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The research suggests when individuals with specific variations in certain genes are exposed to traffic pollution, they display more intense asthma symptoms than people that lack those same gene variations.NIEHS

Asthma patients, with a specific genetic profile, exhibit more intense symptoms following exposure to traffic pollution, according to researchers at the National Institutes of Health and collaborators. The study appeared online in Scientific Reports.

The research team, made up of scientists from the National Institute of Environmental Health Sciences (NIEHS), part of NIH, and Rice University, Houston, also found that asthma patients that lack this genetic profile do not have the same sensitivity to traffic pollution and do not experience worse asthma symptoms. The work brings scientists closer to being able to use precision medicine, an emerging field that intends to prevent and treat disease based on factors specific to an individual.

Co-lead author Shepherd Schurman, M.D., associate medical director of the NIEHS Clinical Research Unit, stated the results are based on genetic variation, the subtle differences in DNA that make each person unique. He further added that to understand the concept, one should think of human genes, which are made up of DNA base pairs A, C, G, and T, as written instructions for making proteins.

"All humans have the same genes, in other words the same basic instructions, but in some people one DNA base pair has been changed," Schurman said. "This common type of genetic variation is called a single nucleotide polymorphism or SNP, and it can alter the way proteins are made and make individuals more or less prone to illness."

Schurman is also head of the Environmental Polymorphisms Registry (EPR), the DNA bank in North Carolina that provided volunteers for the study. The EPR studies how SNPs impact disease risk in combination with environmental exposures.

Together with NIEHS colleague and lung disease expert Stavros Garantziotis, M.D., medical director of the NIEHS Clinical Research Unit, the two scientists examined four SNPs that are involved in a biochemical pathway that leads to inflammatory responses in the body. They explained that SNPs are usually studied one at a time, but they wanted to learn if different combinations of these SNPs, along with pollution exposure, could worsen symptoms in a person with an inflammatory disease like asthma.

Schurman and Garantziotis gathered information about the SNPs, severity of asthma symptoms, and residential addresses of 2,704 EPR participants with asthma. Using the SNPs data, they divided the participants into three groups: hyper-responders, or those very sensitive to air pollution and likely to develop inflammation; hypo-responders, or those insensitive to air pollution and less likely to develop inflammation; and those in between. With the help of collaborators at Rice University, the team used the participants’ addresses to calculate their distance from a major road. Participants were categorized depending on whether they lived more or less than 275 yards from a major roadway. Data suggest that air pollution levels are elevated closer to major roads.

The researchers found that asthma sufferers who were hyper-responders and lived closer to heavily travelled roads had the worst asthma symptoms, such as difficulty breathing, chest pain, cough, and wheezing, compared to the other groups. In contrast, asthma patients who were hypo-responders and lived further away from busy roads had milder symptoms. Garantziotis concluded the work could greatly enhance the quality of life for people with asthma.

"Based on this research, we could propose that hyper-responders, who are exposed to traffic pollution, receive air purification intervention, such as HEPA filters, for their home," Garantziotis said.

NIEHS Clinical Director Janet Hall, M.D., said the results emphasize the importance of gene-environment interactions in the progression of disease.

"This research is a great example of how we can approach disease prevention on a personal level, and tailor our treatments to suit individual patients," she said. "That way we can be more efficient with our treatments and preventative measures, while at the same time cutting health care costs."

Grant Numbers: ZIDES102465, ZIAES102605

About the National Institute of Environmental Health Sciences: NIEHS supports research to understand the effects of the environment on human health and is part of the National Institutes of Health. For more information on NIEHS or environmental health topics, visit www.niehs.nih.gov or subscribe to a news list.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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It’s Asthma!

Do you provide health education or health care services to adolescents and emerging adults with asthma?

Are you looking for health education materials and resources focused on indoor environmental asthma triggers for adolescents and emerging adults?

If so, DeAndra Morris, an ASPPH/EPA Environmental Health Fellow hosted by the U.S. Environmental Protection Agency, Indoor Environments Division, has created the “It’s Asthma” Infographic Series as part of her participation and training in the ASPPH Public Health Fellowship Program.

This infographic series can assist you in your efforts to provide information about indoor environmental asthma triggers to adolescents and emerging adults with asthma.

