Risk factors for onset of asthma - A 12-year prospective follow-up study

Respiratory Unit, Dept of Internal Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
Chest (Impact Factor: 7.48). 03/2006; 129(2):309-16. DOI: 10.1378/chest.129.2.309
Source: PubMed


Asthma development and prognosis have been studied extensively in at-risk populations, but knowledge of the natural history of asthma in the general population is limited.
To describe the incidence and remission of asthma and its predictors, data from a 12-year follow-up study of a random population sample (n = 291; age range, 7 to 17 years) at enrollment, were analyzed.
The sample was examined in 1986 and in 1998. A case history, including data on asthma, allergic diseases, and lifestyle factors, was obtained by questionnaire and interview. Airway hyperresponsiveness (AHR) to histamine, lung function, and skin-prick test reactivity to a standard panel of 10 aeroallergens were measured.
The point prevalence of asthma increased from 4.1% at the first survey to 11.7% at follow-up, at which point 19.6% of the sample had ever experienced asthma symptoms. Of the subjects with ever-asthma, 40% had remitted at follow-up. Asthma developed in 45 subjects (16.1%) during the follow-up period, which was predicted by the following factors: wheezing in childhood (odds ratio [OR], 3.61; 95% confidence interval [CI], 1.34 to 9.75), AHR (OR, 4.94; 95% CI, 2.42 to 10.08), allergic sensitization to house dust mites (OR, 3.23; 95% CI, 1.00 to 10.40), and dermatitis (OR, 2.94; 95% CI, 1.22 to 7.11). The simultaneous presence of more than one of these risk factors was associated with a high probability of developing asthma at follow-up (61.5%). In subjects without any risk factors, such as AHR, allergic sensitization, rhinitis, dermatitis or wheezing in childhood; paternal/maternal allergy, or asthma, asthma developed in only 4% during follow-up.
The presence of AHR and concomitant atopic manifestations in childhood increase the risk of developing asthma in adulthood, and should be recognized as markers of prognostic significance, whereas the absence of these manifestations predicts a very low risk of future asthma.

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Available from: Marie-Louise von Linstow, Oct 03, 2015
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    • "Asthma is a disease with polymorphic phenotype affected by several environmental and genetic factors which both play a key role in the development and persistence of the disease [2] [3]. Among these factors family history of asthma, presence of atopic dermatitis or allergic rhinitis, wheezing episodes during childhood, maternal smoking during pregnancy, and several prenatal and environmental factors are included [4] [5] [6] [7]. Most children who suffer from asthma develop their first symptoms before the 5th year of age [8]. "
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    ABSTRACT: Objectives: In this study a new method for asthma outcome prediction, which is based on Principal Component Analysis and Least Square Support Vector Machine Classifier, is presented. Most of the asthma cases appear during the first years of life. Thus, the early identification of young children being at high risk of developing persistent symptoms of the disease throughout childhood is an important public health priority. Methods: The proposed intelligent system consists of three stages. At the first stage, Principal Component Analysis is used for feature extraction and dimension reduction. At the second stage, the pattern classification is achieved by using Least Square Support Vector Machine Classifier. Finally, at the third stage the performance evaluation of the system is estimated by using classification accuracy and 10-fold cross-validation. Results: The proposed prediction system can be used in asthma outcome prediction with 95.54 % success as shown in the experimental results. Conclusions: This study indicates that the proposed system is a potentially useful decision support tool for predicting asthma outcome and that some risk factors enhance its predictive ability.
    Computational and Mathematical Methods in Medicine 03/2013; 2013:240182. DOI:10.1155/2013/240182 · 0.77 Impact Factor
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    • "They exhibit increased bronchial sensitivity to methacholine or histamine, especially during and slightly after the pollen season. Bronchial hyper-responsiveness is common in people with AR, even if they have no asthma symptoms, and asymptomatic airway hyper-responsiveness is associated with increased risk for developing asthma [Boulet, 2003; Porsbjerg, 2006]. In one study, up to 40% of patients with AR showed hyperresponsiveness to methacholine challenge; those showing hyper-responsiveness were more likely to develop asthma over the following 4–5 years [Braman, 1987]. "
    Allergic Rhinitis, 03/2012; , ISBN: 978-953-51-0288-5
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    • "Another is that AHR in rhinitis patients is a subclinical form of asthma (Ulrik et al., 2000). This is consistent with the finding that subjects with rhinitis and concomitant AHR are at greater risk of developing asthma compared with subjects who only have rhinitis (Porsbjerg et al., 2006). A clinical study of Danish adult twins showed that the genetic liability to asthma symptoms and AHR correlated .70 "
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    ABSTRACT: The genetics of asthma and atopy has been studied frequently in twin populations from various parts of the world. However, emphasis has been put on univariate analysis of questionnaire data, whereas clinical and intermediate traits only sporadically have been studied, especially in multivariate settings. This review focuses on multivariate twin studies of atopy and related traits. We conclude that the genetic liability to most atopic traits is significantly correlated but that trait-specific genes also play a role. Previous studies have estimated the genetic correlation between upper and lower respiratory allergic symptoms, that is, asthma and hay fever, to be between .47 and .95. Furthermore, atopic traits share a portion of their genetic determinants with other complex disorders like obesity and behavioral traits. A correlation of about .3 and .34 has been reported between genes associated with asthma and obesity, and between genes associated with asthma and depression, respectively. We emphasize that multivariate methods applied to twin studies, especially when genetic marker information is available, provide a valuable framework within which complex etiological mechanisms underlying atopy can be disentangled.
    Twin Research and Human Genetics 05/2008; 11(2):112-20. DOI:10.1375/twin.11.2.112 · 2.30 Impact Factor
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