1
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Kachuri L, Mak ACY, Hu D, Eng C, Huntsman S, Elhawary JR, Gupta N, Gabriel S, Xiao S, Keys KL, Oni-Orisan A, Rodríguez-Santana JR, LeNoir MA, Borrell LN, Zaitlen NA, Williams LK, Gignoux CR, Burchard EG, Ziv E. Gene expression in African Americans, Puerto Ricans and Mexican Americans reveals ancestry-specific patterns of genetic architecture. Nat Genet 2023; 55:952-963. [PMID: 37231098 PMCID: PMC10260401 DOI: 10.1038/s41588-023-01377-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/21/2023] [Indexed: 05/27/2023]
Abstract
We explored ancestry-related differences in the genetic architecture of whole-blood gene expression using whole-genome and RNA sequencing data from 2,733 African Americans, Puerto Ricans and Mexican Americans. We found that heritability of gene expression significantly increased with greater proportions of African genetic ancestry and decreased with higher proportions of Indigenous American ancestry, reflecting the relationship between heterozygosity and genetic variance. Among heritable protein-coding genes, the prevalence of ancestry-specific expression quantitative trait loci (anc-eQTLs) was 30% in African ancestry and 8% for Indigenous American ancestry segments. Most anc-eQTLs (89%) were driven by population differences in allele frequency. Transcriptome-wide association analyses of multi-ancestry summary statistics for 28 traits identified 79% more gene-trait associations using transcriptome prediction models trained in our admixed population than models trained using data from the Genotype-Tissue Expression project. Our study highlights the importance of measuring gene expression across large and ancestrally diverse populations for enabling new discoveries and reducing disparities.
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Affiliation(s)
- Linda Kachuri
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
| | - Angel C Y Mak
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Donglei Hu
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Scott Huntsman
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Jennifer R Elhawary
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Namrata Gupta
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - Shujie Xiao
- Center for Individualized and Genomic Medicine Research, Henry Ford Health System, Detroit, MI, USA
| | - Kevin L Keys
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Berkeley Institute for Data Science, University of California, Berkeley, Berkeley, CA, USA
| | - Akinyemi Oni-Orisan
- Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Luisa N Borrell
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Noah A Zaitlen
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Computational Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - L Keoki Williams
- Center for Individualized and Genomic Medicine Research, Henry Ford Health System, Detroit, MI, USA
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Christopher R Gignoux
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Esteban González Burchard
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Elad Ziv
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA.
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
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2
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Herrera-Luis E, Mak ACY, Perez-Garcia J, Martin-Gonzalez E, Eng C, Beckman KB, Huntsman S, Hu D, González-Pérez R, Hernández-Pérez JM, Mederos-Luis E, Sio YY, Poza-Guedes P, Sardón O, Corcuera P, Sánchez-Machín I, Korta-Murua J, Martínez-Rivera C, Mullol J, Muñoz X, Valero A, Sastre J, Garcia-Aymerich J, Llop S, Torrent M, Casas M, Rodríguez-Santana JR, Villar J, del Pozo V, Lorenzo-Diaz F, Williams LK, Melén E, Chew FT, Borrell LN, Burchard EG, Pino-Yanes M. Admixture mapping of severe asthma exacerbations in Hispanic/Latino children and youth. Thorax 2023; 78:233-241. [PMID: 36180068 PMCID: PMC9957797 DOI: 10.1136/thorax-2022-218755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/04/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND In the USA, genetically admixed populations have the highest asthma prevalence and severe asthma exacerbations rates. This could be explained not only by environmental factors but also by genetic variants that exert ethnic-specific effects. However, no admixture mapping has been performed for severe asthma exacerbations. OBJECTIVE We sought to identify genetic variants associated with severe asthma exacerbations in Hispanic/Latino subgroups by means of admixture mapping analyses and fine mapping, and to assess their transferability to other populations and potential functional roles. METHODS We performed an admixture mapping in 1124 Puerto Rican and 625 Mexican American children with asthma. Fine-mapping of the significant peaks was performed via allelic testing of common and rare variants. We performed replication across Hispanic/Latino subgroups, and the transferability to non-Hispanic/Latino populations was assessed in 1001 African Americans, 1250 Singaporeans and 941 Europeans with asthma. The effects of the variants on gene expression and DNA methylation from whole blood were also evaluated in participants with asthma and in silico with data obtained through public databases. RESULTS Genomewide significant associations of Indigenous American ancestry with severe asthma exacerbations were found at 5q32 in Mexican Americans as well as at 13q13-q13.2 and 3p13 in Puerto Ricans. The single nucleotide polymorphism (SNP) rs1144986 (C5orf46) showed consistent effects for severe asthma exacerbations across Hispanic/Latino subgroups, but it was not validated in non-Hispanics/Latinos. This SNP was associated with DPYSL3 DNA methylation and SCGB3A2 gene expression levels. CONCLUSIONS Admixture mapping study of asthma exacerbations revealed a novel locus that exhibited Hispanic/Latino-specific effects and regulated DPYSL3 and SCGB3A2.
