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A BRIEF TARGETED REVIEW OF SUSCEPTIBILITY FACTORS, ENVIRONMENTAL EXPOSURES, ASHTMA INCIDENCE, AND RECOMMENDATIONS FOR FUTURE ASHTMA INCIDENCE RESEARCH
Citation:
YEATTS, K. B., P. SLY, S. SHORE, S. WEISS, F. MARTINEZ, A. M. GELLER, P. BROMBERG, P. ENRIGHT, H. S. KOREN, D. N. WEISSMAN, AND M. K. SELGRADE. A BRIEF TARGETED REVIEW OF SUSCEPTIBILITY FACTORS, ENVIRONMENTAL EXPOSURES, ASHTMA INCIDENCE, AND RECOMMENDATIONS FOR FUTURE ASHTMA INCIDENCE RESEARCH. ENVIRONMENTAL HEALTH PERSPECTIVES. National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC, 114(4):634-640, (2006).
Impact/Purpose:
To review susceptibility factors in the induction of asthma
Description:
Genetics, obesity, age, and lifestyle are major susceptibility factors in the induction of asthma and can interact with environmental exposures either synergistically or antagonistically. Different environmental exposures that increase or decrease the likelihood of developing asthma interact with different genes. Thus asthma induction results from complex interactions between specific exposures and the genes that interact with such exposures during crucial periods in development. In utero exposures can play an important role in asthma induction. Maternal smoking is a major risk factor for asthma; fetal nutrition and the influence of maternal diet (e.g., antioxidants, omega-3 fatty acids) are also important. In utero effects of other environmental agents are still equivocal. Factors predictive of severity and persistence of childhood asthma include parental history of asthma, atopy, gender, degree of airway reactivity, and obesity. Studies support the hygiene hypothesis, i.e., early childhood infections protect against asthma; however, the factors that confer this protection remain unclear. Less is known about the predictors of asthma in adults. Workplace exposures are responsible for 15-25% of asthma in adults, and smoking interacts with airway responsiveness to predict who gets new onset (or recrudescent) asthma. In older adults the prevalence of asthma is increasing, the severity and response to treatment are worse, and the phenotype is more heterogeneous compared with children. Hence, strategies needed to prevent new cases in this population may be different from those needed to protect children. Susceptibility factors clearly have a large role to play in future research and public health interventions aimed at reducing the incidence of asthma.