Pub Date : 2024-12-01DOI: 10.1016/j.anai.2024.07.016
Lisa Frueh MPH , Rachit Sharma MBBS, MPH , Perry E. Sheffield MD, MPH , Jane E. Clougherty MSc, ScD
Over the past 2 decades, epidemiologic studies have identified significant associations between exposure to violence, as a psychosocial stressor, and the incidence or exacerbation of asthma. Across diverse populations, study designs, and measures of community violence, researchers have consistently identified adverse associations. In this review, the published epidemiologic evidence is summarized with special attention to research published in the last 5 years and seminal papers. Hypothesized mechanisms for the direct effects of violence exposure and for how such exposure affects susceptibility to physical agents (eg, air pollution and extreme temperature) are discussed. These include stress-related pathways, behavioral mechanisms, and epigenetic mechanisms. Finally, clinical implications and recommendations are discussed.
{"title":"Community violence and asthma","authors":"Lisa Frueh MPH , Rachit Sharma MBBS, MPH , Perry E. Sheffield MD, MPH , Jane E. Clougherty MSc, ScD","doi":"10.1016/j.anai.2024.07.016","DOIUrl":"10.1016/j.anai.2024.07.016","url":null,"abstract":"<div><div>Over the past 2 decades, epidemiologic studies have identified significant associations between exposure to violence, as a psychosocial stressor, and the incidence or exacerbation of asthma. Across diverse populations, study designs, and measures of community violence, researchers have consistently identified adverse associations. In this review, the published epidemiologic evidence is summarized with special attention to research published in the last 5 years and seminal papers. Hypothesized mechanisms for the direct effects of violence exposure and for how such exposure affects susceptibility to physical agents (eg, air pollution and extreme temperature) are discussed. These include stress-related pathways, behavioral mechanisms, and epigenetic mechanisms. Finally, clinical implications and recommendations are discussed.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 641-648.e12"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.anai.2024.07.023
Yueh-Ying Han PhD, Juan C. Celedón MD, DrPH
In the United States, people living in deprived urban areas and persons in certain minoritized groups are often exposed to violence and affected with asthma, and epidemiologic studies have shown a link between exposure to violence (ETV) and asthma throughout the lifespan. Indeed, ETV at the individual, intrafamilial and community levels has been linked to asthma in children and adults. In this review, we discuss the evidence for a causal relation between ETV and asthma, emphasizing findings published in the last five years. Interpretation of the available evidence is limited by variable quality of the assessment of ETV or asthma, potential recall and selection bias, inability to estimate the relative contribution of various types of violence to the observed associations, lack of objective biomarkers of asthma or asthma endotypes, and inconsistent consideration of potential confounders or modifiers of the ETV-asthma link. Despite such limitations, the aggregate evidence from studies conducted in different locations and populations suggests that ETV affects asthma and asthma outcomes, and that this is explained by direct physiologic effects of violence-related distress and indirect effects (e.g., through risky health behaviors or co-morbidities). Thus, large prospective studies with careful assessment of specific types of ETV, key covariates and comorbidities (including mental illness), and asthma are needed to advance this field. Such research efforts should not preclude screening for maltreatment in children with asthma and ETV-related depression and anxiety in adolescents and adults with asthma. Further, vigorous policies are needed to curtail violence, as such policies could benefit patients with asthma while saving lives.