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Affiliation(s)
- Esther Herrera-Luis
- Genomics and Health Group, Department of Biochemistry,
Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna,
Tenerife, Spain
| | - Angel C. Y. Mak
- Department of Medicine, University of California San
Francisco, San Francisco, California, U.S.A
| | - Javier Perez-Garcia
- Genomics and Health Group, Department of Biochemistry,
Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna,
Tenerife, Spain
| | - Elena Martin-Gonzalez
- Genomics and Health Group, Department of Biochemistry,
Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna,
Tenerife, Spain
| | - Celeste Eng
- Department of Medicine, University of California San
Francisco, San Francisco, California, U.S.A
| | | | - Scott Huntsman
- Department of Medicine, University of California San
Francisco, San Francisco, California, U.S.A
| | - Donglei Hu
- Department of Medicine, University of California San
Francisco, San Francisco, California, U.S.A
| | - Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias,
Santa Cruz de Tenerife, Tenerife, Spain,Asthma Unit, Hospital Universitario de Canarias, La Laguna,
Tenerife, Spain
| | - José M. Hernández-Pérez
- Pulmonary Medicine, Hospital Universitario de N.S de
Candelaria, Santa Cruz de Tenerife, Spain,Pulmonary Medicine, Hospital General de La Palma, La Palma,
Santa Cruz de Tenerife, Spain
| | - Elena Mederos-Luis
- Allergy Department, Hospital Universitario de Canarias,
Santa Cruz de Tenerife, Tenerife, Spain
| | - Yang Yie Sio
- Department of Biological Sciences, National University of
Singapore, Singapore
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias,
Santa Cruz de Tenerife, Tenerife, Spain,Asthma Unit, Hospital Universitario de Canarias, La Laguna,
Tenerife, Spain
| | - Olaia Sardón
- Division of Pediatric Respiratory Medicine, Hospital
Universitario Donostia, San Sebastián, Spain,Department of Pediatrics, University of the Basque
Country (UPV/EHU), San Sebastián, Spain
| | - Paula Corcuera
- Division of Pediatric Respiratory Medicine, Hospital
Universitario Donostia, San Sebastián, Spain
| | | | - Javier Korta-Murua
- Division of Pediatric Respiratory Medicine, Hospital
Universitario Donostia, San Sebastián, Spain,Department of Pediatrics, University of the Basque
Country (UPV/EHU), San Sebastián, Spain
| | - Carlos Martínez-Rivera
- CIBER de Enfermedades Respiratorias, Instituto de Salud
Carlos III, Madrid, Spain,Servicio de Neumología, Hospital Universitario
Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona,
Spain
| | - Joaquim Mullol
- CIBER de Enfermedades Respiratorias, Instituto de Salud
Carlos III, Madrid, Spain,Rhinology Unit & Smell Clinic, ENT Department;
Clinical & Experimental Respiratory Immunoallergy (IDIBAPS), Universitat de
Barcelona, Barcelona, Spain
| | - Xavier Muñoz
- CIBER de Enfermedades Respiratorias, Instituto de Salud
Carlos III, Madrid, Spain,Servicio de Neumología, Hospital Vall
d’Hebron, Barcelona, Spain
| | - Antonio Valero
- CIBER de Enfermedades Respiratorias, Instituto de Salud
Carlos III, Madrid, Spain,Allergy Unit & Severe Asthma Unit, Pneumonology and
Allergy Department, Hospital Clínic; IDIBAPS; Universitat de
Barcelona.Barcelona, Spain
| | - Joaquín Sastre
- CIBER de Enfermedades Respiratorias, Instituto de Salud
Carlos III, Madrid, Spain,Allergy Department, Hospital Universitario
Fundación Jiménez Díaz, Madrid, Spain
| | - Judith Garcia-Aymerich
- Spanish Consortium for Research on Epidemiology and
Public Health (CIBERESP), Madrid, Spain,ISGlobal, Barcelona, Spain,Universitat Pompeu Fabra, Barcelona, Spain
| | - Sabrina Llop
- Spanish Consortium for Research on Epidemiology and
Public Health (CIBERESP), Madrid, Spain,Epidemiology and Environmental Health Joint Research
Unit, FISABIO–Universitat Jaume I–Universitat de València,
Valencia, Spain
| | | | - Maribel Casas
- ISGlobal, Barcelona, Spain,Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Jesús Villar
- CIBER de Enfermedades Respiratorias, Instituto de Salud
Carlos III, Madrid, Spain,Multidisciplinary Organ Dysfunction Evaluation Research
Network, Research Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran
Canaria, Spain
| | - Victoria del Pozo
- CIBER de Enfermedades Respiratorias, Instituto de Salud
Carlos III, Madrid, Spain,Immunology Department, Instituto de Investigación
Sanitaria Hospital Universitario Fundación Jiménez Díaz,
Madrid, Spain
| | - Fabian Lorenzo-Diaz
- Genomics and Health Group, Department of Biochemistry,
Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna,
Tenerife, Spain,Instituto Universitario de Enfermedades Tropicales y
Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), La
Laguna, Tenerife, Spain
| | - L. Keoki Williams
- Center for Individualized and Genomic Medicine Research,
Department of Internal Medicine, Henry Ford Health System, Detroit, MI, U.S.A
| | - Erik Melén
- Department of Clinical Sciences and Education,
Södersjukhuset, Karolinska Institutet, Stockholm, Sweden,Sachs’ Children’s Hospital, South General
Hospital, Stockholm, Sweden
| | - Fook Tim Chew
- Department of Biological Sciences, National University of
Singapore, Singapore
| | - Luisa N. Borrell
- Department of Epidemiology & Biostatistics, Graduate
School of Public Health & Health Policy, City University of New York, New York,
NY, U.S.A
| | - Esteban G. Burchard
- UMN Genomics Center, Minneapolis, Minnesota, U.S.A.,Department of Bioengineering and Therapeutic Sciences,
University of California San Francisco, San Francisco, California, U.S.A
| | - Maria Pino-Yanes
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology, and Genetics, Universidad de La Laguna (ULL), La Laguna, Spain .,CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Tecnologías Biomédicas (ITB), Universidad de La Laguna (ULL), La Laguna, Spain
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3
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Witonsky J, Elhawary JR, Eng C, Rodríguez-Santana JR, Borrell LN, Burchard EG. Race- and Ethnicity-Based Spirometry Reference Equations: Are They Accurate for Genetically Admixed Children? Chest 2022; 162:184-195. [PMID: 35033507 DOI: 10.1016/j.chest.2021.12.664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Variation in genetic ancestry among genetically admixed racial and ethnic groups may influence the fit of guideline-recommended spirometry reference equations, which rely on self-identified race and ethnicity. RESEARCH QUESTION What is the influence of genetic ancestry on the fit of race- and ethnicity-based spirometry reference equations in populations of genetically admixed children? STUDY DESIGN AND METHODS Cross-sectional fit of guideline-recommended race- and ethnicity-based spirometry reference equations was evaluated in healthy control participants from case-control studies of asthma. Anthropometry, blood samples, and spirometric measurements were obtained for 599 genetically admixed children 8 to 21 years of age. Genetic ancestry was estimated using genome-wide genotype data. Equation fit, measured as a mean z score, was assessed in self-identified African American (n = 275) and Puerto Rican (n = 324) children as well as genetic ancestry-defined strata of each population. RESULTS For African American children, African American-derived equations fit for predicting FEV1 and FVC in those with an African ancestry more than the median (81.4%-100.0%), whereas composite equations for "other/mixed" populations fit for predicting FEV1 and FVC in those with African ancestry at or less than the median (30.7%-81.3%). For Puerto Rican children with African ancestry at or less than the median (6.4%-21.3%), White-derived equations fit both FEV1 and FVC, whereas for those with African ancestry more than the median (21.4%-87.5%), White-derived equations fit the FEV1 and the composite equations fit the FVC. INTERPRETATION Guideline-recommended spirometry reference equations yielded biased estimates of lung function in genetically admixed children with high variation of African ancestry. Spirometry could benefit from reference equations that incorporate genetic ancestry, either for more precise application of the current equations or the derivation and use of new equations.
