Prevalence of asthma and asthma‐like symptoms in inner‐city elementary schoolchildren

Webber, Mayris P.; Carpiniello, Kelly E.; Oruwariye, Tosan; Appel, David

doi:10.1002/ppul.10146

Cited by 59 publications

(38 citation statements)

References 17 publications

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“…2,3 Asthma also disproportionately affects African Americans and is present in about 20% of children. 4 In children with SCD, estimates of asthma prevalence are similar to that in children of African descent in the general population, 5,6 making asthma one of the most common co-morbid conditions in SCD.…”

mentioning

confidence: 74%

“…30 CysLTs are important to asthma pathogenesis, and levels of CysLTs correlate with measures of asthma severity, 31 asthma exacerbations 32 and presence of exercise-induced asthma. 33 LTB 4 and CysLT levels are increased in individuals with SCD when they are well and during vaso-occlusive events. Although LTB 4 levels have a lesser role in the process of asthma, its actions on the activation, migration and adhesion of neutrophils to endothelium suggest that LTB 4 could contribute to the process of vaso-occlusion.…”

Section: Leukotrienes Are Inflammatory Mediators That Are Elevated Anmentioning

confidence: 99%

“…Phopholipase A2 liberates arachidonic acid from cell membrane, ultimately leading to the production of leukotriene A 4 . From LTA 4 , two classes of leukotrienes are generated, leukotriene B 4 and cysteinyl leukotrienes (CysLTs).…”

Section: Leukotrienes Are Inflammatory Mediators That Are Elevated Anmentioning

confidence: 99%

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Asthma and sickle cell disease: two distinct diseases or part of the same process?

Field¹,

DeBaun²

2009

Hematology

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A physician diagnosis of asthma in children and adults with sickle cell disease (SCD) has been associated with increased rates of pain and acute chest syndrome (ACS) episodes and premature death. Despite the clinical significance of a doctor’s diagnosis of asthma in individuals with SCD, the criteria for a physician diagnosis of asthma are not well defined. Many features of asthma are common in individuals with SCD, including symptoms of wheezing, obstructive lung disease and airway hyper-responsiveness. However, it is not clear if these signs and symptoms of asthma reflect a physician diagnosis of asthma, or if these asthma features are related to SCD. Further complicating the diagnosis of asthma in children with SCD is the significant overlap in clinical manifestations between an asthma exacerbation and an ACS episode. Evidence supporting the concept that asthma and SCD are separate co-morbid conditions includes a similar prevalence of asthma between children with SCD and those in the general population and the observation that asthma is inherited in a familial pattern in the families of children with SCD. In contrast, there is significant evidence that asthma-like features may be associated with SCD without a diagnosis of asthma, including a higher than expected prevalence of airway hyper-responsiveness and obstructive lung disease. Regardless of whether SCD and asthma are distinct or overlapping co-morbid conditions, we recommend a systematic and complete evaluation of asthma when the diagnosis is suspected or when patients have multiple episodes of pain or ACS.

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mentioning

confidence: 74%

Section: Leukotrienes Are Inflammatory Mediators That Are Elevated Anmentioning

confidence: 99%

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Asthma and sickle cell disease: two distinct diseases or part of the same process?

Field¹,

DeBaun²

2009

Hematology

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“…2,6 Asthma is a common chronic disease affecting approximately 15% to 20% of African American children. [7][8][9][10] Previous retrospective studies suggest a relationship between ACS and asthma among children with SCA. We previously reported a 4-fold higher risk of ACS among children with SCA and a prior doctor diagnosis of asthma within a cohort of children with SCA hospitalized for pain.…”

Section: Introductionmentioning

confidence: 99%

Asthma is associated with acute chest syndrome and pain in children with sickle cell anemia

