Ganesa Wegienka

Henry Ford Hospital, Detroit, Michigan, United States

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Publications (105)292.41 Total impact

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    ABSTRACT: To determine the effect of cervix removal at hysterectomy on patient-centered outcomes including post-operative pain, dyspareunia, well-being, and overall satisfaction during the 3-month post-operative period.
    Archives of Gynecology and Obstetrics 08/2014; · 1.33 Impact Factor
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    ABSTRACT: Recent research has emphasized the need to better discriminate asthma phenotypes and consider underlying mechanistic endotypes in epidemiologic and clinical studies. Although allergic asthma and nonallergic asthma are frequently combined into 1 disease category in observational research and clinical trials, few studies have investigated the extent to which these 2 separate phenotypes are associated with distinct cytokine immunologic profiles in a representative young adult population. To investigate the cytokine production-based endotypes underlying the clinical phenotypes of allergic and nonallergic asthma in a population-based birth cohort evaluated as young adults. Participants included 18- to 21-year-old members (n = 540) of a suburban Detroit birth cohort study, the Childhood Allergy Study. Phorbol myristate acetate-stimulated whole blood interleukin (IL)-4, IL-5, IL-10, IL-12, IL-13, IL-17A, IL-17F, IL-22, and interferon-γ secretory responses were analyzed for associations comparing participants with allergic vs nonallergic asthma phenotypes with those without asthma. T-helper cell type (TH) 2-polarized responses, measured as higher mean IL-5 and IL-13 secretions and lower ratios of interferon-γ and IL-12 to 3 TH2 cytokines (IL-4, IL-5, or IL-13), were observed only in participants with allergic asthma. Nonallergic asthma was associated with TH1-polarized responses, including higher adjusted interferon-γ secretion compared with participants with allergic asthma and, surprisingly, those without asthma (odds ratio 2.5, confidence interval 1.2-5.1, P < .01). As expected, young adults with a history of an allergic asthma phenotype exhibited a TH2-polarized cytokine response after polyclonal stimulation. However, TH1 polarization was observed in patients with a history of nonallergic asthma. Allergic and nonallergic asthma are associated with etiologically distinct immune endotypes, underscoring the importance of discriminating these endotypes in research analyses and clinical management.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 05/2014; · 3.45 Impact Factor
  • Christine C Johnson, Ganesa R Wegienka
    American Journal of Respiratory and Critical Care Medicine 02/2014; 189(4):380-1. · 11.04 Impact Factor
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    ABSTRACT: There is consistent evidence demonstrating that pet-keeping, particularly of dogs, is beneficial to human health. We explored relationships between maternal race and prenatal dog-keeping, accounting for measures of socioeconomic status that could affect the choice of owning a pet, in a demographically diverse, unselected birth cohort. Self-reported data on mothers' race, socioeconomic characteristics and dog-keeping practices were obtained during prenatal interviews and analyzed cross-sectionally. Robust methods of covariate balancing via propensity score analysis were utilized to examine if race (Black vs White), independent of other participant traits, influenced prenatal dog-keeping. A birth cohort study conducted in a health care system in metropolitan Detroit, Michigan between September 2003 and November 2007. 1065 pregnant women (n=775 or 72.8% Black), between ages 21 and 45, receiving prenatal care. Participant's self-report of race/ethnicity and prenatal dog-keeping, which was defined as her owning or caring for > or =1 dog for more than 1 week at her home since learning of her pregnancy, regardless of whether the dog was kept inside or outside of her home. In total, 294 women (27.6%) reported prenatal dog-keeping. Prenatal dog-keeping was significantly lower among Black women as compared to White women (20.9% vs 45.5%, P<.001), and remained significantly different even after propensity score analysis was applied. Findings suggest that there are persistent racial differences in dog-keeping not fully explained by measures of socioeconomic status. Racial differences in prenatal dog-keeping may contribute to childhood health disparities.
