen C, Wang B, Yang J, Fang Z, Xu X. Familial aggregation of airway responsiveness: a community-based study. Ann Epidemiol 2006; 15:737-43. [PMID: 16257359 DOI: 10.1016/j.annepidem.2005.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2004] [Accepted: 02/01/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE We investigated the familial aggregation of airway hyper-responsiveness (AHR) to methacoline among randomly chosen families in a rural community in Anqing, China. METHODS Airway responsiveness (AR) to methacoline and related risk factors were assessed in each subject. We first modeled the within family correlation in AR and demonstrated the familial aggregation of this trait. Furthermore, we examined the effect size (e.g., odds ratio, OR) of this correlation in a "subsequent offspring model." RESULTS The correlation coefficient is significantly positive for parent-offspring and offspring-offspring pairs, but not significant in father-mother pairs, suggesting a genetic component. The strength of the relationships is in the order of father-offspring < mother-offspring < offspring-offspring. The OR of a positive AHR test for subsequent offspring who had mothers and an eldest sibling with positive AHR is 4.12 (95% CI, 1.72-9.87), compared with subsequent offspring whose mother and eldest sibling were negative in the test. CONCLUSION Our study supports a familial clustering of AHR in a Chinese population, which points to a role for genetic factors.
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Affiliation(s)
- Ke Hao
- Program for Population Genetics, Harvard School of Public Health, Boston, MA 02115, USA
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Hao K, Niu T, Xu X, Fang Z, Xu X. Single-nucleotide polymorphisms of the KCNS3 gene are significantly associated with airway hyperresponsiveness. Hum Genet 2005; 116:378-83. [PMID: 15714333 DOI: 10.1007/s00439-005-1256-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2004] [Accepted: 12/23/2004] [Indexed: 10/25/2022]
Abstract
Airway hyperresponsiveness (AHR) is one of the major clinical symptoms and intermediate phenotypes of asthma. A recent genome-wide search for asthma quantitative trait loci has revealed a significant linkage signal between a p-terminal region of chromosome 2 and AHR. Thus, the gene encoding the potassium voltage-gated channel delayed-rectifier protein S3 (KCNS3) in this region is considered a positional candidate for asthma. We have evaluated a total of 12 single-nucleotide polymorphisms (SNPs) of the KCNS3 gene in a validation panel of 48 lymphoblastoid cell line DNA samples of Chinese origin. Three SNPs were found to be polymorphic and were tested. Two independent sets (an initial screening set and a replication set) of cases and controls from the original linkage study sample were collected. In the initial screening set, two SNPs (rs1031771 and rs1031772) showed suggestive association and were further confirmed by the replication set. In combined single-SNP analysis, the rs1031771 G allele (odds ratio=1.42, P=0.006) and rs1031772 T allele (odds ratio=1.40, P=0.018) were associated with a significantly higher risk of AHR. Haplotype analysis also detected significant association (P=0.006). Our findings suggest that SNPs located at the 3' downstream region of KCNS3 have a significant role in the etiology of AHR.
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Affiliation(s)
- Ke Hao
- Program for Population Genetics, Harvard School of Public Health, 665 Huntington Avenue FXB-101, Boston, MA 02115, USA
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Xu X, Weiss ST. Erratum: Familia Aggregation of Bronchodilator Response. Am J Respir Crit Care Med 2002. [DOI: 10.1164/ajrccm.166.5.err4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Xiping Xu
- Harvard School of Public Health, Boston, Massachusetts
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Palmer LJ, Celedón JC, Weiss ST, Wang B, Fang Z, Xu X. Ascaris lumbricoides infection is associated with increased risk of childhood asthma and atopy in rural China. Am J Respir Crit Care Med 2002; 165:1489-93. [PMID: 12045121 DOI: 10.1164/rccm.2107020] [Citation(s) in RCA: 145] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There is growing international interest in the possible relationships between helminthic infection and allergic disease, although the nature of the relationships remains uncertain and controversial. The interrelationships of current and past infection with Ascaris lumbricoides and asthma and atopy were investigated in a cross-sectional sample of 2,164 children between the ages of 8 and 18 years from Anqing Province, China. The children were sampled from a larger family-based study of the genetics of asthma. The prevalence of either a history of or a positive stool examination for Ascaris was 24.5%. Asthma was defined for analytic purposes using previously validated, stringent criteria including airways responsiveness to methacholine. Independently of the other factors assessed, infection with A. lumbricoides was associated with increased risk of asthma (p < 0.001), an increased number of skin tests positive to aeroallergens (p < 0.001), and an increased dose-response slope to methacholine (p = 0.003). The association of sensitization to common aeroallergens with increased asthma risk was enhanced in those children infected with Ascaris, and such infection was associated with an increased risk of asthma independent of sensitization to aeroallergens in this selected population. These data suggest a complex relationship between ascariasis and susceptibility to childhood asthma among predisposed children that may involve an interaction with the immune response to inhaled aeroallergens.
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Affiliation(s)
- Lyle J Palmer
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital.
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Affiliation(s)
- M J Tobin
- Division of Pulmonary and Critical Care Medicine, Loyola University of Chicago Stritch School of Medicine and Edward Hines, Jr., Veterans Affairs Hospital, Hines, Illinois 6041, USA.
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