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Exposure to Violence and Asthma Endotypes in Puerto Rican Youth
Kristina Gaietto1, Molin Yue1,2, Yueh Ying Han1
1Division of Pediatric Pulmonary Medicine, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, and.
Annals of the American Thoracic Society
|June 23, 2025
Summary
Exposure to violence is linked to specific asthma types in Puerto Rican youth, specifically T helper (T)2-high and T17-high asthma. Violence exposure and distress were not associated with T2-low/T17-low asthma endotypes.
Area of Science:
- Environmental health
- Immunology
- Pediatric respiratory medicine
Background:
- Exposure to violence is a known risk factor for asthma development and exacerbation in children.
- Specific asthma endotypes, characterized by distinct inflammatory profiles, are increasingly recognized, but their relationship with violence exposure remains unexplored.
Purpose of the Study:
- To investigate the association between exposure to violence and specific asthma endotypes (T2-high, T17-high, and T2-low/T17-low) in Puerto Rican youth.
- To determine if violence-related distress is associated with these asthma endotypes.
Main Methods:
- Analysis of data from the Epigenetic Variation and Childhood Asthma in Puerto Ricans (EVA-PR) study, including 236 asthma cases and 243 controls (aged 9-20 years).
- Asthma endotyping based on nasal epithelial transcriptomic profiles into T2-high, T17-high, or T2-low/T17-low.
- Assessment of lifetime and past-year exposure to violence, gun violence, and violence-related distress using validated questionnaires.
Main Results:
- Lifetime exposure to violence was associated with T17-high asthma (OR=1.13).
- Gun violence exposure was linked to both T2-high (OR=2.49) and T17-high asthma (OR=1.99).
- Violence-related distress was associated with T2-high asthma (OR=1.69); no associations were found with T2-low/T17-low asthma.
Conclusions:
- Violence exposure and related distress are associated with T2-high and T17-high asthma endotypes in Puerto Rican youth.
- These findings highlight the differential impact of violence on specific asthma inflammatory pathways.
- The study underscores the need to consider environmental exposures like violence in understanding asthma heterogeneity, particularly in vulnerable populations.
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