In this infographic series, adolescence is defined as the developmental period between childhood and adulthood that roughly occurs from the ages of 10–18 years old (Arnett, 2000; Jaworksa & MacQueen, 2015). According to Arnett’s Emerging Adulthood Theory, emerging adulthood is defined as the developmental period between adolescence and young adulthood that occurs from the ages of 18–29 years old, with a specific focus on the ages of 18–25 (Arnett, 2000; Arnett, 2007). Additionally, adolescence and emerging adulthood are the developmental periods characterized by high school or college attendance, the transition from high school to college, workforce entry, transition from pediatric to adult-centered health care, independence, and increased awareness of and responsibility for asthma management (Arnett, 2000; Arnett, 2007; Blum, Garell, Hodgman, Jorissen, Okinow, Orr, & Slap, 1993; Houtrow & Newacheck, 2008).

The data from the Centers for Disease Control and Prevention (CDC) 2015 and 2016 National Current Asthma Prevalence Rates include age group categories of 15–19 and 20–24, which represent these adolescence and emerging adulthood developmental periods. The CDC 2015 National Current Asthma Prevalence Rates* data indicated that adolescents and emerging adults had the highest and fourth highest current asthma prevalence rates, respectively, among all other age groups (CDC, 2018a). The recently published CDC 2016 National Current Asthma Prevalence Rates* data also indicates a high current asthma prevalence among these populations, with adolescents and emerging adults having the second and third highest current asthma prevalence rates, respectively, among all other age groups (CDC, 2018b).

The high current asthma prevalence among adolescents and emerging adults suggests that there may be a need for tailored asthma health education materials targeted toward adolescents and emerging adults with asthma, specifically for those between the ages of 15–24. However, a review of literature shows that there are many asthma health education resources and materials for children, but there are limited asthma health education resources and materials tailored and targeted towards adolescents and emerging adults.

The “It’s Asthma” Infographic Series addresses this need.

“It’s Asthma” is a tailored health education resource targeted toward adolescents and emerging adults with asthma that provides information about indoor environmental asthma triggers and strategies to reduce exposure to these triggers. “It’s Asthma” consists of six infographics that focus on five common indoor environmental asthma triggers (i.e., secondhand smoke, pets, mold, dust mites, and pests), and can be used to assist adolescents and emerging adults with their asthma management.

There are two versions of the series, the long form and short form. The long form provides more details about each trigger, and is available in a color format and a black and white format that can be used for black and white printing. Additionally, the short form version of the document can be used for initial engagement through social media posts, brochures, etc.

Consider using the “It’s Asthma” Infographic Series as you work to promote asthma management among adolescents and emerging adults with asthma!

Copy and paste this link to find the “It’s Asthma” Infographic Series:

https://drive.google.com/drive/folders/1r8y8UFdGfTtFtIe0j67RNDWPtsMTZFhI?usp=sharing

References

Arnett, J. J. (2000). Emerging adulthood. A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480. doi: 10.1037//0003-066X.55.5.469

Arnett, J. J. (2007). Afterword: Aging out of care—Toward realizing the possibilities of emerging adulthood. New Directions for Youth Development, 113, 151–161. doi: 10.1002/yd.207

Blum, R. W., Garell, D., Hodgman, C. H., Jorissen, T. W., Okinow, N. A., Orr, D. P., & Slap, G. B. (1993). Transition from child-centered to adult health-care systems for adolescents with chronic conditions: a position paper of the Society for Adolescent Medicine. Journal of Adolescent Health, 14(7), 570–576.

Centers for Disease Control and Prevention. (2018). Retrieved December 15, 2017. 2015 Previous Most Recent Asthma Data. Retrieved from www.cdc.gov/asthma/archivedata/2015/2015_data.html.

Centers for Disease Control and Prevention. (2018). Retrieved August 20, 2018. Most Recent Asthma Data. Retrieved from www.cdc.gov/asthma/most_recent_data.html.

Houtrow, A. J., & Newacheck, P. W. (2008). Understanding transition issues: Asthma as an example. The Journal of Pediatrics, 152(4), 453–455.

Note

* The CDC 2015 National Current Asthma Prevalence Rates is based on the 2015 National Health Interview Survey (NHIS) Data, and the CDC 2016 National Current Asthma Prevalence Rates data is based on the 2016 National Health Interview Survey (NHIS) Data.