ABSTRACT
Our objective was to investigate the distributions of six single nucleotide polymorphisms (SNPs) MS4A2 E237G, MS4A2 C-109T, ADRB2 R16G, IL4RA I75V, IL4 C-590T, and IL13 C1923T in Mauritian Indian and Chinese Han children with asthma. This case-control association study enrolled 382 unrelated Mauritian Indian children, 193 with asthma and 189 healthy controls, and 384 unrelated Chinese Han children, 192 with asthma and 192 healthy controls. The SNP loci were genotyped using polymerase chain reaction (PCR)-restriction fragment length polymorphism for the Chinese Han samples and TaqMan real-time quantitative PCR for the Mauritian Indian samples. In the Mauritian Indian children, there was a significant difference in the distribution of IL13 C1923T between the asthma and control groups (P=0.033). The frequency of IL13 C1923T T/T in the Mauritian Indian asthma group was significantly higher than in the control group [odds ratio (OR)=2.119, 95% confidence interval=1.048-4.285]. The Chinese Han children with asthma had significantly higher frequencies of MS4A2 C-109T T/T (OR=1.961, P=0.001) and ADRB2 R16G A/A (OR=2.575, P=0.000) than the control group. The IL13 C1923T locus predisposed to asthma in Mauritian Indian children, which represents an ethnic difference from the Chinese Han population. The MS4A2 C-109T T/T and ADRB2 R16G A/A genotypes were associated with asthma in the Chinese Han children.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Young Adult , Asian People/genetics , Asthma/genetics , Genetic Predisposition to Disease/ethnology , Polymorphism, Single Nucleotide/genetics , Asthma/epidemiology , Asthma/ethnology , Case-Control Studies , Causality , China/epidemiology , China/ethnology , Genetic Association Studies , Genetic Loci , Genotype , Genetic Predisposition to Disease/epidemiology , /genetics , /genetics , /genetics , Mauritius/epidemiology , Mauritius/ethnology , Polymorphism, Restriction Fragment Length , Real-Time Polymerase Chain Reaction , /genetics , Receptors, IgE/geneticsABSTRACT
Con el fin de investigar la rentabilidad de la prevención primaria del asma en lactantes de alto riesgo, de hasta 2 años, desde la perspectiva de la sociedad (PREVASC) y con un diagnóstico clínico de asma realizado por un médico generalista (MG) y un diagnóstico epidemiológico de asma basado en un modelo de predicción (EPM), se seleccionaron 476 lactantes de un ensayo aleatorizado y controlado (242 en el grupo de intervención, 234 en el grupo control). Por medio de informes semanales se evaluó la utilización de los recursos de salud. El margen de error acerca de los índices de rentabilidad incremental se determinó por análisis bootstrap. El 26.8% de los niños del grupo de intervención y el 25.5% de los controles recibieron el diagnóstico de asma por parte de un MG, mientras que el 69.9% y el 63.5%, respectivamente, tuvo el diagnóstico basado en un EPM. Con ambas definiciones no hubo diferencias en el diagnóstico de asma entre los participantes del grupo de intervención y el grupo control (odds ratio [OR]: 1.1, intervalo de confianza del 95% [IC]: 0.6-1.8 y OR: 1.3, IC: 0.8-2.2). La media de los costos totales en el grupo de intervención y el grupo control fue de 1564 euros (rango intercuartiles: 669-6 499 euros) y de 967 euros (rango intercuartiles: 29-7 136 euros). El índice de rentabilidad incremental del programa fue de -46 157 euros para el diagnóstico de asma por un MG y de -9 671 euros para la definición EPM, lo cual señala la inferioridad de la situación experimental. Todas las replicaciones bootstrap indicaron que el programa PREVASC es más costoso, con una probabilidad del 37% y del 13%, respectivamente, de que éste fuese más eficaz que la atención usual. La prevención primaria del asma en los primeros 2 años de vida no fue rentable con ambos modelos.
Subject(s)
Humans , Male , Female , Infant , Asthma/diagnosis , Asthma/ethnology , Asthma/prevention & control , Infant , Primary Prevention/instrumentation , Primary Prevention/methods , Child Health ServicesABSTRACT
According to the 2002 census living ion chile 692.192 persons belonging to ethnic groups. Largest groups correspond to the mapuche ethnic group with 604.349 people. Not know the prevalence and caractheristics ofasthma in Chilean aboriginal groups. Worlwide while the number of publications is limited research shows that asthma prevalence is important in adult indigenous population of the Australia and United States. So well havedeveloped some interesting projects in Chile of interaction in health with the mapuche and huilliche communitiesnational studies are needed to enable the development of appropriate health policies for the management of asthma aboriginal populations.
Según el censo 2002 en Chile viven 692.102 personas pertenecientes a grupos étnicos. El grupo más grande corresponde a la etnia mapuche con 604.349 personas. Se desconoce la prevalencia y características del asma bronquial en grupos aborígenes chilenos. A nivel mundial si bien el número de publicaciones es reducido los estudios revelan que el asma presenta una prevalencia importante en población indígena adulta de Australia y Estados Unidos. Si bien en Chile se han desarrollado algunos proyectos interesantes de interacción en salud en comunidades mapuches y huilliches es necesario realizar estudios nacionales que permitan el desarrollo de políticas de salud adecuadas para el manejo del asma en poblaciones indígenas.
