ABSTRACT: A few cross-sectional studies reported an increased risk of inflammatory bowel disease (IBD) among asthmatics. We conducted a population-based, case-control study that applied predetermined criteria for asthma and IBD to determine whether asthma, as a T-helper 2 (Th2) condition, reduces the risk of IBD, a Th1 condition.
This was a population-based, case-control study using criteria-based ascertainment for IBD and asthma. Subjects were all Rochester, Minnesota, residents who had developed IBD between 1964 and 1983 and their age- and gender-matched controls, using 1:1 matching. Controls were randomly selected from the community using the Rochester Epidemiology Project database and confirmed not to have IBD. All cases and controls were merged with the database comprising all Rochester residents with or without asthma between 1964 and 1983.
Of the 231 IBD cases, 55% had ulcerative colitis and the remainder had Crohn's disease. Of these, 50.4% were male and 98.1% were Caucasians. The mean age at the time of IBD diagnosis was 33.8 years. Four cases (1.7%) had asthma prior to the index date of IBD, whereas two controls (0.9%) had asthma (unadjusted odds ratio [OR]: 3.0, 95% confidence interval [CI]: 0.31-28.84, P = 0.34). Similarly, 16 IBD cases (6.9%) had asthma ever while 12 controls (5.2%) had asthma ever (unadjusted OR: 1.4, 95% CI: 0.62-3.38, P = 0.40).
Asthma as a Th2 condition does not reduce the risk of IBD as a Th1 condition. Because of the limitations of our study and others, the association between asthma and IBD needs to be further studied.
Inflammatory Bowel Diseases 11/2010; 16(11):1957-62. · 4.86 Impact Factor
ABSTRACT: Asthma has been reported to be associated with an increased risk of invasive pneumococcal disease (IPD).
We compared serotype-specific antibody responses with pneumococcal polysaccharide antigens of individuals with and without asthma.
A cross-sectional study was conducted for 16 subjects with asthma and 14 subjects without asthma from the community of Rochester, MN. Asthma was determined by predetermined criteria based on comprehensive medical record reviews. Serotype-specific antibody to 23 pneumococcal polysaccharide antigens was measured by enzyme-linked immunosorbent assay, and seropositivity was considered ≥ 1.3 μg/mL. Interferon-γ (IFN-γ) and interleukin-5 (IL-5) were measured from peripheral blood mononuclear cells cultured with house dust mites and staphylococcal enterotoxin B.
Of the 30 subjects, 16 (53%) were male, 21 (70%) were white, and the median age was 26 years. The median numbers of positive serotype-specific antibodies for asthmatics and nonasthmatics were 8.5 and 15.5, respectively (P = 0.034). There was an inverse relationship between the ratio of log-transformed IL-5/IFN-γ and the number of positive serotype-specific antibodies (r = -0.36; P = 0.052). As potential covariates and confounders, a history of pneumococcal vaccination (P = 0.84), having a high-risk condition for IPD (P = 0.68), and taking asthma medications, including inhaled/systemic corticosteroids (P = 0.79), were not associated with the number of positive serotype-specific antibodies.
Asthmatics had significantly lower serotype-specific pneumococcal antibody levels than nonasthmatics. House dust mite-induced T-helper 2 (Th2) cytokine immune profile may be related to the association. This may account for an increased risk of IPD in asthmatics and deserves further investigation.
Postgraduate Medicine 09/2010; 122(5):116-24. · 1.78 Impact Factor
ABSTRACT: We reported an increased risk of serious pneumococcal disease (SPD) among patients with asthma. It is not known whether this is true for patients with other atopic conditions.
To determine the relationship between atopic conditions other than asthma and SPD.
The study subjects were residents of Rochester, Minn, who developed SPD between 1964 and 1983 and their 2 sex-matched and age-matched controls. We used a population-based computer-linked medical diagnosis system to identify all individuals with potential SPD. All records were reviewed by using explicit predetermined criteria for SPD. All individuals with atopic conditions were identified by the physician diagnoses including atopic dermatitis or eczema, allergic rhinitis, and hay fever documented in medical records. The associations between these atopic conditions and SPD were assessed by using conditional logistic regression.
A total of 3941 records were reviewed, and we identified 174 SPD cases. Of these 174 cases, 50.6% were male, and 94.3% were Caucasian. Twenty-six (14.9%) of the SPD cases and 29 (8.3%) of the controls had atopy. Atopic conditions other than asthma were associated with an increased risk of SPD (odds ratio, 2.13; 95% CI, 1.04-4.35; P = .04) after adjusting for smoking status, previous high-risk conditions for SPD, educational status, and ethnicity.
Like asthma, other atopic conditions, particularly atopic dermatitis, are associated with an increased risk of SPD. There may be a common immunogenetic mechanism underlying increased risk of SPD among individuals with either asthma or other atopic conditions. Our study findings need to be studied further.
The Journal of allergy and clinical immunology 01/2010; 125(1):217-21. · 9.17 Impact Factor