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Affiliation(s)
- Jonathan Witonsky
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA.
| | - Jennifer R Elhawary
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | | | - Luisa N Borrell
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
| | - Esteban G Burchard
- Department of Medicine and Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA
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4
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Castellanos CA, Ren X, Gonzalez SL, Li HK, Schroeder AW, Liang HE, Laidlaw BJ, Hu D, Mak ACY, Eng C, Rodríguez-Santana JR, LeNoir M, Yan Q, Celedón JC, Burchard EG, Zamvil SS, Ishido S, Locksley RM, Cyster JG, Huang X, Shin JS. Lymph node-resident dendritic cells drive T H2 cell development involving MARCH1. Sci Immunol 2021; 6:eabh0707. [PMID: 34652961 DOI: 10.1126/sciimmunol.abh0707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Carlos A Castellanos
- Department of Microbiology and Immunology, Sandler Asthma Basic Research Center, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Xin Ren
- Department of Medicine, Lung Biology Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Steven Lomeli Gonzalez
- Department of Microbiology and Immunology, Sandler Asthma Basic Research Center, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Hong Kun Li
- Department of Microbiology and Immunology, Sandler Asthma Basic Research Center, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Andrew W Schroeder
- Department of Pulmonology, Genomics CoLabs, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Hong-Erh Liang
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Brian J Laidlaw
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Donglei Hu
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Angel C Y Mak
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94158, USA
| | | | | | - Qi Yan
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Esteban G Burchard
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94158, USA.,Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Scott S Zamvil
- Department of Neurology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Satoshi Ishido
- Department of Microbiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan
| | - Richard M Locksley
- Department of Medicine, Howard Hughes Medical Institute, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jason G Cyster
- Department of Microbiology and Immunology, Howard Hughes Medical Institute, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Xiaozhu Huang
- Department of Medicine, Lung Biology Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Jeoung-Sook Shin
- Department of Microbiology and Immunology, Sandler Asthma Basic Research Center, University of California, San Francisco, San Francisco, CA 94143, USA
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5
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Jiang Y, Forno E, Han YY, Xu Z, Hu D, Boutaoui N, Eng C, Acosta-Pérez E, Huntsman S, Colón-Semidey A, Keys KL, Rodríguez-Santana JR, Alvarez M, Pino-Yanes M, Canino G, Chen W, Burchard EG, Celedón JC. A genome-wide study of DNA methylation in white blood cells and asthma in Latino children and youth. Epigenetics 2021; 16:577-585. [PMID: 32799603 PMCID: PMC8078676 DOI: 10.1080/15592294.2020.1809872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/11/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022] Open
Abstract
Latinos are heavily affected with childhood asthma. Little is known about epigenetic mechanisms of asthma in Latino youth. We conducted a meta-analysis of two epigenome-wide association studies (EWAS) of asthma, using DNA from white blood cells (WBCs) from 1,136 Latino children and youth aged 6 to 20 years. Genes near the top CpG sites in this EWAS were examined in a pathway enrichment analysis, and we then assessed whether our results replicated those from publicly available data from three independent EWAS conducted in non-Latino populations. We found that DNA methylation profiles differed between subjects with and without asthma. After adjustment for covariates and multiple testing, two CpGs were differentially methylated at a false discovery rate (FDR)-adjusted P < 0.1, and 193 CpG sites were differentially methylated at FDR-adjusted P < 0.2. The two top CpGs are near genes relevant to inflammatory signalling, including CAMK1D (Calcium/Calmodulin Dependent Protein Kinase ID) and TIGIT (T Cell Immunoreceptor With Ig And ITIM Domains). Moreover, 25 genomic regions were differentially methylated between subjects with and without asthma, at Šidák-corrected P < 0.10. An enrichment analysis then identified the TGF-beta pathway as most relevant to asthma in our analysis, and we replicated some of the top signals from publicly available EWAS datasets in non-Hispanic populations. In conclusion, we have identified novel epigenetic markers of asthma in WBCs from Latino children and youth, while also replicating previous results from studies conducted in non-Latinos.
