- Meeting abstract
- Open Access
- Published:
Risk factors for asthma
Italian Journal of Pediatrics volume 40, Article number: A77 (2014)
Asthma is the most common chronic respiratory disease of childhood, and even if there have been many advances in the understanding pathogenesis of the disease, many aspects remain to be clarified.
In the pathogenesis of asthma are involved both "protective" and "predisposing" factors as a result of the complex interactions that occur between genetic predisposition and environmental exposure.
From the genetic point of view, the identified genes responsible are more than 100, and many polymorphisms have been shown to be associated to the onset of asthma, although none of these, alone or in combination, is able to predict the occurrence of disease.
The environmental factors most involved in the onset of asthma in children are represented by allergens, tobacco smoke, respiratory infections and air pollution.
Indoor allergens (dust mites, mold and animal dander) and outdoor (pollens and molds) are able to induce sensitization by prolonged exposure and trigger acute asthma. Allergic sensitization, in the concept of atopic march, represents a major risk factor for the development of asthma. In particular, the subjects polysensitized and with food allergy may present more severe asthma [1].
The exposure to cigarette smoke in both prenatal and postnatal increases the risk of the child becoming asthmatic and the asthma severity.
It has also noted recently that obesity is a risk factor for asthma because it causes an increase of leptin, TNF-α, and IL-6, which exert a pro-inflammatory non-eosinophil action [2]. In addition, the lack of physical activity, for weight gain, contributes to the determinism of the disease [3].
Vitamin D is involved in the processes of development and fetal lung maturation; the levels of 25-OH vitamin D from umbilical cord blood are inversely correlated with the risk of respiratory infections and wheezing in childhood [4]. The vitamin D has immunomodulatory properties exerting an action of inhibiting the production of pro-inflammatory cytokines and induction of the synthesis of antimicrobial peptide on cells of the innate immune system [5]. The vitamin D modulates the effects of glucocorticoids and also has a role in bronchial remodeling, as it regulates the expression of genes of bronchial smooth muscle.
Infections early in life may play a role of "induction" of wheezing or "protection" against the development of allergic diseases (according to the hygiene hypothesis)[6–8]. In infants at risk viral respiratory infections can cause wheezing, which in turn can evolve later in asthma particularly in individuals with atopic predisposition.
References
Simpson A, Tan VY, Winn J, Svensén M, Bishop CM, Heckerman DE, Buchan I, Custovic A: Beyond atopy: multiple patterns of sensitization in relation to asthma in a birth cohort study. Am J Respir Crit Care Med. 2010, 181: 1200-6. 10.1164/rccm.200907-1101OC.
Hjellvik V, Tverdal A, Furu K: Body mass index as predictor for asthma: a cohort study of 118,723 males and females. Eur Respir J. 2010, 35: 1235-42. 10.1183/09031936.00192408.
Devereux G, Seaton A: Diet as a risk factor for atopy and asthma. J Allergy Clin Immunol. 2005, 115: 1109-17. 10.1016/j.jaci.2004.12.1139.
Brehm JM, Schuemann B, Fuhlbrigge AL, Hollis BW, Strunk RC, Zeiger RS, Weiss ST, Litonjua AA, Childhood Asthma Management Program Research Group: Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study. J Allergy Clin Immunol. 2010, 126: 52-58. 10.1016/j.jaci.2010.03.043.
Bosse´ Y, Lemire M, Poon AH, Daley D, He JQ, Sandford A, White JH, James AL, Musk AW, Palmer LJ, Raby BA, Weiss ST, Kosyrksyj AL, Becker A, Hudson TJ, Laprice C: Asthma and genes encoding components of the vitamin D pathway. Respir Res. 2009, 10: 98-10.1186/1465-9921-10-98.
Scott M, Roberts G, Kurukulaaratchy RJ, Matthews S, Nove A, Arshad SH: Multifaceted allergen avoidance during infancy reduces asthma during childhood with the effect persisting until age 18 years. Thorax. 2012, 67: 1046-51. 10.1136/thoraxjnl-2012-202150.
Elliott L, Henderson J, Northstone K, Chiu GY, Dunson D, London SJ: Prospective study of breast-feeding in relation to wheeze, atopy, and bronchial hyperresponsiveness in the Avon Longitudinal Study of Parents and Children (ALSPAC). J Allergy Clin Immunol. 2008, 122: 49-54. 10.1016/j.jaci.2008.04.001.
Visser CA, Garcia-Marcos L, Eggink J, Brand PL: Prevalence and risk factors of wheeze in Dutch infants in their first year of life. Pediatr Pulmonol. 2010, 45: 149-156. 10.1002/ppul.21161.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
About this article
Cite this article
Miraglia del Giudice, M., Allegorico, A., Parisi, G. et al. Risk factors for asthma. Ital J Pediatr 40 (Suppl 1), A77 (2014). https://doi.org/10.1186/1824-7288-40-S1-A77
Published:
DOI: https://doi.org/10.1186/1824-7288-40-S1-A77
Keywords
- Asthma
- Food Allergy
- Umbilical Cord Blood
- Fetal Lung
- Acute Asthma