Influence of Prematurity and Glutation S-Transferase Gene Polymorphisms on the Degree of Asthma Control in Children

Selma Dizdar, V. Mišanović, Mirela Mačkić- Đurović, Almedina Moro
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Abstract

Introduction: asthma is the most common chronic inflammatory disease of the respiratory tract in children. The clinical manifestation of asthma is closely related to the pathomorphological changes presenting the basis of the disease, and it concerns the difficult air flow through the lower airways during the expiratory phase of breathing. Inadequate treatment of children who have asthma affects the appearance of remodeling of the lower airways and, in the most severe cases, permanent reduction of the lung function values. The Aim is to determine the influence of prematurity and GSTT1 and GSTM1 gene polymorphisms on the degree of asthma control. Materials and Methods: The research was designed as a clinical, cohort, observational, retrospective-prospective study. It included 200 patients divided into two groups of one hundred respondents each. The first group of respondents consisted of premature children hospitalized at the Department of Neonatal Intensive Care of the CCUS Pediatric Clinic due to respiratory problems caused by immaturity. In contrast, the second group consisted of at-term-born children monitored through the Pulmonary Counselling of the Pediatric Clinic. Results: The male and female genders were equally represented. In the premature children group, respiratory support was used in 60/100 (60%) cases. GSTT1 polymorphism was proven in 150 respondents, and GSTM1 polymorphism in 98. Fisher's test showed that gestational age at birth significantly influenced asthma control: the test value was 11.281, p=0.019. Conclusion: gestation weeks at birth have a statistically significant effect on the degree of asthma control at older age. Although poorly controlled asthma and uncontrolled asthma were more prevalent in children with positive GSTT1 and GSM1 gene polymorphisms, we could not demonstrate a statistically significant influence of the mentioned polymorphisms on the degree of asthma control.
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早产和谷草转氨酶基因多态性对儿童哮喘控制程度的影响
导言:哮喘是儿童呼吸道最常见的慢性炎症性疾病。哮喘的临床表现与作为疾病基础的病理形态学变化密切相关,它涉及呼吸呼气阶段下气道气流困难的问题。对哮喘患儿的治疗不当会影响下呼吸道重塑的出现,最严重的情况会导致肺功能值永久性下降。本研究旨在确定早产、GSTT1 和 GSTM1 基因多态性对哮喘控制程度的影响。材料和方法:研究设计为临床、队列、观察、回顾性-前瞻性研究。研究对象包括 200 名患者,分为两组,每组 100 人。第一组受访者是因呼吸系统问题而在哥斯达黎加儿童医院儿科诊所新生儿重症监护室住院治疗的早产儿。而第二组则由通过儿科门诊肺部咨询进行监测的足月出生儿童组成。结果显示男女比例相当。在早产儿组中,60/100(60%)的病例使用了呼吸支持。在 150 名受访者中证实了 GSTT1 多态性,在 98 名受访者中证实了 GSTM1 多态性。费雪检验显示,出生时的胎龄对哮喘控制有显著影响:检验值为 11.281,P=0.019。结论:出生时的孕周对年龄较大时的哮喘控制程度有显著的统计学影响。虽然在 GSTT1 和 GSM1 基因多态性呈阳性的儿童中,哮喘控制不佳和哮喘失控的发生率更高,但我们无法证明上述多态性对哮喘控制程度有统计学意义。
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