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Affiliation(s)
- Yale Jiang
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Erick Forno
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yueh-Ying Han
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Zhongli Xu
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- School of Medicine, Tsinghua University, Beijing, China
| | - Donglei Hu
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Nadia Boutaoui
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Celeste Eng
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Edna Acosta-Pérez
- Behavioral Sciences Research Institute, Medical Science Campus, University of Puerto Rico, San Juan, PR
| | - Scott Huntsman
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Angel Colón-Semidey
- Department of Pediatrics, Medical Science Campus, University of Puerto Rico, San Juan, PR
| | - Kevin L. Keys
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Berkeley Institute for Data Science, University of California Berkeley, Berkeley, CA, USA
| | | | - María Alvarez
- Department of Pediatrics, Medical Science Campus, University of Puerto Rico, San Juan, PR
| | - Maria Pino-Yanes
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Glorisa Canino
- Behavioral Sciences Research Institute, Medical Science Campus, University of Puerto Rico, San Juan, PR
| | - Wei Chen
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Esteban G. Burchard
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Juan C. Celedón
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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6
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Borrell LN, Elhawary JR, Fuentes-Afflick E, Witonsky J, Bhakta N, Wu AHB, Bibbins-Domingo K, Rodríguez-Santana JR, Lenoir MA, Gavin JR, Kittles RA, Zaitlen NA, Wilkes DS, Powe NR, Ziv E, Burchard EG. Race and Genetic Ancestry in Medicine - A Time for Reckoning with Racism. N Engl J Med 2021; 384:474-480. [PMID: 33406325 PMCID: PMC8979367 DOI: 10.1056/nejmms2029562] [Citation(s) in RCA: 336] [Impact Index Per Article: 112.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Luisa N Borrell
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Jennifer R Elhawary
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Elena Fuentes-Afflick
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Jonathan Witonsky
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Nirav Bhakta
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Alan H B Wu
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Kirsten Bibbins-Domingo
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - José R Rodríguez-Santana
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Michael A Lenoir
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - James R Gavin
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Rick A Kittles
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Noah A Zaitlen
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - David S Wilkes
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Neil R Powe
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Elad Ziv
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Esteban G Burchard
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
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Borrell LN, Elhawary JR, Fuentes-Afflick E, Witonsky J, Bhakta N, Wu AHB, Bibbins-Domingo K, Rodríguez-Santana JR, Lenoir MA, Gavin JR, Kittles RA, Zaitlen NA, Wilkes DS, Powe NR, Ziv E, Burchard EG. Race and Genetic Ancestry in Medicine - A Time for Reckoning with Racism. N Engl J Med 2021. [PMID: 33406325 DOI: 10.1056/negmms2029562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Luisa N Borrell
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Jennifer R Elhawary
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Elena Fuentes-Afflick
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Jonathan Witonsky
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Nirav Bhakta
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Alan H B Wu
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Kirsten Bibbins-Domingo
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - José R Rodríguez-Santana
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Michael A Lenoir
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - James R Gavin
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Rick A Kittles
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Noah A Zaitlen
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - David S Wilkes
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Neil R Powe
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Elad Ziv
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
| | - Esteban G Burchard
- From the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York (L.N.B.); the Departments of Medicine (J.R.E., J.W., N.B., N.R.P., E.Z., E.G.B.), Pediatrics (E.F.-A., J.W.), Laboratory Medicine (A.H.B.W.), and Epidemiology and Biostatistics (K.B.-D.), Priscilla Chan and Mark Zuckerberg San Francisco General Hospital (K.B.-D., N.R.P.), the Division of General Internal Medicine and the Institute of Human Genetics, Helen Diller Family Comprehensive Cancer Center (E.Z.), and the Department of Bioengineering and Therapeutic Sciences (E.G.B.), University of California, San Francisco, San Francisco, Bay Area Pediatrics, Oakland (M.A.L.), the Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte (R.A.K.), and the Department of Neurogenetics, University of California, Los Angeles, Los Angeles (N.A.Z.) - all in California; the Centro de Neumología Pediátrica, San Juan, PR (J.R.R.-S.); Emory University School of Medicine, Atlanta (J.R.G.); and the School of Medicine, University of Virginia, Charlottesville (D.S.W.)
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Neophytou AM, Oh SS, Hu D, Huntsman S, Eng C, Rodríguez-Santana JR, Kumar R, Balmes JR, Eisen EA, Burchard EG. In utero tobacco smoke exposure, DNA methylation, and asthma in Latino children. Environ Epidemiol 2019; 3:e048. [PMID: 31342008 PMCID: PMC6571182 DOI: 10.1097/ee9.0000000000000048] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/26/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Maternal smoking during pregnancy is a risk factor for chronic disease later in life and has been associated with variability of DNA methylation at specific cytosine-phosphate-guanine (CpG) loci. We assessed the role of DNA methylation as a potential mediator of adverse effects of in utero tobacco smoke exposures on asthma outcomes in Latino children from the US mainland and Puerto Rico. METHODS Relationships between self-reported exposure and DNA methylation at CpG loci previously reported to be associated with maternal smoking were assessed in a subsample consisting of 572 children aged 8-21 years (310 cases with asthma, 262 healthy controls), sampled from a larger asthma case-control study. Subsequently, we assessed associations between top loci and asthma-related outcomes, followed by mediation analysis for loci for which associations with outcomes were observed. RESULTS Self-reported maternal smoking was associated with a -1.5% (95% confidence interval (CI) = -2.4%, -0.6%) lower methylation at CpG locus cg05575921 on the AHRR gene; a 1% increase in DNA methylation at the same locus resulted in an odds ratio (OR) of 0.90 (95% CI = 0.83, 0.96) for the odds of asthma. The OR for the indirect effect of maternal smoking on asthma mediated through methylation at the cg05575921 locus was 1.18 (95% CI = 1.07, 1.68), compared to the OR for the total effect of exposure in the parent study of 1.48 (95% CI = 1.03, 2.11). CONCLUSIONS Our findings suggest potential mediation by DNA methylation in the association between maternal smoking during pregnancy and asthma status.