    Ethnicity & disease 01/2014; 24(1):104-9. · 1.12 Impact Factor
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    ABSTRACT: Background Recent research has emphasized the need to better discriminate asthma phenotypes and consider underlying mechanistic endotypes in epidemiologic and clinical studies. Although allergic asthma and nonallergic asthma are frequently combined into 1 disease category in observational research and clinical trials, few studies have investigated the extent to which these 2 separate phenotypes are associated with distinct cytokine immunologic profiles in a representative young adult population. Objective To investigate the cytokine production-based endotypes underlying the clinical phenotypes of allergic and nonallergic asthma in a population-based birth cohort evaluated as young adults. Methods Participants included 18- to 21-year-old members (n = 540) of a suburban Detroit birth cohort study, the Childhood Allergy Study. Phorbol myristate acetate–stimulated whole blood interleukin (IL)-4, IL-5, IL-10, IL-12, IL-13, IL-17A, IL-17F, IL-22, and interferon-γ secretory responses were analyzed for associations comparing participants with allergic vs nonallergic asthma phenotypes with those without asthma. Results T-helper cell type (TH) 2-polarized responses, measured as higher mean IL-5 and IL-13 secretions and lower ratios of interferon-γ and IL-12 to 3 TH2 cytokines (IL-4, IL-5, or IL-13), were observed only in participants with allergic asthma. Nonallergic asthma was associated with TH1-polarized responses, including higher adjusted interferon-γ secretion compared with participants with allergic asthma and, surprisingly, those without asthma (odds ratio 2.5, confidence interval 1.2–5.1, P < .01). Conclusion As expected, young adults with a history of an allergic asthma phenotype exhibited a TH2–polarized cytokine response after polyclonal stimulation. However, TH1 polarization was observed in patients with a history of nonallergic asthma. Allergic and nonallergic asthma are associated with etiologically distinct immune endotypes, underscoring the importance of discriminating these endotypes in research analyses and clinical management.
    Annals of Allergy, Asthma & Immunology. 01/2014;
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    ABSTRACT: Background Atopic sensitization (ie, atopy) is the most commonly reported risk factor for asthma. Recent studies have begun to suggest that atopy, as conventionally defined, might be an umbrella term that obfuscates more specific allergic disease types. Objective We sought to determine whether distinct and meaningful atopic phenotypes exist within a racially diverse birth cohort using 10 allergen-specific serum IgE (sIgE) measurements from children aged 2 years. Methods Using the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (WHEALS) birth cohort (62% black), we analyzed sIgE data on 10 allergens (Dermatophagoides farinae, dog, cat, timothy grass, ragweed, Alternaria alternata, egg, peanut, milk, and German cockroach) obtained from 594 children at age 2 years. Conventional atopy was defined as at least 1 sIgE level of 0.35 IU/mL or greater. Results A 4-class solution (latent class model) was the best fit. Class types were labeled “low to no sensitization” (76.9% of sample), “highly sensitized” (2.7%), “milk and egg dominated” (15.3%), and “peanut and inhalant(s)” (5.1%). Almost one third (32.2%) of the low to no sensitization group met the criteria for conventional atopy. The highly sensitized group was significantly associated with a doctor's diagnosis of asthma after age 4 years (odds ratio [OR], 5.3; 95% CI, 1.6-17.4), whereas the milk and egg dominated and peanut and inhalant(s) groups were not (ORs of 1.6 [95% CI, 0.8-3.0] and 1.8 [95% CI, 0.6-4.9], respectively). Children of black race were more likely to be in the 3 multisensitized groups (P = .04). Conclusion Classification by sIgE patterns defined groups whose membership is more strongly associated with atopic dermatitis, wheeze, and asthma compared with conventional atopy.
