Risk Factors for Asthma - Health Tips!
Adult Asthma Tied to Recent Infections
A history of respiratory infections can heighten your risk of developing adult asthma.
By Kurt Ullman, MedPage Today
Medically Reviewed by Robert Jasmer, MD
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WEDNESDAY, Dec. 28, 2011 (MedPage Today) —Recent respiratory infections may be linked to adult-onset asthma according to the results of a population-based incident case-control study.
The risk of asthma was increased in those who had been diagnosed with lower respiratory tract infections in the 12-month period prior to the asthma diagnosis, reported Jouni J.K. Jaakkola, MD, PhD, from the University of Oulu, Finland, inPLoS ONE.
Although not as strong, there was also a link between upper respiratory tract infections such as the common cold, sinusitis, tonsillitis, and otitis media and the onset of asthma.
Although it has been established that respiratory infections may play a role in the development of asthma in children, little data exists to define what, if any, impact infections might have in adults. The authors undertook this study to assess the relationship between respiratory infections in the previous 12 months and a diagnosis of asthma.
The researchers recruited all new asthma cases in patients ages 21 to 63 who were living in the Pirkanmaa Hospital district. The study took place between 1997 and 2000. Controls were randomly selected from the same population. There were 521 cases matched with 932 controls. The medical records of all cases were checked, and only those with no previous asthma diagnosis or long-term use of asthma-related medications were included.
Significant increases in asthma risk were found when individual infections were considered separately. These included acute bronchitis, pneumonia, common cold, sinusitis, and otitis media. Only the adjusted OR for tonsillitis failed to reach significance.
There was also a clear exposure-response relationship when they estimated the risks according to increasing number of lower respiratory tract infections. The results were what the authors called "suggestive" for upper respiratory tract infections.
The authors next analyzed the joint effect of lower tract infections experienced during the previous 12 months and a current or past history of allergies. Those with allergic disease but no infections had an increased risk for asthma compared with those with no allergies and no lower tract infections.
Those who had lower respiratory tract infections and no allergies had an excess risk of 749 percent. Among those with both lower tract infections and allergies, the excess risk rose to 1,038 percent. This, according to the authors, suggests a "slight synergistic effect of atopy and lower respiratory tract infections on the additive scale."
Although less, there was also a slight synergistic effect when parental allergies and infections in the cases were studied. The excess risk in this group was 897 percent.
"A strongly increased risk of asthma was detected especially in relation to lower respiratory tract infections, but all types of respiratory infections studied, i.e., common cold, sinusitis, otitis, acute bronchitis, and pneumonia increased the risk of asthma onset," the authors wrote. "This could mean that reducing occurrence of respiratory infections might prevent onset of asthma in adulthood, especially in individuals with an atopic disease or hereditary propensity to it."
They suggested that biological pathways could underlie these observations, such as the immune system acting against respiratory infectious agents, which may lead to chronic inflammation of the airways and tissue damage.
"So respiratory infections could act as the primary inducers of inflammation leading to the development of asthma, or they may act as triggers of onset in subjects already experiencing inflammation due to other factors, such as environmental exposures," the authors stated.
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