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Affiliation(s)
- Andreas M. Neophytou
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Sam S. Oh
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Donglei Hu
- Department of Medicine, University of California, San Francisco, California
| | - Scott Huntsman
- Department of Medicine, University of California, San Francisco, California
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, California
| | | | - Rajesh Kumar
- Division of Allergy and Immunology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - John R. Balmes
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California
- Department of Medicine, University of California, San Francisco, California
| | - Ellen A. Eisen
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California
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9
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Neophytou AM, Oh SS, White M, Mak A, Hu D, Huntsman S, Eng C, Serebrisky D, Borrell LN, Farber HJ, Meade K, Davis A, Avila PC, Thyne SM, Rodríguez-Cintrón W, Rodríguez-Santana JR, Kumar R, Brigino-Buenaventura E, Sen S, Lenoir MA, Williams LK, Benowitz NL, Balmes JR, Eisen EA, Burchard EG. Secondhand smoke exposure and asthma outcomes among African-American and Latino children with asthma. Thorax 2018; 73:1041-1048. [PMID: 29899038 PMCID: PMC6225993 DOI: 10.1136/thoraxjnl-2017-211383] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/29/2018] [Accepted: 05/08/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Secondhand smoke (SHS) exposures have been linked to asthma-related outcomes but quantitative dose-responses using biomarkers of exposure have not been widely reported. OBJECTIVES Assess dose-response relationships between plasma cotinine-determined SHS exposure and asthma outcomes in minority children, a vulnerable population exposed to higher levels of SHS and under-represented in the literature. METHODS We performed analyses in 1172 Latino and African-American children with asthma from the mainland USA and Puerto Rico. We used logistic regression to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalisations, emergency room visits or oral steroid prescription) in the previous year and asthma control. The shape of dose-response relationships was assessed using a continuous exposure variable in generalised additive logistic models with penalised splines. RESULTS The OR for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with <0.05 ng/mL, was 1.40 (95% CI 1.03 to 1.89), while the OR for poor asthma control was 1.53 (95% CI 1.12 to 2.13). Analyses for dose-response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposures. CONCLUSIONS Exposure to SHS was associated with higher odds of asthma exacerbations and having poorly controlled asthma with an increasing dose-response even at low levels of exposure. Our results support the conclusion that there are no safe levels of SHS exposures.
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Affiliation(s)
- Andreas M. Neophytou
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley CA, USA
| | - Sam S. Oh
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Marquitta White
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Angel Mak
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Donglei Hu
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Scott Huntsman
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Luisa N. Borrell
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Harold J. Farber
- Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
| | - Kelley Meade
- Children’s Hospital and Research Center, Oakland, CA, USA
| | - Adam Davis
- Children’s Hospital and Research Center, Oakland, CA, USA
| | - Pedro C. Avila
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shannon M. Thyne
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | - Rajesh Kumar
- Division of Allergy and Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | | | - Saunak Sen
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - L. Keoki Williams
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Neal L. Benowitz
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - John R. Balmes
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Ellen A. Eisen
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley CA, USA
| | - Esteban G. Burchard
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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10
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Galanter JM, Gignoux CR, Torgerson DG, Roth LA, Eng C, Oh SS, Nguyen EA, Drake KA, Huntsman S, Hu D, Sen S, Davis A, Farber HJ, Avila PC, Brigino-Buenaventura E, LeNoir MA, Meade K, Serebrisky D, Borrell LN, Rodríguez-Cintrón W, Estrada AM, Mendoza KS, Winkler CA, Klitz W, Romieu I, London SJ, Gilliland F, Martinez F, Bustamante C, Williams LK, Kumar R, Rodríguez-Santana JR, Burchard EG. Genome-wide association study and admixture mapping identify different asthma-associated loci in Latinos: the Genes-environments & Admixture in Latino Americans study. J Allergy Clin Immunol 2014; 134:295-305. [PMID: 24406073 PMCID: PMC4085159 DOI: 10.1016/j.jaci.2013.08.055] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 08/27/2013] [Accepted: 08/27/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Asthma is a complex disease with both genetic and environmental causes. Genome-wide association studies of asthma have mostly involved European populations, and replication of positive associations has been inconsistent. OBJECTIVE We sought to identify asthma-associated genes in a large Latino population with genome-wide association analysis and admixture mapping. METHODS Latino children with asthma (n = 1893) and healthy control subjects (n = 1881) were recruited from 5 sites in the United States: Puerto Rico, New York, Chicago, Houston, and the San Francisco Bay Area. Subjects were genotyped on an Affymetrix World Array IV chip. We performed genome-wide association and admixture mapping to identify asthma-associated loci. RESULTS We identified a significant association between ancestry and asthma at 6p21 (lowest P value: rs2523924, P < 5 × 10(-6)). This association replicates in a meta-analysis of the EVE Asthma Consortium (P = .01). Fine mapping of the region in this study and the EVE Asthma Consortium suggests an association between PSORS1C1 and asthma. We confirmed the strong allelic association between SNPs in the 17q21 region and asthma in Latinos (IKZF3, lowest P value: rs90792, odds ratio, 0.67; 95% CI, 0.61-0.75; P = 6 × 10(-13)) and replicated associations in several genes that had previously been associated with asthma in genome-wide association studies. CONCLUSIONS Admixture mapping and genome-wide association are complementary techniques that provide evidence for multiple asthma-associated loci in Latinos. Admixture mapping identifies a novel locus on 6p21 that replicates in a meta-analysis of several Latino populations, whereas genome-wide association confirms the previously identified locus on 17q21.
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Affiliation(s)
- Joshua M Galanter
- Department of Medicine, University of California, San Francisco, Calif; Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, Calif.
