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Paternal asthma, mold exposure, and increased airway responsiveness among children with asthma in Costa Rica
Authors:Ly Ngoc P  Soto-Quirós Manuel E  Avila Lydiana  Hunninghake Gary M  Raby Benjamin A  Laskey Daniel  Sylvia Jody S  Celedón Juan C
Institution:Channing Laboratory, 181 Longwood Ave, Boston, MA 02115, USA.
Abstract:BACKGROUND: Little is known about the determinants of airway hyperresponsiveness (AHR) among children with asthma in Hispanic America. METHODS: We examined the relations among selected familial and environmental factors, markers of allergy, spirometric measures of lung function, and AHR in a cross-sectional study of 403 Costa Rican children with asthma between the ages of 6 and 14 years. Study participants completed a protocol that included questionnaires, spirometry, measurements of serum total and allergen-specific IgE, peripheral blood eosinophil count, and body mass index, and the assessment of airway responsiveness to methacholine (ie, a methacholine challenge test MCT]). AHR to MCT was defined as the provocative dose of methacholine causing a 20% fall in FEV(1). Linear regression was used for the univariate and multivariate analyses. RESULTS: Of the 403 asthmatic children who underwent an MCT, 350 (86.8%) had AHR to methacholine. In a multivariate analysis, paternal asthma (p = 0.004), parental report of mold/mildew in the child's home (p = 0.04), FEV(1)/FVC ratio (p < 0.0001), and a positive IgE response to Der p 1 (p = 0.008) were significantly associated with AHR among Costa Rican children with asthma. CONCLUSION: Our results suggest that paternal asthma and environmental exposure to mold/mildew are strong determinants of AHR in Costa Rican children with asthma. FEV(1)/FVC ratio may be a useful measure of AHR (a marker of asthma severity) among Costa Ricans and other Hispanic Americans for whom reference values for FEV(1) are not currently available.
Keywords:airway hyperresponsiveness  asthma  Hispanics  mold  paternal asthma  AHR"}  {"#name":"keyword"  "$":{"id":"cekeyw80"}  "$$":[{"#name":"text"  "_":"airway hyperresponsiveness  BMI"}  {"#name":"keyword"  "$":{"id":"cekeyw120"}  "$$":[{"#name":"text"  "_":"body mass index  MCT"}  {"#name":"keyword"  "$":{"id":"cekeyw160"}  "$$":[{"#name":"text"  "_":"methacholine challenge test
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