Risk factors for incidence and persistence of asthma-like symptoms

Persistent Link:
http://hdl.handle.net/10150/280354
Title:
Risk factors for incidence and persistence of asthma-like symptoms
Author:
Guerra, Stefano
Issue Date:
2003
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Asthma represents the most common chronic disease in childhood. Children with asthma are at increased risk for developing long-term irreversible airway obstruction in adult life, the fourth leading cause of death in USA. Our aims were to: (1) Determine whether reduced IFNgamma production and plasma soluble CD14 (sCD14) levels in early life are significant risk factors for the development of wheezing in the first year of life; (2) Estimate rates of persistence and remission of childhood wheezing after puberty; (3) Study risk factors affecting persistence of childhood wheezing after puberty. We used data from the two large ongoing birth cohorts of the Tucson Infant Immune Study (IIS) and the Tucson Children's Respiratory Study (CRS). Among 238 children from IIS, we found the odds of developing recurrent wheezing in the first year of life to be 4.5 times higher for children in the lowest quartile of IFNgamma production at 3 months (p = .0005) and 3.2 times higher for children in the lowest quartile of sCD14 levels at birth (p = .004) as compared with children in the other 3 combined quartiles of IFNgamma and sCD14, respectively. We studied persistence and remission of wheezing after puberty among 732 children from the CRS cohort. We found that 29% of children with infrequent wheezing during childhood experienced persistent wheezing after contrast, the proportion of persistent wheezing was much higher (60%) among children meeting the for asthma during childhood. Frequency of wheezing during childhood, obesity, an early onset of puberty, bronchial hyperresponsiveness, and skin test sensitization were significant predictors of persistent asthma after puberty. By looking at genetic factors, we also found that the homozygous status for Gly in codon 16 of the beta2 Adrenoceptor doubled the risk for persistent wheezing after puberty among boys (RR 2.01, p = .0008) but not girls. Our findings from two population-based longitudinal cohorts provide the first evidence that altered immunological markers precede the onset of wheezing early in life, challenge the commonly held view that most asthma cases remit during adolescence, and provide a profile of risk.
Type:
text; Dissertation-Reproduction (electronic)
Keywords:
Biology, Genetics.; Health Sciences, Medicine and Surgery.; Health Sciences, Public Health.
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Graduate College; Epidemiology
Degree Grantor:
University of Arizona
Advisor:
Sherrill, Duane L.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_US
dc.titleRisk factors for incidence and persistence of asthma-like symptomsen_US
dc.creatorGuerra, Stefanoen_US
dc.contributor.authorGuerra, Stefanoen_US
dc.date.issued2003en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractAsthma represents the most common chronic disease in childhood. Children with asthma are at increased risk for developing long-term irreversible airway obstruction in adult life, the fourth leading cause of death in USA. Our aims were to: (1) Determine whether reduced IFNgamma production and plasma soluble CD14 (sCD14) levels in early life are significant risk factors for the development of wheezing in the first year of life; (2) Estimate rates of persistence and remission of childhood wheezing after puberty; (3) Study risk factors affecting persistence of childhood wheezing after puberty. We used data from the two large ongoing birth cohorts of the Tucson Infant Immune Study (IIS) and the Tucson Children's Respiratory Study (CRS). Among 238 children from IIS, we found the odds of developing recurrent wheezing in the first year of life to be 4.5 times higher for children in the lowest quartile of IFNgamma production at 3 months (p = .0005) and 3.2 times higher for children in the lowest quartile of sCD14 levels at birth (p = .004) as compared with children in the other 3 combined quartiles of IFNgamma and sCD14, respectively. We studied persistence and remission of wheezing after puberty among 732 children from the CRS cohort. We found that 29% of children with infrequent wheezing during childhood experienced persistent wheezing after contrast, the proportion of persistent wheezing was much higher (60%) among children meeting the for asthma during childhood. Frequency of wheezing during childhood, obesity, an early onset of puberty, bronchial hyperresponsiveness, and skin test sensitization were significant predictors of persistent asthma after puberty. By looking at genetic factors, we also found that the homozygous status for Gly in codon 16 of the beta2 Adrenoceptor doubled the risk for persistent wheezing after puberty among boys (RR 2.01, p = .0008) but not girls. Our findings from two population-based longitudinal cohorts provide the first evidence that altered immunological markers precede the onset of wheezing early in life, challenge the commonly held view that most asthma cases remit during adolescence, and provide a profile of risk.en_US
dc.typetexten_US
dc.typeDissertation-Reproduction (electronic)en_US
dc.subjectBiology, Genetics.en_US
dc.subjectHealth Sciences, Medicine and Surgery.en_US
dc.subjectHealth Sciences, Public Health.en_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplineEpidemiologyen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorSherrill, Duane L.en_US
dc.identifier.proquest3106994en_US
dc.identifier.bibrecord.b44660443en_US
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