    The Journal of allergy and clinical immunology 01/2014; · 12.05 Impact Factor
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    ABSTRACT: It is unknown whether family members with detectable specific immunoglobulin E (sIgE) and/or allergic symptoms to pets are more or less likely to reside in a household with pets. We cross-sectionally investigated potential relationships between family members' allergic sensitization and symptoms to dogs and cats and current household pet-keeping practices, using birth cohort data. Blood samples taken from children enrolled in a birth cohort and their biological mothers and fathers, when the children were aged 18 years, were assessed for sIgE to dog and cat allergens. Interviews assessed subjects' self-reported pet exposure symptoms, current household pet-keeping practices, and socioeconomic characteristics. Overall, household dog or cat keeping was not associated with sIgE to these animals and/or self-reported allergic symptoms in the presence of these animals, even after controlling for factors such as education and household income. In subgroup analyses, current household dog keeping among dog-symptomatic teens (n = 40) was significantly lower than among teens who were not dog symptomatic (n = 289), at 48.8 and 61.1%, respectively (p = 0.036). Current household cat keeping was significantly lower among cat-symptomatic mothers (n = 27) compared with mothers who were not cat symptomatic (n = 120), at 24.3 and 37.0%, respectively (p = 0.015). However, when considering those who were both sensitized and reported symptoms, only the mother and cat-keeping associations persisted (p = 0.049). When cat-sensitized mothers report allergic symptoms to cats, these pets may be less likely to be kept in homes. Elevated dog and cat allergen sIgE does not appear to be associated with the keeping of these pets.
    Allergy and Asthma Proceedings 11/2013; 34(6):504-10. · 2.19 Impact Factor
  • American Journal Of Reproductive Immunology 07/2013; · 3.32 Impact Factor
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    ABSTRACT: PROBLEM: Uterine leiomyomata are the most common reproductive tumor in women, and their cause is not known. METHODS OF STUDY: Plasma samples from 155 women (74 with and 81 without ultrasound-confirmed leiomyoma) from a new study of leiomyoma risk factors in the Detroit, Michigan area, were examined for any cross-sectional associations between commonly examined cytokines and leiomyoma presence. RESULTS: Associations varied by season of sample collection defined a priori as winter (December-February) and non-winter seasons. In the winter months, interleukin (IL)13 and IL17 were positively and IP10 was inversely associated with having a leiomyoma. In the non-winter samples, VEGF, G-CSF, and IP10 were positively associated and Monocyte chemotactic protein-1, IL13, and IL17 were inversely associated with having a leiomyoma. Associations were not changed by adjustment for age or BMI. CONCLUSIONS: These data suggest that new insight into leiomyoma formation may be acquired through investigation of the immune system.
    American Journal Of Reproductive Immunology 04/2013; · 3.32 Impact Factor
  • Edward M Zoratti, Ganesa Wegienka
    Evidence-based nursing 03/2013;
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    ABSTRACT: Racial disparities are present in many facets of health and disease. Allergy and asthma are no exceptions. Secondary results from cross-sectional and cohort studies have provided information on the scope of racial disparities in allergic sensitization in the United States. African American/Black individuals tend to be sensitized more frequently than White individuals. Little is known about rates in other race groups. Genetics are unlikely to be the sole or major cause of the observed differences. Home dust allergen and endotoxin levels cannot explain the differences. Studies that have been designed to specifically address the sources of these racial disparities are needed. A "Multilevel Framework" that considers the roles of the individual, family and community presents an excellent approach to guide design of future studies of the causes of these disparities. Understanding the causes of the disparities could lead to interventions that would improve the health of all individuals.
    Current Allergy and Asthma Reports 02/2013; · 2.75 Impact Factor
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    ABSTRACT: Background Environmental allergens may induce the generation of allergen-specific IgE (sIgE) and IgG4 (sIgG4). Some studies report an association of sIgG4 to protection against allergic symptoms after exposure to the relevant allergen. Objective We examined the relationship of dog and cat sIgE and sIgG4 levels to self-reported allergic symptoms on pet contact. Methods Participants 18 years of age in the Detroit Childhood Allergy Study cohort were asked whether they experienced symptoms on exposure to cats and dogs. Serum was assayed for cat and dog sIgE and sIgG4. Geometric means, ratios of cat and dog sIgE, sIgG4, and ratios of sIgG4/sIgE were compared between symptomatic and asymptomatic teens with the use of Wilcoxon rank sum tests. Ratios of sIgG4/sIgE, adjusted for presence of sIgE (≥0.35 kU/mL), were analyzed with logistic regression. Results Data on 500 participants were analyzed. Compared with asymptomatic teens, teens symptomatic with cat exposure had higher cat sIgE, sIgG4, and lower ratio of sIgG4/sIgE. Teens symptomatic after dog exposure had higher dog sIgE levels and lower sIgG4/sIgE, but similar levels of sIgG4 compared with asymptomatic participants. Increasing cat and dog sIgG4/sIgE ratios were associated with a lower likelihood of reporting allergic symptoms (cat: adjusted odds ratio, 0.8; 95% CI, 0.6-0.9; dog: adjusted odds ratio, 0.8; 95% CI, 0.7-1.0). Conclusion sIgG4 levels to cat and dog allergens correlate with lower rates of pet-induced allergic symptoms when interpreted in the context of concomitant sIgE. However, sIgG4 appears to have little utility as an isolated marker to indicate that pet exposure will be well tolerated.
