Epidemiologic Reviews 24:176-189 (2002)
© 2002 by the Johns Hopkins Bloomberg School of Public Health
Genetic and Perinatal Risk Factors for Asthma Onset and Severity: A Review and Theoretical Analysis
1 Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT. 2 Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT. 3 The Wellcome Trust, University of Oxford, Oxford, United Kingdom. 4 Occupational Health Program, Harvard School of Public Health, Cambridge, MA.
Received for publication July 24, 2002; accepted for publication January 3, 2003.
Abbreviations: AR, adrenergic receptor; Ig, immunoglobulin; IL, interleukin; TNF, tumor necrosis factor.
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INTRODUCTION |
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Asthma is a major chronic disease, and several studies indicate that it is on the rise worldwide (1). A recent report (2) from the Centers for Disease Control and Prevention estimated that the prevalence of self-reported asthma in the United States rose 75 percent from 1980 to 1994, with 17.3 million asthmatics in 1998 (3). In 2000, asthma accounted for more than 11.2 million medical visits, including 1.8 million to emergency rooms (4, 5). Asthma is characterized by lung inflammation, reversible airflow obstruction, and enhanced airway responsiveness to a variety of environmental stimuli and is a phenotypically heterogeneous disorder with variable disease expression.
Asthma has a considerably greater impact on Hispanics and African Americans than on Whites in the United States (2, 6–12). Compared with Whites, African-American children have higher (1.1–1.7 times) asthma prevalence rates (
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GENETIC FACTORS |
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Genes for allergic sensitization
Interleukin (IL)-4. IL-13. Genes for inflammation and tissue damage
Tumor necrosis factor. Genes for asthma severity and bronchial hyperreactivity
Fc
RI. IL-4. IL-13. ß2 Adrenergic receptor gene. ADAM-33.
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PERINATAL RISK FACTORS |
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Intrauterine risk factors for atopy and asthma development
Allergic sensitization in the fetus. Influences of the fetal environment. The influence of lactation and diet
Early neonatal risk factors
Environmental risk factors in infancy and early childhood
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SUMMARY AND THEORETICAL MODEL |
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ACKNOWLEDGMENTS |
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