Subject(s)
Humans , Asthma/epidemiology , Indians, South American , Asthma/ethnology , Chile/ethnology , Prevalence , Risk FactorsABSTRACT
Transforming growth factor-beta (TGF-beta) and its receptors have been suggested to play key roles in the pathogenesis of asthma. The aim of this study was to evaluate the effects of genetic variations in the TGF-beta receptor type III (TGFBR3) on asthma and on its related phenotypes in the general population. A cohort of 2,118 subjects aged from 10 to 18 years responded to a questionnaire concerning asthma symptoms and risk factors. Methacholine airway hyperresponsiveness (AHR), skin test responses to common aeroallergens, and serum total IgE levels were evaluated in the cohort. A total of 19 SNPs for TGFBR3 were found using direct re-sequencing in 24 healthy adults. Of these, informative SNPs [+44T>C (S15F) and +2753G>A at 3'UTR] were selected and scored using the high throughput single base extension method. Atopy was identified in subjects with 44T>C allele [P = 0.04, OR (95% CI) = 0.79 (0.62-0.99)] and in subjects with Ht1 (CG) more frequently than in subjects with other haplotypes [P = 0.04, OR (95% CI) = 1.27 (1.01-1.59)]. The A allele in 2753G>A was more common in subjects with non-atopic asthma [OR (95% CI) = 1.76 (1.01-3.05)]. A significant association was found between non-atopic asthma and 44T_2753A [OR (95% CI) = 2.16 (1.22-3.82)]. Genetic variations in TGFBR3 appear to be associated with a genetic predisposition to development of asthma and to phenotypes of asthma. Also, the minor allele 2753G and the haplotype TA in the TGFBR3 gene were associated with a pathogenesis of non-atopic asthma.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Asian People/genetics , Asthma/ethnology , Case-Control Studies , Cohort Studies , Gene Frequency , Genetic Predisposition to Disease , Genetic Variation/physiology , Genetics, Population , Genome-Wide Association Study , Genotype , Immunoglobulin E/immunology , Linkage Disequilibrium , Proteoglycans/genetics , Receptors, Transforming Growth Factor beta/geneticsABSTRACT
OBJETIVO: Analisar os significados culturais da asma infantil com origem na mãe-cuidadora. PROCEDIMENTOS METODOLÓGICOS: Pesquisa qualitativa realizada em 2004, no município de Fortaleza, CE. Foi utilizada a observação participante com abordagem etnográfica e entrevistas com sete mães acompanhantes de seus filhos em unidade de emergência hospitalar. Os significados das falas das mães foram identificados utilizando-se a técnica de análise temática. ANÁLISE DOS RESULTADOS: Foram identificadas duas categorias de discussão; na primeira, "desinformação sobre a doença", foi possível perceber que as mães não são informadas sobre a doença do filho. Na segunda categoria, "cuidado cultural", as mães referem informações sobre os cuidados e utilizam recursos do saber popular para prevenir a asma dos filhos, como o cuidado ambiental e a utilização de remédios caseiros à base de plantas medicinais. CONCLUSÕES: As características de desinformação e desconhecimento materno em relação à asma do filho mostram a necessidade de haver um trabalho educativo intenso, dialógico e problematizador em estreita colaboração com o tratamento, visando à melhoria do prognóstico da doença.
Subject(s)
Humans , Female , Child , Anthropology, Cultural , Asthma/ethnology , Child Health , Mother-Child Relations , Brazil , Qualitative ResearchABSTRACT
The genetics of asthma and atopy is complex, but can be approached by studies of both candidate genes and mapping of susceptibility loci. Genetic factors conferring susceptibility to disease may vary among ethnic groups. We present our experience with some candidate gene studies for asthma and atopy and susceptibility locus mapping for linkage to chromosome 5q.
Subject(s)
Asian People/genetics , Asthma/ethnology , Cytokines/genetics , Genetic Predisposition to Disease , Humans , Hypersensitivity, Immediate/ethnologyABSTRACT
We investigated the aeroallergens affecting 200 asthmatics from the University Hospital in Kuala Lumpur, Malaysia and found 164 (82%) patients with skin prick test (SPT) reactivity to one or more of a panel of 14 allergens, which included indoor and outdoor animal and plant aeroallergens. Reactivity was most frequent to the indoor airborne allergens, with 159 (79.5%) reacting to either or both house dust mite (Dermatophagoides) species and 87 (43.5%) to cockroach. The SPT reactivity to house dust mites corresponded with the finding that patients found house dust to be the main precipitant of asthmatic attacks.
Subject(s)
Air , Allergens/immunology , Animals , Asthma/ethnology , Cats , Cockroaches/immunology , Dogs , Dust , Hair/immunology , Humans , Longitudinal Studies , Malaysia , Mites/immunology , Poaceae/immunology , Pollen/immunology , Skin Tests , Trees/immunologyABSTRACT
Para determinar algunas características epidemiológicas del asma en la costa caribe colombiana, se examinaron cuatro mil personas de Cartagena para establecer la prevalencia de esta enfermedad y los registros de defunciones ocurridas desde 1986 hasta 1990 en dos departamentos representativos del sector geográfico (Bolivar y Atlántico), con el fin de investigar la tendencia de la tasa de mortalidad por asma en ese período. Además, se investigó la importancia del asma entre otras enfermedades alérgicas haciendo un estudio poblacional con los pacientes que asistieron a un consultorio de alergias en Cartagena, en el cual se obtuvieron las frecuencias de las enfermedades alérgicas por la que consultaron. Los resultados mostraron una prevalencia de asma acumulativa y puntual de 8.8 por ciento y 12.2 por ciento respectivamente y una tasa de mostalidad en ascenso con valores que van desde 0.74 en 1986 hasta 1.62 en 1990. Setenta por ciento de la población general afectada por asma tenían menos de 15 años de edad y en la consulta de alergias se observó que el asma era la segunda enfermedad más frecuente después de la rinitis. Los datos de estos estudios sugieren que la frecuencia de asma es alta, la mortalidad por dicha enfermedad no es muy diferente a la encontrada en otros sitios y la distribución de las enfermedades alérgicas muestra un predominio de los procesos respiratorios.