Department of Pulmonary Medicine, University of Tsukuba, Tsukuba, Japan.
Tsukuba Medical Center, Tsukuba, Japan.
Clin Exp Allergy. 2020 Nov;50(11):1223-1229. doi: 10.1111/cea.13699. Epub 2020 Jul 23.
Adult-onset asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous diseases caused by complex gene-environment interactions. A functional single nucleotide polymorphism of cadherin-related family member 3 (CDHR3), known as a receptor of rhinovirus-C, is associated with childhood-onset asthma especially in atopic individuals.
Here, we identified risk factors for adult-onset asthma and COPD, focusing on the impact of the CDHR3 variant in atopic individuals.
We conducted a longitudinal, retrospective, observational cohort study of 1523 healthy adults with baseline examinations at Tsukuba Medical Center Hospital in 2008 and retrospectively identified new-onset, physician-diagnosed asthma or COPD from 2009 to 2018. We assessed risk factors by the Cox regression analysis. The impact of CDHR3 variant rs6967330 was also examined in individuals with pre-existing atopy.
Over 10 study years, 103 people developed airway diseases (79 asthma and 24 COPD; 52 females, average onset-age 55 years old, range 38-80). Higher body mass index (BMI) and lower forced expiratory volume in one second/forced vital capacity (FEV /FVC) ratio were significant risk factors (BMI: HR 1.072 [95% CI 1.005-1.14], P = .034; FEV /FVC ratio: HR 1.091 [1.044-1.14], P = .00011). Restriction to atopic individuals saw the A allele at rs6967330 and lower FEV /FVC ratio to associate with adult-onset disease (A allele: HR 2.89 [1.57-5.20], P = .00062; FEV /FVC ratio: HR 1.10 [1.04-1.17], P = .0010).
Genetic susceptibility to rhinovirus-C infection in atopic individuals is a risk factor for chronic airway diseases even in later life.
成人起病哮喘和慢性阻塞性肺疾病(COPD)是由复杂的基因-环境相互作用引起的异质性疾病。黏附蛋白家族成员 3(CDHR3)的功能性单核苷酸多态性,作为鼻病毒-C 的受体,与儿童起病哮喘有关,尤其是在特应性个体中。
本研究旨在确定成人起病哮喘和 COPD 的危险因素,重点关注 CDHR3 变异在特应性个体中的影响。
我们对 1523 名健康成年人进行了一项纵向、回顾性、观察性队列研究,这些成年人在 2008 年于筑波医疗中心医院进行了基线检查,并从 2009 年至 2018 年回顾性地确定了新诊断的、由医生诊断的哮喘或 COPD。我们通过 Cox 回归分析评估了危险因素。还在有预先存在特应性的个体中检查了 CDHR3 变异 rs6967330 的影响。
在 10 年的研究期间,有 103 人患上了气道疾病(79 例哮喘和 24 例 COPD;52 名女性,平均发病年龄为 55 岁,范围为 38-80 岁)。较高的体重指数(BMI)和较低的用力呼气量/用力肺活量(FEV/FVC)比值是显著的危险因素(BMI:HR 1.072[95%CI 1.005-1.14],P=0.034;FEV/FVC 比值:HR 1.091[1.044-1.14],P=0.00011)。限制在特应性个体中,rs6967330 的 A 等位基因和较低的 FEV/FVC 比值与成人起病疾病相关(A 等位基因:HR 2.89[1.57-5.20],P=0.00062;FEV/FVC 比值:HR 1.10[1.04-1.17],P=0.0010)。
特应性个体中鼻病毒-C 感染的遗传易感性是慢性气道疾病的危险因素,即使在晚年也是如此。