ABSTRACT: To identify the risk factors for persistent asthma among common environmental exposures, like ambient air pollutants and second hand smoke, animals, place of residence, decreased ventilation, dust, as well as history of allergic conditions like rhinitis, dermatitis and family history of asthma in children.
This hospital-based, cross-sectional study was conducted after institutional ethical clearance. Children aged 1-12 y with asthma were recruited after parental consent. Children were classified into asthma severity categories according to GINA 2002 and level of control categories according to GINA 2009 guidelines. Adjusted logistic regression analysis was used to identify factors associated with persistent asthma.
From August 2008 through October 2010, 205 asthmatic children were recruited of which 73 (35.60 %) had intermittent and 132 (64.40 %) had persistent asthma. Asthma was controlled in 19 (9.26 %), partly controlled in 90 (43.90 %) and uncontrolled in 96 (46.82 %). Patients with persistent asthma were more likely to have uncontrolled asthma (OR = 8.28; 95 % CI: 2.43-31.01; p < 0.001). Adjusting for age, sex, socioeconomic status and place of residence, persistent asthma was associated with residence within 1.5 km from heavy traffic (OR = 4.58; 95%CI: 2.18-9.59; p < 0.001) and father smoking indoors >5 cigarettes or "bidi"/day (OR = 17.76; 95 % CI: 1.85-170.76; p = 0.01).
Since patients with persistent asthma are more likely to have uncontrolled asthma and since persistent asthma is associated with residence closer to heavy traffic and exposure to second hand smoke, minimizing exposures to these may help in better asthma control.
The Indian Journal of Pediatrics 06/2012; 79(10):1311-7. · 0.52 Impact Factor
ABSTRACT: With the rapid advances in molecular techniques, various methods for genotyping single-nucleotide polymorphisms (SNPs) are available. Still, the search for easy, robust, and less costly techniques continues. We wished to develop a Tetra primer-amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) based technique for the corticotrophin-releasing hormone receptor 1 (CRHR1) (rs242939) SNP for use in our research lab.
To detect SNPs in a single-step PCR, we set up two genotyping methods, T-ARMS-PCR and restriction fragment length polymorphism (RFLP). The study was performed using thirty blood samples taken from clinically defined asthmatic patients. The efficiency and effectiveness of results obtained by T-ARMS were validated by PCR-RFLP and sequencing. This study demonstrates that T-ARMS is feasible and applicable to discriminate a wild-type allele from the respective mutant allele in one step.
This work is the first that presents a rapid, sensitive, and high throughput genotyping method for the CRHR1 (rs242939) polymorphism and can be used for both large- and small-scale genotyping studies.
Genetic Testing and Molecular Biomarkers 02/2012; 16(7):794-7. · 1.11 Impact Factor
ABSTRACT: Asthma is a complex disease with multiple genetic and environmental factors contributing to it. A component of this complexity is a highly variable response to pharmacological therapy. Pharmacogenomics is the study of the role of genetic determinants in the variable response to therapy. A number of examples of possible pharmacogenomic approaches that may prove of value in the management of asthma are discussed below.
A search of PubMed, Google scholar, E-Medicine, BMJ and Mbase was done using the key words "pharmacogenomics of asthma", "pharmacogenomics of β-agonist, glucocorticoids, leukotriene modifiers, theophylline, muscarinic antagonists in asthma".
Presently, there are limited examples of gene polymorphism that can influence response to asthma therapy. Polymorphisms that alter response to asthma therapy include Arg16Gly, Gln27Glu, Thr164Ile for β-agonist receptor, polymorphism of glucocorticoid receptor gene, CRHR1 variants and polymorphism of LTC4S, ALOX5. Polymorphic variants of muscarinic receptors, PDE4 and CYP450 gene variants.
It was concluded that genetic variation can improve the response to asthma therapy. However, no gene polymorphism has been associated with consistent results in different populations. Therefore, asthma pharmacogenomic studies in different populations with a large number of subjects are required to make possible tailoring the asthma therapy according to the genetic characteristic of individual patient.
Indian Journal of Human Genetics 09/2010; 16(3):111-8.