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Relationship between Pesticide Metabolites, Cytokine Patterns, and Asthma-Related Outcomes in Rural Women Workers.

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Relationship between Pesticide Metabolites, Cytokine Patterns, and Asthma-Related Outcomes in Rural Women Workers.

Int J Environ Res Public Health. 2016;13(10)

Authors: Mwanga HH, Dalvie MA, Singh TS, Channa K, Jeebhay MF

Abstract
The objective of this study was to investigate the relationship between exposure to organophosphate (OP) and pyrethroid (PYR) pesticides with serum cytokine patterns and asthma-related outcomes among rural women workers. A cross-sectional study was conducted among rural women (n = 211), including those working and living on farms and nearby town dwellers. Pesticide exposure was assessed using urinary metabolite concentrations of OP and PYR pesticides. Health outcome assessment was ascertained through the European Community Respiratory Health Survey (ECRHS) questionnaire, fractional exhaled nitric oxide (FeNO), and serum cytokines associated with asthma. The prevalence of doctor-diagnosed asthma was 11%, adult-onset asthma 9%, and current asthma 6%. In this population, the proportion of T helper type 2 (Th2) cytokines (interleukin (IL)-4, IL-5, and IL-13) detectable in subjects was between 18% and 40%, while the proportion of non-Th2 cytokines (IL-6, IL-8, IL-10, IL-17, and interferon gamma) was between 35% and 71%. Most Th2 and non-Th2 cytokines were positively associated with either OP or PYR metabolites. Non-Th2 cytokines showed much stronger associations with OP metabolites (Dimethyl phosphate OR = 4.23; 95% CI: 1.54-11.65) than Th2 cytokines (Dimethyl phosphate OR = 1.69; 95% CI: 0.83-3.46). This study suggests that exposure to most OP and some PYR pesticides may be associated with asthma-related cytokines, with non-Th2 cytokines demonstrating consistently stronger relationships.

PMID: 27690066 [PubMed – as supplied by publisher]

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Determinants of longitudinal health-related quality of life change in children with asthma from low-income families: a report from the PROMIS(®) Pediatric Asthma Study.

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Determinants of longitudinal health-related quality of life change in children with asthma from low-income families: a report from the PROMIS(®) Pediatric Asthma Study.

Clin Exp Allergy. 2016 Sep 24;

Authors: Li Z, Leite W, Thompson L, Gross HE, Shenkman E, Reeve BB, DeWalt DA, Huang IC

Abstract
BACKGROUND: How the longitudinal asthma control status and other socio-demographic factors influence the changes of health-related quality of life (HRQOL) among asthmatic children, especially from low-income families, has not been fully investigated.
OBJECTIVES: This study aimed to describe the trajectories of asthma-specific HRQOL over 15 months, and examine the effect of asthma control status on HRQOL by taking socio-demographic factors into consideration.
METHODS: 229 dyads of asthmatic children and their parents enrolled in public insurance programs were recruited for assessing asthma control status and HRQOL over 4 time points of assessment. Asthma control status was measured using the Asthma Control and Communication Instrument and asthma-specific HRQOL was assessed using the Patient-Reported Outcomes Measurement Information System’s Pediatric Asthma Impact Scale. Latent growth models (LGMs) were applied to examine the trajectory of HRQOL and the factors contributing to the changes of HRQOL.
RESULTS: Unconditional LGM revealed that HRQOL was improved over time. Conditional LGM suggested that accounting for asthma control and participants’ socio-demographic factors, the variation in the initial level of HRQOL was significant, yet the rate of change was not. Conditional LGM also revealed that poorly-controlled asthma status was associated with poor HRQOL at each time point (p’s<0.05). Lower parental education was associated with lower baseline HRQOL (p<0.05). Hispanic children had a larger increase in HRQOL over time (p<0.01) than non-Hispanic White children.
CONCLUSIONS: Vulnerable socio-demographic characteristics and poorly controlled asthma status affect HRQOL in children. This finding encourages interventions to improve asthma control status and HRQOL in minority children. This article is protected by copyright. All rights reserved.

PMID: 27664979 [PubMed – as supplied by publisher]

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Step 4: stick or twist? A review of asthma therapy.

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Step 4: stick or twist? A review of asthma therapy.

BMJ Open Respir Res. 2016;3(1):e000143

Authors: Slater MG, Pavord ID, Shaw DE

Abstract
Many people with asthma do not achieve disease control, despite bronchodilators and inhaled corticosteroid therapy. People with uncontrolled asthma are at higher risk of an asthma attack and death, with mortality rates estimated at 1000 deaths/year in England and Wales. The recent National Review of Asthma Deaths (NRAD) report, ‘Why asthma still kills’, recommended that patients at step 4 or 5 of the British Thoracic Society/Scottish Intercollegiate Guidelines Network (BTS/SIGN) guidance must be referred to a specialist asthma service. This article reviews the 2014 evidence base for therapy of asthma patients at BTS/SIGN step 4 of the treatment cascade, in response to key findings of the NRAD report and lack of preferred treatment option at this step.

PMID: 27651907 [PubMed]

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