Boyd

Macklin

Strunk

et al. 2006

Blood

218

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Pain and acute chest syndrome (ACS) episodes are 2 of the most common causes of hospitalization in children with sickle cell anemia (SCA). However, very few potentially modifiable risk factors for either condition have been identified. In this prospective infant cohort study, we tested the hypothesis that asthma is associated with an increased incidence rate of pain and ACS episodes. An infant cohort was composed of 291 African American children with hemoglobin SS enrolled in the Cooperative Study for Sickle Cell Disease before age 6 months and followed beyond age 5 years. Asthma was defined by a physician diagnosis, an acute asthma event, or use of prescription asthma medications. The incidence rates of ACS and painful episodes were compared for children with and without asthma. A clinical diagnosis of asthma was made in 17% of the cohort. Asthma was associated with more frequent ACS episodes (0.39 vs 0.20 events per patient year, P < .001) and painful episodes (1.39 vs 0.47 events per patient year, P < .001). In conclusion, in children with SCA, asthma is associated with an increased incidence of sickle cell disease-related morbidity, including ACS and painful episodes. IntroductionPainful episodes and acute chest syndrome (ACS) are common complications of sickle cell anemia (SCA) and are the 2 leading causes of hospitalization among people with SCA. 1,2 ACS affects up to 50% of individuals with SCA and is the leading cause of premature death. [2][3][4] The pathogenesis of ACS is multifactorial and remains unclear. In a large prospective study, several etiologies were identified, but in approximately 50% of episodes, no cause was determined. 5 Known risk factors for the development of ACS include younger age, degree of anemia (higher steady-state hemoglobin level), lower hemoglobin F, and higher steady-state white blood cell count. 2,6 Asthma is a common chronic disease affecting approximately 15% to 20% of African American children. [7][8][9][10] Previous retrospective studies suggest a relationship between ACS and asthma among children with SCA. We previously reported a 4-fold higher risk of ACS among children with SCA and a prior doctor diagnosis of asthma within a cohort of children with SCA hospitalized for pain. 11 Knight-Madden et al 12 reported a 6-fold higher risk of recurrent ACS among children with SCA and a parental report of doctor-diagnosed asthma. Airway obstruction and airway lability have been previously described in patients with SCA, suggesting that asthma may contribute to the pulmonary complications of the disease. [13][14][15][16] These data suggest that in children with SCA, a diagnosis of asthma may be a risk factor for ACS. This study also seeks to determine whether asthma is also associated with painful episodes, a common complication in SCA that often precedes or occurs concurrently with ACS episodes.In a cohort of infants established and followed for 20 years by the Cooperative Study of Sickle Cell Disease (CSSCD), we tested the hypothesis that a concurrent diagnosis of asthma in p...

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“…With respect to the gender cofactor, several studies demonstrated lower (total and specific) IgE levels, and a lower incidence of atopy and asthma in females. [12][13][14][15][16] Thus, gender is an important cofactor influencing prevalence and phenotype of IgE-mediated allergic diseases. Taking this into account, we are confident that there are more immune response genes identified that influence IgE or atopy/asthma in a gender-restricted fashion.…”

mentioning

confidence: 99%

Novel genetic variation of human interleukin-21 receptor is associated with elevated IgE levels in females

et al. 2003

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The interleukin-21 receptor (IL21R) was recently discovered as a novel member of the class-I-cytokine-receptor family and is selectively expressed in lymphoid tissues. IL21R shows strong sequence homologies to the interleukin-4 receptor a chain gene (IL4RA). In addition, both genes are adjacent and share structural similarity. We analyzed all the exons of the human IL21R gene and its 5 0 flanking region for sequence variation. We identified four novel single nucleotide polymorphisms (SNPs) and genotyped 300 healthy blood donors. Total serum IgE levels were measured in all subjects and associated with IL21R SNPs. Results revealed a significant association of one IL21R polymorphism (T-83C) with elevated IgE levels (4100 kU/I) in females (OR ¼ 3.000, CI ¼ [1.163;8.385], P ¼ 0.015, n ¼ 138). This was confirmed in a second prospectively collected group of female blood donors (OR ¼ 2.535, CI ¼ [0.927;6.733], P ¼ 0.046, n ¼ 123). In contrast, no effects were observed in male subjects in either population. These findings identify IL21R as a possible novel target locus influencing IgE synthesis in female individuals.

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Prevalence of asthma and asthma‐like symptoms in inner‐city elementary schoolchildren

Cited by 59 publications

References 17 publications

Asthma and sickle cell disease: two distinct diseases or part of the same process?

Asthma and sickle cell disease: two distinct diseases or part of the same process?

Asthma is associated with acute chest syndrome and pain in children with sickle cell anemia

Novel genetic variation of human interleukin-21 receptor is associated with elevated IgE levels in females

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