在美国，生活在城市贫困地区的人和某些少数群体中的人经常会受到暴力的影响而患上哮喘，流行病学研究表明，在人的一生中，受到暴力影响（ETV）与哮喘之间存在联系。事实上，个人、家庭内部和社区层面的暴力暴露都与儿童和成人的哮喘有关。在这篇综述中，我们讨论了 ETV 与哮喘之间因果关系的证据，并强调了过去五年中发表的研究结果。对 ETV 或哮喘的评估质量参差不齐、潜在的回忆和选择偏差、无法估计各种类型的暴力对观察到的关联的相对贡献、缺乏哮喘或哮喘内型的客观生物标志物，以及对 ETV 与哮喘关联的潜在混杂因素或调节因素的考虑不一致，这些因素限制了对现有证据的解释。尽管存在这些局限性，但在不同地区和人群中进行的研究得出的综合证据表明，ETV 会影响哮喘和哮喘的预后，而这是由暴力相关痛苦的直接生理效应和间接效应（如通过危险的健康行为或合并疾病）造成的。因此，需要开展大型前瞻性研究，仔细评估特定类型的 ETV、关键的协变量和合并症（包括精神疾病）以及哮喘，以推进这一领域的研究。这些研究工作不应排除对患有哮喘的儿童进行虐待筛查，以及对患有哮喘的青少年和成人进行与 ETV 相关的抑郁和焦虑筛查。此外，还需要制定有力的政策来遏制暴力，因为这些政策在挽救生命的同时也能使哮喘患者受益。
{"title":"The effects of violence and related stress on asthma","authors":"Yueh-Ying Han PhD, Juan C. Celedón MD, DrPH","doi":"10.1016/j.anai.2024.07.023","DOIUrl":"10.1016/j.anai.2024.07.023","url":null,"abstract":"<div><div>In the United States, people living in deprived urban areas and persons in certain minoritized groups are often exposed to violence and affected with asthma, and epidemiologic studies have shown a link between exposure to violence (ETV) and asthma throughout the lifespan. Indeed, ETV at the individual, intrafamilial and community levels has been linked to asthma in children and adults. In this review, we discuss the evidence for a causal relation between ETV and asthma, emphasizing findings published in the last five years. Interpretation of the available evidence is limited by variable quality of the assessment of ETV or asthma, potential recall and selection bias, inability to estimate the relative contribution of various types of violence to the observed associations, lack of objective biomarkers of asthma or asthma endotypes, and inconsistent consideration of potential confounders or modifiers of the ETV-asthma link. Despite such limitations, the aggregate evidence from studies conducted in different locations and populations suggests that ETV affects asthma and asthma outcomes, and that this is explained by direct physiologic effects of violence-related distress and indirect effects (e.g., through risky health behaviors or co-morbidities). Thus, large prospective studies with careful assessment of specific types of ETV, key covariates and comorbidities (including mental illness), and asthma are needed to advance this field. Such research efforts should not preclude screening for maltreatment in children with asthma and ETV-related depression and anxiety in adolescents and adults with asthma. Further, vigorous policies are needed to curtail violence, as such policies could benefit patients with asthma while saving lives.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 630-640"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.anai.2024.08.004
Spencer R. Hagwood BS, Matthew Elliott MD, Gailen D. Marshall MD, PhD
{"title":"Comparing prevalence of food allergy in exercise-induced bronchoconstriction vs asthma","authors":"Spencer R. Hagwood BS, Matthew Elliott MD, Gailen D. Marshall MD, PhD","doi":"10.1016/j.anai.2024.08.004","DOIUrl":"10.1016/j.anai.2024.08.004","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 722-723"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.anai.2024.09.005
Melissa H. Bloodworth MD, PhD , Patrick J. Staso MD , Shi Huang PhD , Eric Farber-Eger BS , Kevin D. Niswender MD, PhD , Frank E. Harrell Jr PhD , Quinn S. Wells MD , Leonard B. Bacharier MD , Megan M. Shuey PhD , Katherine N. Cahill MD
Background
Obesity and metabolic dysregulation (MetD) have increasing prevalence and adversely affect asthma morbidity and therapeutic response.
Objective
To determine the role of weight and MetD on incident asthma in adulthood.
Methods
In a retrospective, longitudinal cohort of patients, we performed a time-to-asthma diagnosis analysis after a 3-year landmark period (t0-t3) during which weight and MetD components were evaluated. We assessed incident asthma risk with MetD components and weight.
Results
In total, 90,081 patients met the inclusion criteria, with 836 cases (0.93%) of incident asthma in our primary cohort. Diabetes present at t0, but no other MetD components, was associated with increased risk of asthma (adjusted hazard ratio = 1.85, 95% CI: 1.27-2.71, P = .0002). The effect of weight on asthma risk, independent of other MetD components, identified individuals with overweight or obesity as having a 10-year attributable risk of 15.4%. Metformin was prescribed more frequently, and hemoglobin A1c levels were lower in patients with diabetes in whom asthma did not develop (P < .0001).
