Assessment of a Medication-Based Asthma Index for  Population Research

Ungar, Wendy J.; Santos, Maria Teresa

doi:10.1164/ajrccm.165.2.2102012

Cited by 30 publications

(23 citation statements)

References 22 publications

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“…Existing clinical scales focus on three domains – respiratory symptoms, asthma medication use and pulmonary function. However, these scales are not easily adapted to population-based research where access to detailed clinical information is usually not available (Ungar et al, 2002; Reddel et al, 2009). Surrogate outcome variables for each of the three domains were therefore used.…”

Section: Methodsmentioning

confidence: 99%

Serum Adiponectin is Associated with Adverse Outcomes of Asthma in Men but Not in Women

Sood¹,

Dominic²,

Qualls³

et al. 2011

Front. Pharmacol.

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Background: Murine studies suggest a beneficial effect of systemic adiponectin on asthma. Our objective was to determine the association between serum adiponectin concentrations and asthma control/severity outcomes in men and women separately. Methods: Cross-sectional and longitudinal analyses of data from years 10, 15, and 20 examinations of the prospective coronary artery risk development in young adults study in the United States were performed. Asthma was defined by self-reported provider diagnosis at or prior to year 15 examination. Outcomes included presence of active disease, number of respiratory symptoms, and number of asthma medications; as well as longitudinal decline in absolute FEV1. Year 15 serum adiponectin concentration was the predictor variable. Results: In a multivariable analysis of 411 eligible subjects, after adjusting for body mass index and covariates, higher serum adiponectin concentrations were associated with more frequent active disease (including more frequent use of any asthma medication), and greater number of respiratory symptoms and asthma medications among men but not among women with asthma (p for interactions between sex and adiponectin for all analyses < 0.05). Conclusions: Higher serum adiponectin concentrations may be independently associated with adverse clinical outcomes of asthma in men but not in women. If biological effect is confirmed in future studies, modification of systemic adiponectin concentrations may open up newer ways to treat asthma in men.

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Section: Methodsmentioning

confidence: 99%

Serum Adiponectin is Associated with Adverse Outcomes of Asthma in Men but Not in Women

Sood¹,

Dominic²,

Qualls³

et al. 2011

Front. Pharmacol.

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“…The study protocols were approved by the institutional review boards of both hospitals, and informed consent was obtained. The diagnosis of asthma was made when a subject with symptoms of dyspnea or wheezing showed reversible airway obstruction based on the National Institutes of Health guidelines (15), and asthma severity was determined according to lung function and the medication use index needed to obtain control, as previously described (16,17). The diagnosis of RA was made according to the 1987 revised criteria of the American College of Rheumatology (formerly the American Rheumatism Association) (18).…”

Section: Subjectsmentioning

confidence: 99%

STAT4 Expression in Human T Cells Is Regulated by DNA Methylation but Not by Promoter Polymorphism

Shin

Park

Jeong

et al. 2005

The Journal of Immunology

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STAT4, which plays a pivotal role in Th1 immune responses, enhances IFN-γ transcription in response to the interaction of IL-12 with the IL-12R. Mice deficient in STAT4 lack IL-12-induced IFN-γ production and Th1 differentiation and display a predominantly Th2 phenotype. Although these findings indicate that STAT4 expression levels are important for the development of cytokine-producing Th1 cells, the transcriptional and posttranscriptional mechanisms regulating STAT4 expression are unknown. We sought to identify and characterize the transcriptional regulatory elements in the promoter region of the human STAT4 gene. We found that disruption of multiple transcriptional regions covering the CREB, OCT1, and SP1 motifs significantly reduced STAT4 promoter activity. However, genomic DNA isolated from 91 patients with asthma or rheumatoid arthritis showed no evidence of mutations in the defined STAT4 essential promoter region. The 5′ flanking region of the promoter was found to contain a −149A/G change in ∼20–35% of patients, but this polymorphism had no effect on promoter activity. Interestingly, STAT4 expression was drastically increased in human T cells following treatment with a DNA methyltransferase inhibitor, and truncation of methylation sites in the proximal regulatory elements of the STAT4 promoter markedly enhanced transcriptional activity. Thus, our findings provide molecular insight into STAT4 expression and suggest that, in human T cells, STAT4 expressional regulation is associated with DNA hypermethylation, but not promoter polymorphisms.

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“…By using information on asthma diagnosis from different sources and prescribed drugs as a proxy for disease it is possible to obtain objective measures of exposure. Indices developed to assess the severity and control of asthma can be used in epidemiological studies [20], [21].…”

Section: Introductionmentioning

confidence: 99%

Asthma during Pregnancy in a Population-Based Study - Pregnancy Complications and Adverse Perinatal Outcomes

et al. 2014

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BackgroundAsthma is one of the most common chronic diseases, and prevalence, severity and medication may have an effect on pregnancy. We examined maternal asthma, asthma severity and control in relation to pregnancy complications, labour characteristics and perinatal outcomes.MethodsWe retrieved data on all singleton births from July 1, 2006 to December 31, 2009, and prescribed drugs and physician-diagnosed asthma on the same women from multiple Swedish registers. The associations were estimated with logistic regression.ResultsIn total, 266 045 women gave birth to 284 214 singletons during the study period. Maternal asthma was noted in 26 586 (9.4%) pregnancies. There was an association between maternal asthma and increased risks of pregnancy complications including preeclampsia or eclampsia (adjusted OR 1.15; 95% CI 1.06–1.24) and premature contractions (adj OR 1.52; 95% CI 1.29–1.80). There was also a significant association between maternal asthma and emergency caesarean section (adj OR 1.29; 95% CI 1.23–1.34), low birth weight, and small for gestational age (adj OR 1.23; 95% CI 1.13–1.33). The risk of adverse outcomes such as low birth weight increased with increasing asthma severity. For women with uncontrolled compared to those with controlled asthma the results for adverse outcomes were inconsistent displaying both increased and decreased OR for some outcomes.ConclusionMaternal asthma is associated with a number of serious pregnancy complications and adverse perinatal outcomes. Some complications are even more likely with increased asthma severity. With greater awareness and proper management, outcomes would most likely improve.

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Assessment of a Medication-Based Asthma Index for Population Research

Cited by 30 publications

References 22 publications

Serum Adiponectin is Associated with Adverse Outcomes of Asthma in Men but Not in Women

Serum Adiponectin is Associated with Adverse Outcomes of Asthma in Men but Not in Women

STAT4 Expression in Human T Cells Is Regulated by DNA Methylation but Not by Promoter Polymorphism

Asthma during Pregnancy in a Population-Based Study - Pregnancy Complications and Adverse Perinatal Outcomes

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