    The Journal of Allergy and Clinical Immunology: In Practice. 01/2013; 1(4):350–353.
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    ABSTRACT: The relationship between obesity and asthma is an area of debate. To investigate the association of elevated body mass index (BMI) at a young age and young adult asthma. BMI, questionnaires, and serologic tests results were analyzed in participants of a predominantly white, middle-class, population-based birth cohort from Detroit, Michigan at 6 to 8 and 18 years of age. Asthma diagnosis was based on medical record data. Allergen specific IgE was analyzed using UniCAP, with atopy defined as 1 or more allergen specific IgE levels of 0.35 kU/L or higher. Overweight was defined as a BMI in 85th percentile or higher. A total of 10.6% of overweight males at 6 to 8 years of age had current asthma at 18 to 20 years of age compared with 3.2% of males who were normal or underweight (relative risk [RR], 3.3; 95% confidence interval [CI], 1.0-11.0; P=.048). A total of 19.6% of females who were overweight at 6 to 8 years of age had asthma compared with 10.3% of females who were normal or underweight (RR, 1.9; 95% CI, 0.9-3.9; P=.09). After adjustment for atopy at 6 to 8 years of age, overweight males had an adjusted RR of 4.7 (95% CI, 1.4-16.2; P=.01), and overweight females had an adjusted RR of 1.7 (95% CI, 0.8-3.3; P=.15). Change in BMI between 6 to 8 years of age and 18 to 20 years of age was also examined. Patients with persistently elevated BMI exhibited increased risk of asthma as young adults (RR, 2.4; 95% CI, 1.2-4.7) but not with an increasing BMI (RR, 0.8; 95% CI, 0.3-2.2) or a decreasing BMI (RR, 0.8; 95% CI, 0.3-2.2). Overweight males 6 to 8 years of age have increased risk of asthma as young adults. Being overweight remains a predictor of asthma after adjustment for early atopy. A similar but not statistically significant trend was also seen among overweight females. Overweight body habitus throughout childhood is a risk factor for young adult asthma.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 12/2012; 109(6):408-411.e1. · 3.45 Impact Factor
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    ABSTRACT: Previous studies have suggested that exposure to cats and dogs during early childhood reduces the risk of allergic disease, possibly by increasing home endotoxin exposure. This study asked the question of whether cats and dogs are the dominant influence on dust endotoxin concentrations in homes after considering other variables reportedly associated with endotoxin. The presence of cats or dogs in homes, household and home characteristics, and dust endotoxin concentrations from 5 locations were assessed in 966 urban and suburban homes. Whether considered together as pets or as cats and dogs separately, the presence of cats and dogs significantly contributed to living room and bedroom floor endotoxin concentrations but not to bed endotoxin concentrations. However, the two variables consistently related to endotoxin in all home sites were the home occupant density (occupants/room) and cleanliness of the home. Our data suggests that reducing occupant density and improving home cleanliness would reduce home endotoxin concentrations more than removing pet cats or dogs from the home. © 2012 John Wiley & Sons A/S.
    Indoor Air 11/2012; · 3.30 Impact Factor
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    ABSTRACT: OBJECTIVE: The impact of obesity on the recurrence rates of stress urinary incontinence (SUI) after urethrolysis/sling revision was analyzed. STUDY DESIGN: A retrospective analysis was conducted of patients who underwent urethrolysis or sling revision from January 2004 to November 2010. RESULTS: Data from 74 patients were included. The mean body mass index (BMI) was 29.8 kg/m (SD, 6.3) and 37/74 (50%) women were obese (BMI ≥ 30 kg/m) with a mean length of follow-up of 27 weeks (range, 6-132 weeks). The following urethrolysis/sling revision surgical techniques were varied: partial transvaginal urethrolysis, complete transvaginal urethrolysis, abdominal urethrolysis, sling transection, and transvaginal sling stretching.Of the 74 cases, 25 (33.8%) had recurrent SUI after urethrolysis or sling revision. The BMI did not differ between those who did and did not have a recurrence (t test P = 0.68); 25/49 (51%) women who did not have a recurrence were obese and 12/25 (48%) women with recurrence were obese. CONCLUSIONS: Obesity was not associated with increased rates of SUI recurrence after urethrolysis/sling revision.
