Does environment mediate earlier onset of the persistent childhood asthma phenotype?
Does environment mediate earlier onset of the persistent childhood asthma phenotype?
Objective. We investigated the role of environmental and hereditary factors in determining whether persistent childhood wheezing phenotypes had an early or late onset.
Methods. In a whole population birth cohort (n = 1456), children were seen at birth and at 1, 2, 4, and 10 years. At each visit, information was collected prospectively regarding wheeze prevalence and used to classify subjects into wheezing phenotypes. Information on genetic and environmental risk factors in early life was also obtained prospectively, and skin-prick testing to common allergens was performed at 4 years.
Results. Early-onset persistent wheezers (n = 125) had wheeze onset in the first 4 years, still present at age 10, whereas late-onset persistent wheezers (n = 81) had wheeze onset after age 4 years that was still present at 10 years. Multivariate logistic regression analysis identified independent significance only for inherited factors (parental asthma, family history of rhinitis, eczema at 4 years, and atopic status at 4 years) in the development of late-onset persistent wheeze. However, low social class at birth, recurrent chest infections at 2 years, and parental smoking at 2 years plus inherited factors (eczema at 2 years; food allergy at 4 years; maternal asthma, sibling asthma, maternal urticaria, and atopic status at 4 years) demonstrated independent significance for early-onset persistent wheeze.
Conclusion. Inheritance seems to be of prime significance in the cause of persistent childhood wheeze. Environmental exposure in early life may combine with this tendency to produce an early onset of persistent wheeze. Absence of these environmental factors might delay but not prevent the onset of wheeze in children with atopic heredity.
Age of Onset, Asthma/complications, Child, Child, Preschool, Cohort Studies, Eczema/complications, Environment, Female, Humans, Hypersensitivity/complications, Infant, Infant, Newborn, Logistic Models, Male, Phenotype, Prevalence, Respiratory Sounds/etiology, Rhinitis/complications, Risk Factors, Tobacco Smoke Pollution, United Kingdom/epidemiology
345- 350
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Matthews, Sharon
da71ceaa-c974-4fda-aea0-13c7cdecaf04
Arshad, S. Hasan
917e246d-2e60-472f-8d30-94b01ef28958
1 February 2004
Kurukulaaratchy, Ramesh J.
9c7b8105-2892-49f2-8775-54d4961e3e74
Matthews, Sharon
da71ceaa-c974-4fda-aea0-13c7cdecaf04
Arshad, S. Hasan
917e246d-2e60-472f-8d30-94b01ef28958
Kurukulaaratchy, Ramesh J., Matthews, Sharon and Arshad, S. Hasan
(2004)
Does environment mediate earlier onset of the persistent childhood asthma phenotype?
Pediatrics, 113 (2), .
(doi:10.1542/peds.113.2.345).
Abstract
Objective. We investigated the role of environmental and hereditary factors in determining whether persistent childhood wheezing phenotypes had an early or late onset.
Methods. In a whole population birth cohort (n = 1456), children were seen at birth and at 1, 2, 4, and 10 years. At each visit, information was collected prospectively regarding wheeze prevalence and used to classify subjects into wheezing phenotypes. Information on genetic and environmental risk factors in early life was also obtained prospectively, and skin-prick testing to common allergens was performed at 4 years.
Results. Early-onset persistent wheezers (n = 125) had wheeze onset in the first 4 years, still present at age 10, whereas late-onset persistent wheezers (n = 81) had wheeze onset after age 4 years that was still present at 10 years. Multivariate logistic regression analysis identified independent significance only for inherited factors (parental asthma, family history of rhinitis, eczema at 4 years, and atopic status at 4 years) in the development of late-onset persistent wheeze. However, low social class at birth, recurrent chest infections at 2 years, and parental smoking at 2 years plus inherited factors (eczema at 2 years; food allergy at 4 years; maternal asthma, sibling asthma, maternal urticaria, and atopic status at 4 years) demonstrated independent significance for early-onset persistent wheeze.
Conclusion. Inheritance seems to be of prime significance in the cause of persistent childhood wheeze. Environmental exposure in early life may combine with this tendency to produce an early onset of persistent wheeze. Absence of these environmental factors might delay but not prevent the onset of wheeze in children with atopic heredity.
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Published date: 1 February 2004
Keywords:
Age of Onset, Asthma/complications, Child, Child, Preschool, Cohort Studies, Eczema/complications, Environment, Female, Humans, Hypersensitivity/complications, Infant, Infant, Newborn, Logistic Models, Male, Phenotype, Prevalence, Respiratory Sounds/etiology, Rhinitis/complications, Risk Factors, Tobacco Smoke Pollution, United Kingdom/epidemiology
Identifiers
Local EPrints ID: 446444
URI: http://eprints.soton.ac.uk/id/eprint/446444
ISSN: 0031-4005
PURE UUID: ff6f0bb2-c401-4d87-a2c9-b8adc218fe32
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Date deposited: 10 Feb 2021 17:30
Last modified: 17 Mar 2024 02:49
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Author:
Sharon Matthews
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