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Correlation of vitamin D receptor genotypes, specific IgE levels and other variables with asthma control in children
Walid Al-Qerem1, Anan Jarab2,3, Yazun Jarrar4
1Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.
Insights
Poor inhaler technique is linked to uncontrolled childhood asthma, not vitamin D receptor gene variants. Improving inhaler use may enhance asthma management in children.
Area of Science:
- Pediatric Respiratory Medicine
- Clinical Genetics
- Public Health
Background:
- Asthma affects millions of children globally, necessitating effective management strategies.
- Understanding factors influencing asthma control, including adherence and genetic predispositions, is crucial for improving patient outcomes.
- The role of the vitamin D receptor (VDR) gene in asthma pathogenesis and control requires further investigation.
Purpose of the Study:
- To assess factors associated with asthma management in children.
- To investigate the impact of atopy level and vitamin D receptor (VDR) gene variants on childhood asthma control.
- To identify key variables related to asthma control and spirometry measures.
Main Methods:
- Recruitment of 313 asthmatic children in an outpatient respiratory clinic.
- Collection of data on medication adherence, medical history, sociodemographics, and inhaler technique.
- Assessment of asthma severity using spirometry (FEV1%, FVC%) and the Asthma Control Test, alongside VDR gene genotyping and radioallergosorbent testing (RAST).
Main Results:
- Only 46% of participants had controlled asthma, indicating a high prevalence of poorly controlled disease.
- Lower doses of Inhaled corticosteroids (ICS) and higher inhaler scores were significantly associated with controlled asthma.
- No association was found between VDR genotype and asthma control, spirometry values, or asthma-related hospitalizations.
Conclusions:
- Poor inhaler technique is a significant factor contributing to uncontrolled asthma in children.
- While VDR genotype did not correlate with asthma control in this cohort, optimizing inhaler technique presents a modifiable target for improving asthma management.
- Further research may explore other genetic or environmental factors influencing asthma control.
Introduction:
Asthma is a common condition affecting millions of children globally. The main goal of this study is to assess factors related to asthma management, particularly atopy level and the impact of genetic variants of the vitamin D receptor (VDR) gene.
Methods:
Asthmatic children were enrolled in an outpatient respiratory clinic. Information on patients' medication adherence, medical and medication factors, and sociodemographic were gathered. Spirometry FEV1% and FVC% measurements, and the asthma control test were used to evaluate the severity of asthma, and genotyping of the VDR gene and radioallergosorbent test (RAST) were conducted. Regression analyses were conducted to evaluate variables associated with asthma control and spirometry measures.
Results:
A total of 313 participants (67.4% males) were recruited in the current study. The mean age was 9.37 (±3.45) years. The mean score for adherence was 4.26 (±2.52), and only 46% of the participants had controlled asthma. Forward conditional stepwise binary regression showed that low and moderate Inhaled corticosteroids (ICS) dose (OR= 0.42 (95% CI 0.20-0.90), p = 0.026; OR = 0.371 (95% CI 0.2-0.72), p = 0.003, respectively) decreased the odds of being in the controlled asthma group, while higher inhaler score (OR = 2.75 (95% CI 2.17-3.49, p < 0.001)) increased the odds of being in the controlled asthma group. However, results found no association between VDR genotype and asthma control, spirometry values or hospitalization due to asthma.
Conclusions:
The results indicated that many of the asthma patients had poorly controlled asthma. Factors that were associated with poor asthma control included poor inhaler technique.
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