Jung Young-Ho, Seo Ju-Hee, Kim Hyung Young, Kwon Ji-Won, Kim Byoung-Ju, Kim Hyo-Bin, Lee So-Yeon, Jang Gwang Cheon, Song Dae Jin, Kim Woo Kyung, Shim Jung Yeon, Hong Soo-Jong
Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea; Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Pediatr Pulmonol. 2015 Jan;50(1):8-16. doi: 10.1002/ppul.22978. Epub 2013 Dec 23.
Asthma is a complex genetic disorder that is associated with both genetic and environmental factors. The aim of study was to investigate the combined effect of toll-like receptor 4 (TLR4), cluster of differentiation 14 (CD14), and interleukin-13 (IL-13) polymorphisms and bronchiolitis in the development of childhood asthma.
A modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to survey 1,341 elementary school children and 919 nursery children in Seoul, Korea. TLR4 (rs1927911), CD14 (rs2569190), and IL-13 (rs20541) polymorphisms were genotyped by the TaqMan assay.
In elementary school and nursery children, parental history of asthma (adjusted odds ratio [aOR] 2.56 [95% CI 1.16-5.63], aOR 3.60 [95% CI 1.66-7.76], respectively), and past history of bronchiolitis (aOR 3.11 [95% CI 1.84-5.24], aOR 3.94 [95% CI 2.27-6.84], respectively) were independent risk factors for asthma diagnosis. When compared to children with each CC of TLR4 polymorphism or TT of CD14 polymorphism or GG of IL13 polymorphism and no past history of bronchiolitis, children with CT or TT of TLR4 polymorphism and past history of bronchiolitis had 4.23 and 5.34 times higher risk to develop asthma, respectively; children with TT of CD14 polymorphism and past history of bronchiolitis had 3.57 and 7.22 times higher risk for asthma, respectively; children with GA or AA of IL-13 polymorphism and past history of bronchiolitis had 3.21 and 4.13 times higher risk for asthma, respectively.
Family history of asthma or allergic rhinitis and past history of bronchiolitis could be independent risk factors for the development of childhood asthma. The relationship between asthma and bronchiolitis is modified by the TLR4, CD14, and IL-13 polymorphisms in Korean children.
哮喘是一种复杂的遗传疾病，与遗传和环境因素均相关。本研究的目的是调查Toll样受体4（TLR4）、分化簇14（CD14）和白细胞介素-13（IL-13）基因多态性与细支气管炎在儿童哮喘发病中的联合作用。
采用改良的儿童哮喘和过敏国际研究（ISAAC）问卷对韩国首尔的1341名小学生和919名幼儿园儿童进行调查。通过TaqMan分析法对TLR4（rs1927911）、CD14（rs2569190）和IL-13（rs20541）基因多态性进行基因分型。
在小学生和幼儿园儿童中，哮喘家族史（调整后的优势比[aOR]分别为2.56[95%置信区间1.16 - 5.63]，aOR为3.60[95%置信区间1.66 - 7.76]）和既往细支气管炎病史（aOR分别为3.11[95%置信区间1.84 - 5.24]，aOR为3.94[95%置信区间2.27 - 6.84]）是哮喘诊断的独立危险因素。与TLR4基因多态性为CC型或CD14基因多态性为TT型或IL13基因多态性为GG型且无既往细支气管炎病史的儿童相比，TLR4基因多态性为CT型或TT型且有既往细支气管炎病史的儿童患哮喘的风险分别高4.23倍和5.34倍；CD14基因多态性为TT型且有既往细支气管炎病史的儿童患哮喘的风险分别高3.57倍和7.22倍；IL-13基因多态性为GA型或AA型且有既往细支气管炎病史的儿童患哮喘的风险分别高3.21倍和4.13倍。
哮喘或过敏性鼻炎家族史以及既往细支气管炎病史可能是儿童哮喘发病的独立危险因素。在韩国儿童中，哮喘与细支气管炎之间的关系因TLR4、CD14和IL-13基因多态性而改变。