| | - Christopher R Gignoux
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, Calif
| | - Dara G Torgerson
- Department of Medicine, University of California, San Francisco, Calif
| | - Lindsey A Roth
- Department of Medicine, University of California, San Francisco, Calif
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, Calif
| | - Sam S Oh
- Department of Medicine, University of California, San Francisco, Calif
| | | | - Katherine A Drake
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, Calif
| | - Scott Huntsman
- Department of Medicine, University of California, San Francisco, Calif
| | - Donglei Hu
- Department of Medicine, University of California, San Francisco, Calif
| | - Saunak Sen
- Department of Epidemiology & Biostatistics, University of California, San Francisco, Calif
| | - Adam Davis
- Children's Hospital and Research Center Oakland, Oakland, Calif
| | - Harold J Farber
- Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine and Texas Children's Hospital, Houston, Tex
| | - Pedro C Avila
- Division of Allergy-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | | | | | - Kelley Meade
- Children's Hospital and Research Center Oakland, Oakland, Calif
| | | | - Luisa N Borrell
- Department of Health Sciences, Graduate Program in Public Health, Lehman College, City University of New York, Bronx, NY
| | | | | | | | - Cheryl A Winkler
- Frederick National Laboratory for Cancer Research, National Institutes of Health, Frederick, Md
| | - William Klitz
- School of Public Health, University of California, Berkeley, Calif
| | | | - Stephanie J London
- National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, Research Triangle Park, NC
| | - Frank Gilliland
- Department of Preventive Medicine, University of Southern California, Los Angeles, Calif
| | | | | | - L Keoki Williams
- Department of Internal Medicine, Henry Ford Health System, Detroit, Mich
| | - Rajesh Kumar
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | | | - Esteban G Burchard
- Department of Medicine, University of California, San Francisco, Calif; Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, Calif
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11
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Torgerson DG, Capurso D, Ampleford EJ, Li X, Moore WC, Gignoux CR, Hu D, Eng C, Mathias RA, Busse WW, Castro M, Erzurum SC, Fitzpatrick AM, Gaston B, Israel E, Jarjour NN, Teague WG, Wenzel SE, Rodríguez-Santana JR, Rodríguez-Cintrón W, Avila PC, Ford JG, Barnes KC, Burchard EG, Howard TD, Bleecker ER, Meyers DA, Cox NJ, Ober C, Nicolae DL. Genome-wide ancestry association testing identifies a common European variant on 6q14.1 as a risk factor for asthma in African American subjects. J Allergy Clin Immunol 2012; 130:622-629.e9. [PMID: 22607992 DOI: 10.1016/j.jaci.2012.03.045] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 02/22/2012] [Accepted: 03/06/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND Genetic variants that contribute to asthma susceptibility might be present at varying frequencies in different populations, which is an important consideration and advantage for performing genetic association studies in admixed populations. OBJECTIVE We sought to identify asthma-associated loci in African American subjects. METHODS We compared local African and European ancestry estimated from dense single nucleotide polymorphism genotype data in African American adults with asthma and nonasthmatic control subjects. Allelic tests of association were performed within the candidate regions identified, correcting for local European admixture. RESULTS We identified a significant ancestry association peak on chromosome 6q. Allelic tests for association within this region identified a single nucleotide polymorphism (rs1361549) on 6q14.1 that was associated with asthma exclusively in African American subjects with local European admixture (odds ratio, 2.2). The risk allele is common in Europe (42% in the HapMap population of Utah residents with Northern and Western European ancestry from the Centre d'Etude du Polymorphisme Humain collection) but absent in West Africa (0% in the HapMap population of Yorubans in Ibadan, Nigeria), suggesting the allele is present in African American subjects because of recent European admixture. We replicated our findings in Puerto Rican subjects and similarly found that the signal of association is largely specific to subjects who are heterozygous for African and non-African ancestry at 6q14.1. However, we found no evidence for association in European American or Puerto Rican subjects in the absence of local African ancestry, suggesting that the association with asthma at rs1361549 is due to an environmental or genetic interaction. CONCLUSION We identified a novel asthma-associated locus that is relevant to admixed populations with African ancestry and highlight the importance of considering local ancestry in genetic association studies of admixed populations.
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Affiliation(s)
- Dara G Torgerson
- Department of Human Genetics, University of Chicago, Chicago, Il 60637, USA
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Torgerson DG, Gignoux CR, Galanter JM, Drake KA, Roth LA, Eng C, Huntsman S, Torres R, Avila PC, Chapela R, Ford JG, Rodríguez-Santana JR, Rodríguez-Cintrón W, Hernandez RD, Burchard EG. Case-control admixture mapping in Latino populations enriches for known asthma-associated genes. J Allergy Clin Immunol 2012; 130:76-82.e12. [PMID: 22502797 DOI: 10.1016/j.jaci.2012.02.040] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Revised: 12/20/2011] [Accepted: 02/02/2012] [Indexed: 12/22/2022]
Abstract
BACKGROUND Polymorphisms in more than 100 genes have been associated with asthma susceptibility, yet much of the heritability remains to be explained. Asthma disproportionately affects different racial and ethnic groups in the United States, suggesting that admixture mapping is a useful strategy to identify novel asthma-associated loci. OBJECTIVE We sought to identify novel asthma-associated loci in Latino populations using case-control admixture mapping. METHODS We performed genome-wide admixture mapping by comparing levels of local Native American, European, and African ancestry between children with asthma and nonasthmatic control subjects in Puerto Rican and Mexican populations. Within candidate peaks, we performed allelic tests of association, controlling for differences in local ancestry. RESULTS Between the 2 populations, we identified a total of 62 admixture mapping peaks at a P value of less than 10(-3) that were significantly enriched for previously identified asthma-associated genes (P= .0051). One of the peaks was statistically significant based on 100 permutations in the Mexican sample (6q15); however, it was not significant in Puerto Rican subjects. Another peak was identified at nominal significance in both populations (8q12); however, the association was observed with different ancestries. CONCLUSION Case-control admixture mapping is a promising strategy for identifying novel asthma-associated loci in Latino populations and implicates genetic variation at 6q15 and 8q12 regions with asthma susceptibility. This approach might be useful for identifying regions that contribute to both shared and population-specific differences in asthma susceptibility.
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Affiliation(s)
- Dara G Torgerson
- Department of Medicine, University of California San Francisco, San Francisco, CA 94158, USA.
