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Published on: August 7, 2017
Paternal history of asthma and airway responsiveness in children with asthma
Benjamin A Raby1, Kristel Van Steen, Juan C Celedón
1Channing Laboratory, Department of Medicine, and Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. benjamin.raby@channing.harvard.edu
Insights
A father's history of asthma is linked to greater airway hyperresponsiveness (AHR) in children with asthma. This suggests a genetic influence from the father on AHR, a key factor in childhood asthma severity.
Area of Science:
- Pediatric Pulmonology
- Genetics of Asthma
- Respiratory Medicine
Background:
- The link between parental asthma history and children's airway hyperresponsiveness (AHR) is not well understood.
- Airway hyperresponsiveness (AHR) is a critical factor in childhood asthma severity.
Purpose of the Study:
- To investigate the association between parental asthma history and AHR in children with asthma.
- To analyze genetic contributions to AHR in pediatric asthma patients.
Main Methods:
- Utilized data from 1,041 children with asthma in the Childhood Asthma Management Program (CAMP).
- Performed methacholine challenge testing annually over 4.5 years to assess AHR (PC20).
- Employed cross-sectional and longitudinal analyses, adjusting for confounders, to model the relationship between parental asthma history and AHR.
Main Results:
- A paternal history of asthma was significantly associated with greater AHR at baseline and longitudinally.
- Children with two parents with asthma exhibited significantly higher AHR compared to those with no parental history.
- Maternal asthma history alone did not show a significant association with AHR.
Conclusions:
- Paternal genetic contribution appears to play a significant role in the development of AHR in children with asthma.
- Understanding these genetic links can inform strategies for managing childhood asthma severity.
Rationale:
Little is known regarding the relationship between parental history of asthma and subsequent airway hyperresponsiveness (AHR) in children with asthma.
Objectives:
We evaluated this relationship in 1,041 children with asthma participating in a randomized trial of antiinflammatory medications (the Childhood Asthma Management Program [CAMP]).
Methods:
Methacholine challenge testing was performed before treatment randomization and once per year over an average of 4.5 years postrandomization. Cross-sectional and longitudinal repeated measures analyses were performed to model the relationship between PC20 (the methacholine concentration causing a 20% fall in FEV1) with maternal, paternal, and joint parental histories of asthma. Models were adjusted for potential confounders.
Measurements And Main Results:
At baseline, AHR was strongly associated with a paternal history of asthma. Children with a paternal history of asthma demonstrated significantly greater AHR than those without such history (median log(e)PC20, 0.84 vs. 1.13; p = 0.006). Although maternal history of asthma was not associated with AHR, children with two parents with asthma had greater AHR than those with no parents with asthma (median log(e)PC20, 0.52 vs. 1.17; p = 0.0008). Longitudinal multivariate analysis of the relation between paternal history of asthma and AHR using repeated PC20 measurements over 44 months postrandomization confirmed a significant association between paternal history of asthma and AHR among children in CAMP.
Conclusions:
Our findings suggest that the genetic contribution of the father is associated with AHR, an important determinant of disease severity among children with asthma.
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Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Asthma-I: Introduction
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Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
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