Recommendation the Medical Journal Review section of the WAO Web site.
- Acetaminophen use and the risk of asthma in children and adults: a systematic review and metaanalysis.
The authors searched databases including MEDLINE (1966-2008) and EMBASE (1980-2008) to identify studies of acetaminophen use and its relation to a diagnosis of asthma. Thirteen cross-sectional, four cohort and two case-control studies of 425,140 subjects were included. The pooled odds ratio (OR) for asthma among acetaminophen users was 1.63 (95% CI, 1.46-1.77). The risk of asthma in children among acetaminophen users in the year prior to a diagnosis of asthma and in the first year of life was elevated (1.60 [95% CI, 1.48-1.74], 1.47 [95% CI, 1.36-1.56] respectively). Only one study reported the association between high acetaminophen dose and asthma in children (3.23 [95%CI, 2.9-3.6]). There was an increased risk of asthma and wheezing with prenatal use of acetaminophen by mothers (1.28 [95% CI, 1.16-41], 1.50 [95% CI, 1.10-2.05] respectively).
Editor’s comment: The results are consistent with an increase in the risk of asthma and wheezing in both children and adults exposed to acetaminophen.
Etminan M et al. Acetaminophen use and the risk of asthma in children and adults: a systematic review and metaanalysis, Chest 2009;136(5):1316-1323, November 2009.
- GA²LEN skin test study III: Minimum battery of test inhalent allergens needed in epidemiological studies in patients.
The authors defined the minimal number and the necessary allergens required to identify a sensitized patient in the Pan-European GA²LEN skin prick test study (17 centers in 14 countries). A standardized panel of 18 allergens was employed to evaluate 3034 subjects. 1996 (68.2%) were sensitized to at least one allergen. Overall, eight allergens (grass pollen, D. pteronyssinus, birch pollen, cat dander, Artemisia, olive pollen, Blatella and Alternaria) identified more than 95% of sensitized subjects. Depending on the country, up to 13 allergens were needed to identify all sensitized subjects. The authors concluded that a panel of eight to ten allergens was sufficient to identify the majority of sensitized subjects. For clinical care, the whole battery of 18 allergens is needed.
Editor’s comment: Knowing the number of allergens necessary to identify a sensitized patient is important for a cost-effective approach in epidemiological studies.
Bousquet P et al. GA²LEN skin test study III: Minimum battery of test inhalent allergens needed in epidemiological studies in patients. Allergy 2009;64(11):1656-1662.
- Adrenergic β2-receptor(ADRB2) genotype predisposes to exacerbations in steroid-treated asthmatic patients taking frequent albuterol or salmeterol.
The researchers studied the role of the Arg16 allele on asthma exacerbations requiring the use of albuterol and salmeterol. Arg/Gly status at position 16 of ADRB2 was assessed in 1182 young asthmatic patients (age, 3-22 years). An increased risk of exacerbations per copy of the Arg16 allele was observed, regardless of treatment regimen (OR, 1.30; 95% CI, 1.09-1.55; P = .003). The risk of exacerbations in patients with the Arg16 allele was only observed in those receiving daily inhaled long- or short-acting β2-agonists (OR, 1.64; 95% CI, 1.22-2.20; P = .001). There was no genotypic risk in patients using inhaled β2-agonists less than once a day (OR, 1.08; 95% CI, 0.85-1.36; P = .525). The Arg16 genotype-associated risk for exacerbations was significantly different in those exposed to β2-agonists daily versus those that were not (test for interaction, P = .022)
Editor’s comment: The Arg16 genotype of ADRB2 is associated with exacerbations in asthmatic children and young adults exposed daily to β2-agonists.
Basu K et al. Adrenergic β2-receptor(ADRB2) genotype predisposes to exacerbations in steroid-treated asthmatic patients taking frequent albuterol or salmeterol, J Clin Allergy Immun 2009: Article in press, published online 05 October 2009.
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