Stress and Bronchodilator Response in Children with Asthma

被引：82

作者：

Brehm, John M. ^{[1
]}

Ramratnam, Sima K. ^{[1
]}

Tse, Sze Man ^{[3
]}

Croteau-Chonka, Damien C. ^{[3
]}

Pino-Yanes, Maria ^{[4
,5
,6
]}

Rosas-Salazar, Christian ^{[1
]}

Litonjua, Augusto A. ^{[3
]}

Raby, Benjamin A. ^{[3
]}

Boutaoui, Nadia ^{[1
]}

Han, Yueh-Ying ^{[1
]}

Chen, Wei ^{[1
]}

Forno, Erick ^{[1
]}

Marsland, Anna L. ^{[2
]}

Nugent, Nicole R. ^{[7
]}

Eng, Celeste ^{[4
,5
]}

Colon-Semidey, Angel ^{[8
]}

Alvarez, Maria ^{[8
]}

Acosta-Perez, Edna ^{[8
]}

Spear, Melissa L. ^{[4
,5
]}

Martinez, Fernando D. ^{[9
,10
]}

Avila, Lydiana ^{[11
]}

Weiss, Scott T. ^{[3
]}

Soto-Quiros, Manuel ^{[11
]}

Ober, Carole ^{[12
]}

Nicolae, Dan L. ^{[12
]}

Barnes, Kathleen C. ^{[13
]}

Lemanske, Robert F., Jr. ^{[14
,15
]}

Strunk, Robert C. ^{[16
]}

Liu, Andrew ^{[17
]}

London, Stephanie J. ^{[18
]}

Gilliland, Frank ^{[19
]}

Sleiman, Patrick ^{[20
,21
]}

March, Michael ^{[20
]}

Hakonarson, Hakon ^{[20
,21
]}

Duan, Qing Ling ^{[3
]}

Kolls, Jay K. ^{[1
]}

Fritz, Gregory K.

Hu, Donglei ^{[4
,5
]}

Fani, Negar ^{[22
]}

Stevens, Jennifer S. ^{[22
]}

Almli, Lynn M. ^{[22
]}

Burchard, Esteban G. ^{[4
,5
]}

Shin, Jaemin ^{[23
,24
]}

McQuaid, Elizabeth L.

Ressler, Kerry ^{[22
]}

Canino, Glorisa ^{[8
]}

Celedon, Juan C. ^{[1
]}

机构：

[1] Univ Pittsburgh, Med Ctr, Childrens Hosp Pittsburgh, Div Pulm Med Allergy & Immunol, Pittsburgh, PA USA

[2] Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 USA

[3] Harvard Univ, Sch Med, Brigham & Womens Hosp, Channing Div Network Med, Boston, MA USA

[4] Univ Calif San Francisco, Dept Bioengn & Therapeut Sci, San Francisco, CA 94143 USA

[5] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA

[6] Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain

[7] Brown Univ, Sch Med, Dept Psychiat & Human Behav, Providence, RI 02912 USA

[8] Univ Puerto Rico, Behav Sci Res Inst, San Juan, PR 00936 USA

[9] Univ Arizona, Arizona Resp Ctr, Tucson, AZ USA

[10] Univ Arizona, Inst BIO5, Tucson, AZ USA

[11] Hosp Nacl Ninos Dr Carlos Saenz Herrera, Div Pediat Pulmonol, San Jose, Costa Rica

[12] Univ Chicago, Dept Human Genet, Chicago, IL 60637 USA

[13] Johns Hopkins Univ, Dept Med, Baltimore, MD USA

[14] Univ Wisconsin, Dept Pediat, Sch Med & Publ Hlth, Madison, WI USA

[15] Univ Wisconsin, Dept Med, Sch Med & Publ Hlth, Madison, WI USA

[16] Washington Univ, Sch Med, Dept Pediat, St Louis, MO 63110 USA

[17] Natl Jewish Hlth, Dept Pediat, Denver, CO USA

[18] NIEHS, NIH, Dept Hlth & Human Serv, Res Triangle Pk, NC 27709 USA

[19] Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA 90033 USA

[20] Childrens Hosp Philadelphia, Res Inst, Ctr Appl Genom, Philadelphia, PA 19104 USA

[21] Univ Penn, Perelman Sch Med, Dept Pediat, Philadelphia, PA 19104 USA

[22] Emory Univ, Dept Psychiat & Behav Sci, Atlanta, GA 30322 USA

[23] Georgia Inst Technol, Ctr Adv Brain Imaging, Atlanta, GA 30332 USA

[24] Georgia State Univ, Atlanta, GA 30303 USA

来源：

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE | 2015年 / 192卷 / 01期

基金：

美国国家卫生研究院;

关键词：

asthma; Puerto Ricans; bronchodilator response; stress; PUERTO-RICAN; ADCYAP1R1; GENOTYPE; DIAGNOSTIC-ACCURACY; GENE POLYMORPHISM; VIOLENCE EXPOSURE; CHILDHOOD ASTHMA; SYMPTOMS; DISORDER; RESPONSIVENESS; POPULATION;

D O I：

10.1164/rccm.201501-0037OC

中图分类号：

R4 [临床医学];

学科分类号：

100218 [急诊医学];

摘要：

Rationale: Stress is associated with asthma morbidity in Puerto Ricans (PRs), who have reduced bronchodilator response (BDR). Objectives: To examine whether stress and/or a gene regulating anxiety (ADCYAP1R1) is associated with BDR in PR and non-PR children with asthma. Methods: This was a cross-sectional study of stress-and BDR (percent change in FEV1 after BD) in 234 PRs ages 9-14 years with asthma. We assessed child stress using the Checklist of Children's Distress Symptoms, and maternal stress using the Perceived Stress Scale. Replication analyses were conducted in two cohorts. Polymorphisms in ADCYAP1R1 were genotyped in our study and six replication studies. Multivariable models of stress and BDR were adjusted for age, sex, income, environmental tobacco smoke, and use of inhaled corticosteroids. Measurements and Main Results: High child stress was associated with reduced BDR in three cohorts. PR children who were highly stressed (upper quartile, Checklist of Children's Distress Symptoms) and whose mothers had high stress (upper quartile, Perceived Stress Scale) had a BDR that was 10.2% (95% confidence interval, 6.1-14.2%) lower than children who had neither high stress nor a highly stressed mother. A polymorphism in ADCYAP1R1 (rs34548976) was associated with reduced BDR. This single-nucleotide polymorphism is associated with reduced expression of the gene for the beta(2)-adrenergic receptor (ADRB2) in CD4(+) lymphocytes of subjects with asthma, and it affects brain connectivity of the amygdala and the insula (a biomarker of anxiety). Conclusions: High child stress and an ADCYAP1R1 single-nucleotide polymorphism are associated with reduced BDR in children with asthma. This is likely caused by down-regulation of ADRB2 in highly stressed children.

引用

页码：47 / 56

页数：10

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