Characterization of obstructive airway disease in family members of probands with Asthma - An algorithm for the diagnosis of asthma

被引:52
作者
Panhuysen, CIM
Bleecker, ER
Koeter, GH
Meyers, DA
Postma, DS
机构
[1] Beatrixoord Hosp, Dept Pulm Med, Haren, Netherlands
[2] Univ Groningen Hosp, Dept Pulm Med, Groningen, Netherlands
[3] Univ Maryland, Dept Med & Pediat, Baltimore, MD 21201 USA
关键词
D O I
10.1164/ajrccm.157.6.9606088
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
To investigate the genetic susceptibility to asthma, we developed an algorithm to classify the phenotype of each family member enrolled in a family study on the genetics of asthma. This algorithm was applied to 92 two-and three-generation families, identified through a subject (proband) with asthma first diagnosed 25 yr previously. The algorithm consisted of five classes based on the presence or absence of bronchial hyperresponsiveness (BHR), respiratory symptoms, smoking, airways obstruction, and bronchodilator reversibility. All family members were classified as: (1) definite asthma; (2) probable asthma; (3) unclassifiable airway disease; (4) chronic obstructive pulmonary disease (COPD); (5) unaffected (without clinical evidence of asthma and COPD). Thirteen of the 92 probands (14%) could not be classified as asthmatic when retested 25 yr later because of loss of BHR, loss of bronchodilator reversibility, or a current history of cigarette smoking. Of the 265 first-degree offspring, 49 (18%) were classified as having definite asthma (Class 1), and 22 (8%) as probable asthma (Class 2). A large number of offspring with clinical evidence of asthma did not have a prior physician's diagnosis of asthma, and offspring in Class 1 (definite asthma), with and without a physician's diagnosis, had similar clinical and physiologic characteristics. These results support the usefulness of this approach to classify subjects with asthma for genetic epidemiologic studies and show that reliance on a prior physician's diagnosis may result in misclassification or underdiagnosis. Characterization of the offspring in this family study showed that there is familial clustering, which supports the presence of a hereditary component in asthma.
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页码:1734 / 1742
页数:9
相关论文
共 56 条
[1]  
[Anonymous], 1965, LANCET, V1, P775
[2]  
[Anonymous], 1987, Am Rev Respir Dis, V136, P1285
[3]  
[Anonymous], 1959, Thorax
[4]   RECENT ADVANCES IN THE GENETICS OF ASTHMA [J].
BLEECKER, ER ;
MEYERS, DA .
CLINICAL AND EXPERIMENTAL ALLERGY, 1995, 25 :1-2
[5]   COLLABORATIVE STUDIES ON THE GENETICS OF ASTHMA - NATIONAL HEART, LUNG AND BLOOD INSTITUTE [J].
BLUMENTHAL, MN ;
BANKSSCHLEGEL, S ;
BLEECKER, ER ;
MARSH, DG ;
OBER, C .
CLINICAL AND EXPERIMENTAL ALLERGY, 1995, 25 :29-32
[6]   INTERPRETATION OF BRONCHODILATOR RESPONSE IN PATIENTS WITH OBSTRUCTIVE AIRWAYS DISEASE [J].
BRAND, PLP ;
QUANJER, PH ;
POSTMA, DS ;
KERSTJENS, HAM ;
KOETER, GH ;
DEKHUIJZEN, PNR ;
SLUITER, HJ .
THORAX, 1992, 47 (06) :429-436
[7]   PERCEPTION OF AIRWAY-OBSTRUCTION IN A RANDOM-POPULATION SAMPLE - RELATIONSHIP TO AIRWAY HYPERRESPONSIVENESS IN THE ABSENCE OF RESPIRATORY SYMPTOMS [J].
BRAND, PLP ;
RIJCKEN, B ;
SCHOUTEN, JP ;
KOETER, GH ;
WEISS, ST ;
POSTMA, DS .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1992, 146 (02) :396-401
[8]   THE RELATION BETWEEN CHANGE IN AIRWAY REACTIVITY AND CHANGE IN RESPIRATORY SYMPTOMS AND MEDICATION IN A COMMUNITY STUDY [J].
BRITTON, JR ;
BURNEY, PGJ ;
CHINN, S ;
PAPACOSTA, AO ;
TATTERSFIELD, AE .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1988, 138 (03) :530-534
[9]   HAS THE PREVALENCE OF ASTHMA INCREASED IN CHILDREN - EVIDENCE FROM THE NATIONAL STUDY OF HEALTH AND GROWTH 1973-86 [J].
BURNEY, PGJ ;
CHINN, S ;
RONA, RJ .
BRITISH MEDICAL JOURNAL, 1990, 300 (6735) :1306-1310
[10]   INTERACTIONS OF SMOKING AND IMMUNOLOGICAL FACTORS IN RELATION TO AIRWAYS OBSTRUCTION [J].
BURROWS, B ;
LEBOWITZ, MD ;
BARBEE, RA ;
KNUDSON, RJ ;
HALONEN, M .
CHEST, 1983, 84 (06) :657-661