    Journal of Pelvic Medicine and Surgery 11/2012; 18(6):332-334.
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    ABSTRACT: Asthma is more common in black children than in white children. Allergic sensitization has been shown to be associated with increased likelihood of asthma. This study was designed to determine whether there are racial differences in the allergens to which children are sensitized in the Detroit metropolitan area and determine whether sensitization was associated with wheeze outcomes. Pregnant women were recruited for the Wayne County Health, Environment, Allergy, and Asthma Longitudinal Study birth cohort to follow the health of their children in the Detroit metropolitan area. Specific IgE (sIgE) was measured for Alternaria, cat, cockroach, dog, Dermatophagoides farinae, short ragweed, timothy grass, egg, milk, and peanut in blood samples from the children at age 2 years. A positive allergen sIgE was defined as ≥0.35 IU/mL. Mothers reported their child's race and completed interviews at age 2 years about characteristics of wheezing episodes in their child (frequency, medication, acute care, or emergency department visit). Black children (n = 384) were more likely than white children (n = 180) to have been positive for each of the allergens tested and also tended to have positive responses to a greater number of allergens (four or more allergens: 9.2% versus 3.5%). Children who had two or more positive sIgEs (adjusted odds ratio [aOR] = 2.68; 95% 95% confidence interval [CI], 1.33, 5.46) or three or more positive sIgEs (aOR = 2.67, 95% CI, 1.19, 6.01) were more likely to have wheezed four or more times in the last 12 months. Racial differences in sensitization at this young age may contribute to the racial difference in asthma prevalence at later ages.
    Allergy and Asthma Proceedings 11/2012; 33(6):493-9. · 2.19 Impact Factor
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    ABSTRACT: Racial differences in allergic diseases have been reported, with black subjects suffering disproportionately compared with white subjects, although such studies have been more commonly done in pediatric populations. We sought to determine whether there are differences in rates of allergic sensitization or prior diagnoses of asthma, hay fever, or eczema in black and white pregnant women. Women were recruited during pregnancy (regardless of allergic history) as part of a birth cohort study in the Detroit metropolitan area and were interviewed about prior doctors' diagnoses of asthma, hay fever/nasal allergies/allergic rhinitis, and eczema. Blood samples were collected, total IgE levels were determined, and specific IgE levels were measured for Alternaria alternata, cat, cockroach, dog, Dermatophagoides farinae, short ragweed, timothy grass, and egg. Black women (n = 563) were more likely than white women (n = 219) to have had at least 1 specific IgE level of 0.35 IU/mL or greater (62.5% vs 40.2%, P < .001). Black women had higher total IgE levels (geometric mean, 47.8 IU/mL [95% CI, 42.5-53.8 IU/mL] vs 20.0 IU/mL [95% CI, 16.2-24.6 IU/mL]; P < .001, Wilcoxon rank sum test). Black women were more likely to have had a prior doctor's diagnosis of asthma (22.7% vs 16.0%, P = .04) and eczema (21.9% vs 14.8%) but not hay fever (white women: 17.5% vs black women: 15.7%, P = .55). Associations persisted for total IgE levels, having 1 or more positive allergen-specific IgE levels, and eczema after adjusting for common socioeconomic or environmental variables. Racial differences in allergic sensitization and diagnoses were present, even after controlling for various factors. Future research should focus on prevention to ameliorate these disparities.