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Arjomandi M, Galanter JM, Choudhry S, Eng C, Hu D, Beckman K, Chapela R, Rodríguez-Santana JR, Rodríguez-Cintrón W, Ford J, Avila PC, Burchard EG. Polymorphism in Osteopontin Gene (SPP1) Is Associated with Asthma and Related Phenotypes in a Puerto Rican Population. Pediatr Allergy Immunol Pulmonol 2011; 24:207-214. [PMID: 22276228 DOI: 10.1089/ped.2011.0095] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 08/21/2011] [Indexed: 11/12/2022]
Abstract
Recent studies have shown that osteopontin, a cytokine with suggested immunoregulatory functions, may contribute to pathogenesis of asthma. To determine whether single-nucleotide polymorphisms (SNPs) in SPP1, the gene encoding osteopontin, are associated with risk of asthma, we genotyped 6 known SNPs in SPP1 in the well-characterized Genetics of Asthma in Latino Americans population of 294 Mexican and 365 Puerto Rican parent-child asthma trios. The associations between SNPs and asthma or asthma-related phenotypes were examined by transmission disequilibrium tests as implemented in the family-based association test program. Three polymorphisms, 1 in exon 7 (rs1126616C) and 2 in the 3'-untranslated region (rs1126772A and rs9138A) of SPP1, were associated with diagnosis of asthma, severity of asthma, asthma in subjects with elevated immunoglobulin E (IgE) (IgE >100 IU/mL), and postbronchodilator FEV(1) in Puerto Ricans (P values=0.00007-0.04). The CC genotype of rs1126616 conferred an odds ratio of 1.7 (95% CI=[1.3, 2.3], P value adjusted for multiple comparisons=0.001) for asthma compared with the CT and TT genotypes. Furthermore, haplotype analysis identified rs1126616C-rs1126772A-rs9138A to be associated with an increased risk for asthma, severity of asthma, and asthma in subjects with elevated IgE (P=0.03). There was no association between the SPP1 SNPs and asthma outcomes in Mexicans. Our findings suggest that the SPP1 gene is a risk factor for asthma and asthma-related phenotypes in Puerto Ricans, and are consistent with previous animal and human studies on the role of osteopontin in pathogenesis of asthma.
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Kovacic MB, Myers JMB, Wang N, Martin LJ, Lindsey M, Ericksen MB, He H, Patterson TL, Baye TM, Torgerson D, Roth LA, Gupta J, Sivaprasad U, Gibson AM, Tsoras AM, Hu D, Eng C, Chapela R, Rodríguez-Santana JR, Rodríguez-Cintrón W, Avila PC, Beckman K, Seibold MA, Gignoux C, Musaad SM, Chen W, Burchard EG, Hershey GKK. Identification of KIF3A as a novel candidate gene for childhood asthma using RNA expression and population allelic frequencies differences. PLoS One 2011; 6:e23714. [PMID: 21912604 PMCID: PMC3166061 DOI: 10.1371/journal.pone.0023714] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 07/23/2011] [Indexed: 11/18/2022] Open
Abstract
Background Asthma is a chronic inflammatory disease with a strong genetic predisposition. A major challenge for candidate gene association studies in asthma is the selection of biologically relevant genes. Methodology/Principal Findings Using epithelial RNA expression arrays, HapMap allele frequency variation, and the literature, we identified six possible candidate susceptibility genes for childhood asthma including ADCY2, DNAH5, KIF3A, PDE4B, PLAU, SPRR2B. To evaluate these genes, we compared the genotypes of 194 predominantly tagging SNPs in 790 asthmatic, allergic and non-allergic children. We found that SNPs in all six genes were nominally associated with asthma (p<0.05) in our discovery cohort and in three independent cohorts at either the SNP or gene level (p<0.05). Further, we determined that our selection approach was superior to random selection of genes either differentially expressed in asthmatics compared to controls (p = 0.0049) or selected based on the literature alone (p = 0.0049), substantiating the validity of our gene selection approach. Importantly, we observed that 7 of 9 SNPs in the KIF3A gene more than doubled the odds of asthma (OR = 2.3, p<0.0001) and increased the odds of allergic disease (OR = 1.8, p<0.008). Our data indicate that KIF3A rs7737031 (T-allele) has an asthma population attributable risk of 18.5%. The association between KIF3A rs7737031 and asthma was validated in 3 independent populations, further substantiating the validity of our gene selection approach. Conclusions/Significance Our study demonstrates that KIF3A, a member of the kinesin superfamily of microtubule associated motors that are important in the transport of protein complexes within cilia, is a novel candidate gene for childhood asthma. Polymorphisms in KIF3A may in part be responsible for poor mucus and/or allergen clearance from the airways. Furthermore, our study provides a promising framework for the identification and evaluation of novel candidate susceptibility genes.
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Affiliation(s)
- Melinda Butsch Kovacic
- Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
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Jin Y, Hu D, Peterson EL, Eng C, Levin AM, Wells K, Beckman K, Kumar R, Seibold MA, Karungi G, Zoratti A, Gaggin J, Campbell J, Galanter J, Chapela R, Rodríguez-Santana JR, Watson HG, Meade K, Lenoir M, Rodríguez-Cintrón W, Avila PC, Lanfear DE, Burchard EG, Williams LK. Dual-specificity phosphatase 1 as a pharmacogenetic modifier of inhaled steroid response among asthmatic patients. J Allergy Clin Immunol 2010; 126:618-25.e1-2. [PMID: 20673984 DOI: 10.1016/j.jaci.2010.06.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 06/03/2010] [Accepted: 06/08/2010] [Indexed: 11/15/2022]
Abstract
BACKGROUND Inhaled corticosteroids (ICSs) are considered first-line treatment for persistent asthma, yet there is significant variability in treatment response. Dual-specificity phosphatase 1 (DUSP1) appears to mediate the anti-inflammatory action of corticosteroids. OBJECTIVE We sought to determine whether variants in the DUSP1 gene are associated with clinical response to ICS treatment. METHODS Study participants with asthma were drawn from the following multiethnic cohorts: the Genetics of Asthma in Latino Americans (GALA) study; the Study of African Americans, Asthma, Genes & Environments (SAGE); and the Study of Asthma Phenotypes and Pharmacogenomic Interactions by Race-ethnicity (SAPPHIRE). We screened GALA study participants for genetic variants that modified the relationship between ICS use and bronchodilator response. We then replicated our findings in SAGE and SAPPHIRE participants. In a group of SAPPHIRE participants treated with ICSs for 6 weeks, we examined whether a DUSP1 polymorphism was associated with changes in FEV(1) and self-reported asthma control. RESULTS The DUSP1 polymorphisms rs881152 and rs34507926 localized to different haplotype blocks and appeared to significantly modify the relationship between ICS use and bronchodilator response among GALA study participants. This interaction was also seen for rs881152 among SAPPHIRE but not SAGE participants. Among the group of SAPPHIRE participants prospectively treated with ICSs for 6 weeks, rs881152 genotype was significantly associated with changes in self-reported asthma control but not FEV(1). CONCLUSION DUSP1 polymorphisms were associated with clinical response to ICS therapy and therefore might be useful in the future to identify asthmatic patients more likely to respond to this controller treatment.