Conclusion
Weight and diabetes prevention and management represent modifiable risk factors for adult asthma development.
{"title":"Impact of metabolic and weight components on incident asthma using a real-world cohort","authors":"Melissa H. Bloodworth MD, PhD , Patrick J. Staso MD , Shi Huang PhD , Eric Farber-Eger BS , Kevin D. Niswender MD, PhD , Frank E. Harrell Jr PhD , Quinn S. Wells MD , Leonard B. Bacharier MD , Megan M. Shuey PhD , Katherine N. Cahill MD","doi":"10.1016/j.anai.2024.09.005","DOIUrl":"10.1016/j.anai.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Obesity and metabolic dysregulation (MetD) have increasing prevalence and adversely affect asthma morbidity and therapeutic response.</div></div><div><h3>Objective</h3><div>To determine the role of weight and MetD on incident asthma in adulthood.</div></div><div><h3>Methods</h3><div>In a retrospective, longitudinal cohort of patients, we performed a time-to-asthma diagnosis analysis after a 3-year landmark period (t<sub>0</sub>-t<sub>3</sub>) during which weight and MetD components were evaluated. We assessed incident asthma risk with MetD components and weight.</div></div><div><h3>Results</h3><div>In total, 90,081 patients met the inclusion criteria, with 836 cases (0.93%) of incident asthma in our primary cohort. Diabetes present at t<sub>0</sub>, but no other MetD components, was associated with increased risk of asthma (adjusted hazard ratio = 1.85, 95% CI: 1.27-2.71, <em>P</em> = .0002). The effect of weight on asthma risk, independent of other MetD components, identified individuals with overweight or obesity as having a 10-year attributable risk of 15.4%. Metformin was prescribed more frequently, and hemoglobin A1c levels were lower in patients with diabetes in whom asthma did not develop (<em>P</em> < .0001).</div></div><div><h3>Conclusion</h3><div>Weight and diabetes prevention and management represent modifiable risk factors for adult asthma development.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 660-666.e5"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.anai.2024.07.033
Brock A. Williams PhD , Yigong Guo PhD , Lianne Soller PhD , Edmond S. Chan MD , Anubhav Pratap-Singh PhD
{"title":"Total protein content and in vitro protein penetration rates of sublingual immunotherapy preparations","authors":"Brock A. Williams PhD , Yigong Guo PhD , Lianne Soller PhD , Edmond S. Chan MD , Anubhav Pratap-Singh PhD","doi":"10.1016/j.anai.2024.07.033","DOIUrl":"10.1016/j.anai.2024.07.033","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 723-725"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.anai.2024.09.017
Theresa B. Dunham MD , Linda Zhu MD , Justin H. Lee MPH , Meryl Sperling MD , Elizabeth Hoyte RN , Ronald Gibbs MD , Anne Y. Liu MD , Julia F. Simard ScD
{"title":"A hidden workflow inequity of penicillin allergy evaluation in pregnancy","authors":"Theresa B. Dunham MD , Linda Zhu MD , Justin H. Lee MPH , Meryl Sperling MD , Elizabeth Hoyte RN , Ronald Gibbs MD , Anne Y. Liu MD , Julia F. Simard ScD","doi":"10.1016/j.anai.2024.09.017","DOIUrl":"10.1016/j.anai.2024.09.017","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 725-727"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.anai.2024.10.001
Navya Kartha DO , Alexandra E. Conway BA , Marcus S. Shaker MD, MS
{"title":"Allergy and the 4P's: probabilities, perspectives, paradigms, and patients","authors":"Navya Kartha DO , Alexandra E. Conway BA , Marcus S. Shaker MD, MS","doi":"10.1016/j.anai.2024.10.001","DOIUrl":"10.1016/j.anai.2024.10.001","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 628-629"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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