The role of social and familial factors in the development of childhood asthma by age 6 years was studied in a birth cohort of New Zealand children. Rates of asthma varied markedly with the child's sex; boys had twice the rate of asthma as girls. In addition, the factors associated with asthma varied with the child's sex. For boys, wheeze during infancy, early eczema, and parental asthma were all significant risk factors; for girls, the only risk factor was early eczema. Proportional hazards modeling of the data failed to show any significant associations between the development of asthma and a large range of other social and familial factors including breast-feeding, parental smoking habits, pets in the child's family, stress in the family, or family social background. It was concluded that asthma in early childhood appeared to be inherited to some extent, its age of expression was related to the child's sex, and it had a complex interaction with other forms of allergic disease. There was no evidence to suggest that the structure, practices, or dynamics of the child's family played a significant role in the development of asthma for children in this birth cohort.
"The expression pattern of these genes, however, was not straightforward but indicated complex interactions with several environmental risk factors. Known risk factors are obesity and male sex for childhood asthma . Environmental risk factors that foster the development of asthma are indoor and outdoor allergens, such as house dust mite (HDM), cockroach allergens, cat and dog dander or Aspergillus mold. "
[Show abstract][Hide abstract] ABSTRACT: Asthma and chronic obstructive pulmonary disease (COPD) are the two most prominent chronic inflammatory lung diseases with increasing prevalence. Both diseases are associated with mild or severe remodeling of the airways. In this review, we postulate that the pathologies of asthma and COPD may result from inadequate responses and/or a deregulated balance of a group of cell differentiation regulating factors, the CCAAT/Enhancer Binding Proteins (C/EBPs). In addition, we will argue that the exposure to environmental factors, such as house dust mite and cigarette smoke, changes the response of C/EBPs and are different in diseased cells. These novel insights may lead to a better understanding of the etiology of the diseases and may provide new aspects for therapies.
The Open Respiratory Medicine Journal 04/2012; 6(1):1-13. DOI:10.2174/1874306401206010001
"Predictors that have already been identified include environmental factors; i.e. exposure to allergens [3-6], tobacco smoke [7,8] , respiratory (viral) infections [9-11], and diet (particularly breastfeeding) . But also 'non environmental' factors such as sex [13,14] and obesity [15,16] are predictors for asthma. It is thought that early identification of children at high risk for asthma may improve their management resulting in fewer respiratory symptoms, exacerbations and emergency medical visits while improving their quality of life (QoL) and preventing loss of lung function and airway remodelling over time [17-20]. "
[Show abstract][Hide abstract] ABSTRACT: Asthma is a difficult diagnosis to establish in preschool children. A few years ago, our group presented a prediction rule for young children at risk for asthma in general practice. Before this prediction rule can safely be used in practice, cross-validation is required. In addition, general practitioners face many therapeutic management decisions in children at risk for asthma. The objectives of the study are: (1) identification of predictors for asthma in preschool children at risk for asthma with the aim of cross-validating an earlier derived prediction rule; (2) compare the effects of different treatment strategies in preschool children.
In this prospective cohort study one to five year old children at risk of developing asthma were selected from general practices. At risk was defined as 'visited the general practitioner with recurrent coughing (>or= 2 visits), wheezing (>or=1) or shortness of breath (>or=1) in the previous 12 months'. All children in this prospective cohort study will be followed until the age of six. For our prediction rule, demographic data, data with respect to clinical history and additional tests (specific immunoglobulin E (IgE), fractional exhaled nitric oxide (FENO), peak expiratory flow (PEF)) are collected. History of airway specific medication use, symptom severity and health-related quality of life (QoL) are collected to estimate the effect of different treatment intensities (as expressed in GINA levels) using recently developed statistical techniques. In total, 1,938 children at risk of asthma were selected from general practice and 771 children (40%) were enrolled. At the time of writing, follow-up for all 5-year olds and the majority of the 4-year olds is complete. The total and specific IgE measurements at baseline were carried out by 87% of the children. Response rates to the repeated questionnaires varied from 93% at baseline to 73% after 18 months follow-up; 89% and 87% performed PEF and FENO measurements, respectively.
In this study a prediction rule for asthma in young children, to be used in (general) practice, will be cross-validated. Our study will also provide more insight in the effect of treatment of asthma in preschool children.
BMC Pulmonary Medicine 04/2009; 9(1):13. DOI:10.1186/1471-2466-9-13 · 2.40 Impact Factor
"Several studies report a greater asthma or allergic disease rates in higher socioeconomic classes  , but others reported no such association  . We used parental education to represent socioeconomic class in our study; both maternal and paternal educational levels showed no significant correlations with allergic rhinitis. "
[Show abstract][Hide abstract] ABSTRACT: To investigate the incidence and prenatal risk factors for allergic rhinitis among elementary school children in an urban city.
Risk factor data were collected by questionnaire and direct physical examination. Multiple logistic regression analysis was used to calculate the odds ratios of developing allergic rhinitis among children 6-13 years of age.
From January 2006 to December 2006, we enrolled 1368 elementary school children in the study. Sampling was done by a multi-stage clustered-stratified random method to determine the study subject. All the children studied attended 12 elementary schools located in the six districts in Taipei, with two schools in each district. Odds ratios were adjusted for the confounding effects of gender, parity, maternal age at childbirth, maternal education, gestational complications, tobacco smokers in the residence, pets, carpets, molds, and air pollution.
The incidence of allergic rhinitis in the study was 50.1% (685/1368). Factors like gender (p<.001), parity (p<.05), carpets (p<.025), and air pollution (p<.001) increased risk, while the other factors did not (p>.05 for all).
Gender, parity, carpets, and air pollution increased the risk of developing allergic rhinitis among elementary school children. Other potential factors such as low birth weight, maternal age at childbirth, parental education, gestational complications, presence of tobacco smokers, and exposure to pets and molds did not significantly increase risk of developing allergic rhinitis.
International journal of pediatric otorhinolaryngology 03/2009; 73(6):807-10. DOI:10.1016/j.ijporl.2009.02.023 · 1.19 Impact Factor
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