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Affiliation(s)
- Ying Jin
- Center for Health Services Research, Henry Ford Health System, Detroit, Mich; Wayne State University School of Medicine, Detroit, Mich 48202, USA
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Galanter J, Choudhry S, Eng C, Nazario S, Rodríguez-Santana JR, Casal J, Torres-Palacios A, Salas J, Chapela R, Watson HG, Meade K, LeNoir M, Rodríguez-Cintrón W, Avila PC, Burchard EG. ORMDL3 gene is associated with asthma in three ethnically diverse populations. Am J Respir Crit Care Med 2008; 177:1194-200. [PMID: 18310477 DOI: 10.1164/rccm.200711-1644oc] [Citation(s) in RCA: 203] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Independent replication of genetic associations in complex diseases, particularly in whole-genome association studies, is critical to confirm the association. OBJECTIVES A whole-genome association study identified ORMDL3 as a promising candidate gene for asthma in white populations. Here, we attempted to confirm the role of ORMDL3 genetic variants in asthma in three ethnically diverse populations: Mexican, Puerto Rican, and African American. METHODS We used family-based analyses to test for association between seven candidate single-nucleotide polymorphisms (SNPs) in and around the ORMDL3 gene and asthma and related phenotypes in 701 Puerto Rican and Mexican parent-child trios. We also evaluated these seven SNPs and an additional ORMDL3 SNP in 264 African American subjects with asthma and 176 healthy control subjects. MEASUREMENTS AND MAIN RESULTS We found significant associations between two SNPs within ORMDL3 (rs4378650 and rs12603332) and asthma in Mexicans and African Americans (P = 0.028 and 0.001 for rs4378650 and P = 0.021 and 0.001 for rs12603332, respectively), and a trend toward association in Puerto Ricans (P = 0.076 and 0.080 for SNPs rs4378650 and rs12603332, respectively). These associations became stronger among Mexican and Puerto Rican subjects with asthma with IgE levels greater than 100 IU/ml. We did not find any association between ORMDL3 SNPs and baseline lung function or response to the bronchodilator albuterol. CONCLUSIONS Our results confirm that the ORMDL3 locus is a risk factor for asthma in ethnically diverse populations. However, inconsistent SNP-level results suggest that further studies will be needed to determine the mechanism by which ORMDL3 predisposes to asthma.
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Affiliation(s)
- Joshua Galanter
- Lung Biology Center, Department of Medicine, Institute for Human Genetics, University of California, San Francisco, California 94143-2911, USA.
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Abstract
A low anaerobic power has been proposed as a factor that may be limiting the achievement of a plateau in VO2 of children who perform maximal aerobic power tests. This study examined the frequency of plateau achievement in pre-pubertal children and compared VO2max, peak (PP) and mean (MP) anaerobic power in subjects who either achieved a plateau (PLAT) or did not (NO PLAT). Eighteen healthy pre-pubertal (Tanner Stage, pubic hair = 1) males (age = 9.1 1.6 yrs, ht = 134.4 +/- 9.7cm, wt = 33.3 +/- 9.2kg, VO2max = 40.0 +/- 6.7 ml x kg(-1) min(-1)) were tested. All subjects completed a 30 sec Wingate Anaerobic Test and a McMaster aerobic protocol to volitional fatigue on a cycle ergometer. Only 33% of the subjects met the PLAT criterion. No differences were found for PP or MP between those who achieved a plateau and those who did not (PLAT: PP= 6.3 +/- 0.8W/kg and MP = 5.2 +/- 0.7W/kg; NO PLAT: PP= 6.3 +/- 1.2 W/kg and MP = 5.2 +/- 1.3 W/kg). We conclude that anaerobic power is not a factor limiting the achievement of a plateau in VO2 of pre-pubertal boys who perform maximal aerobic power tests.
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Affiliation(s)
- A M Rivera-Brown
- Cardiovascular Center, Department of Pediatrics, University of Puerto Rico School of Medicine, San Juan, USA.
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Rivera JF, Rodríguez-Santana JR, Vázquez-Agosto S, Vélez-Vega W, Sifontes JE, Mayol PM. Flexible bronchoscopy in children at the University of Puerto Rico Pediatric Hospital. Review of 324 consecutive patients. Bol Asoc Med P R 1990; 82:211-5. [PMID: 2375811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Described are the findings resulting from 324 bronchoscopies performed with the flexible bronchoscope during the past 8 years at the University of Puerto Rico Pediatric Hospital. Neonates, infants, children and adolescents were included. The most frequent indications for the procedure were stridor, recurrent or persistent pneumonia, atelectasis, recurrent croup and persistent wheezing. An abnormality was detected in 88 per cent of the patients and the finding often resulted in significant modifications of treatment or allowed for reassurance. Complications were minor and there was no mortality. We conclude that the procedure, as we describe it, is save, effective and useful.
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Affiliation(s)
- J F Rivera
- Department of Pediatrics, University of Puerto Rico School of Medicine
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Rodríguez-Santana JR, Gotay F, Fernández-Seín A, Sifontes JE, Mayol PM. Bacterial infraglottitis and adult respiratory distress syndrome: case report. Bol Asoc Med P R 1986; 78:162-9. [PMID: 3459475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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