    The Journal of allergy and clinical immunology 07/2012; 130(3):657-662.e2. · 12.05 Impact Factor
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    ABSTRACT: Racial disparities in allergic disease outcomes have been reported with African Americans suffering disproportionately compared to White individuals. To examine whether or not racial disparities are present as early as age 2 years in a racially diverse birth cohort in the Detroit metropolitan area. All children who were participants in a birth cohort study in the Detroit metropolitan area were invited for a standardized physician exam with skin prick testing and parental interview at age 2 years. Physicians made inquiries regarding wheezing and allergy symptoms and inspected for and graded any atopic dermatitis (AD). Skin testing was performed for Alternaria, cat, cockroach, dog, Dermatophagoides farinae (Der F), Short Ragweed, Timothy grass, egg, milk and peanut. Specific IgE was measured for these same allergens and total IgE was determined. African American children (n = 466) were more likely than White children (n = 223) to have experienced any of the outcomes examined: at least 1 positive skin prick test from the panel of 10 allergens (21.7% vs. 11.0%, P = 0.001); at least one specific IgE ≥ 0.35 IU/mL (out of a panel of 10 allergens) (54.0% vs. 42.9%, P = 0.02); had AD (27.0% vs. 13.5%, Chi-square P < 0.001); and to ever have wheezed (44.9% vs. 36.0%, P = 0.03). African American children also tended to have higher total IgE (geometric means 23.4 IU/mL (95%CI 20.8, 27.6) vs. 16.7 IU/mL (95%CI 13.6, 20.6 IU/mL), Wilcoxon Rank Sum P = 0.004). With the exception of wheezing, the associations did not vary after adjusting for common social economic status variables (e.g. household income), environmental variables (endotoxin; dog, cat and cockroach allergen in house dust) or variables that differed between the racial groups (e.g. breastfeeding). After adjustment, the wheeze difference was ameliorated. With disparities emerging as early as age 2 years, investigations into sources of the disparities should include the prenatal period and early life.
    Clinical & Experimental Allergy 06/2012; 42(6):909-17. · 4.79 Impact Factor
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    ABSTRACT: Prior studies have shown relationships between serum immunoglobulin E (IgE) and asthma. To investigate relationships between total and allergen-specific IgE concentrations and lung function in young adults. Measurements of total IgE, allergen-specific IgE to 6 common allergens, and spirometry (forced expiratory volume in one second [FEV(1)], forced vital capacity [FVC], FEV(1)/FVC, and percent change in FEV(1) after bronchodilation) were used to calculate correlations between the logarithmically transformed IgE values and measures of lung function among participants in a birth cohort not selected for risk of allergic disease stratified by current asthma, prior asthma, or no asthma. The 428 participants were 51.6% female, 93% white, and 18.4 (standard deviation = 0.6) years old. Forty-eight (11.2%) had current asthma, 55 (12.9%) had a history of asthma, and 325 (75.9%) never had asthma. For males with current asthma, correlations between total IgE and FEV(1)% and FVC% were -0.51 (P = .06) and -0.70 (P = .005), respectively. For females with current asthma, the only significant correlation was between total IgE and the FEV(1)/FVC ratio (-0.55, P = .001). After excluding smokers and individuals without detectable allergen-specific IgE, the negative correlations for both males and females remained statistically significant. The correlations among males or females with prior asthma or no history of asthma were minimal and not statistically significant. The sum of the allergen-specific IgEs showed the same pattern of relationships to lung function as did total IgE. Our results show significant negative correlations that vary by gender between both total and allergen-specific IgE and measurements of lung function in young adults with current asthma.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 06/2012; 108(6):429-34. · 3.45 Impact Factor

Publication Stats

545 Citations
292.41 Total Impact Points

Institutions

  • 2003–2014
    • Henry Ford Hospital
      • Department of Internal Medicine
      Detroit, Michigan, United States
    • University of North Carolina at Chapel Hill
      • Department of Epidemiology
      Chapel Hill, NC, United States
    • National Institutes of Health
      • Branch of Epidemiology (EPI)
      Maryland, United States
  • 2003–2013
    • Henry Ford Health System
      • Department of Public Health Sciences
      Detroit, Michigan, United States
  • 2007–2010
    • Georgia Health Sciences University
      • Department of Pediatrics
      Augusta, GA, United States
  • 2008
    • Wayne State University
      • Department of Internal Medicine
      Detroit, MI, United States