Gaietto Kristina, Yue Molin, Han Yueh Ying, Rosser Franziska J, Canino Glorisa, Forno Erick, Chen Wei, Celedón Juan C
University of Pittsburgh, Division of Pediatric Pulmonary Medicine, Pittsburgh, Pennsylvania, United States.
University of Pittsburgh, Pediatric Pulmonary Medicine, Pittsburgh, Pennsylvania, United States.
Ann Am Thorac Soc. 2025 Jun 23. doi: 10.1513/AnnalsATS.202502-151OC.
Exposure to violence has been associated asthma and worse asthma outcomes in youth, but no study has tested for an association between exposure to violence and specific asthma endotypes including T helper (T)2-low endotypes. We sought to determine if exposures to violence are associated with T2-high, T17-high, and T2-low/T17-low endotypes.
We analyzed data from Puerto Rican youth aged 9-20 years with (cases) and without (controls) asthma in the Epigenetic Variation and Childhood Asthma in Puerto Ricans study (EVA-PR). Using nasal (airway) epithelial transcriptomic profiles, participants with asthma were categorized into T2-high, T17-high, or T2-low/T17-low endotypes. Lifetime exposure to violence (ETV), past year ETV, and gun violence exposure (assessed using the validated ETV Scale questionnaire) and violence-related distress, assessed using the validated Checklist Children's Distress Symptoms questionnaire, were our exposures of interest, and asthma endotype was our outcome of interest.
There were 236 cases (69 (29%) T2-high, 82 (35%) T17-high, and 85 (36%) T2-low/T17-low) and 243 controls. In multivariable analyses, ETV was associated with T17-high asthma (odds ratio [OR]=1.13, 95% confidence interval [CI]=1.002-1.274), gun violence exposure was associated with both T2-high asthma (OR=2.49, 95% CI=1.22-5.08) and T17-high asthma (OR=1.99, 95% CI=1.05-3.74), and violence-related distress was associated with T2-high asthma (OR=1.69, 95% CI=1.11-2.59). Neither exposure to violence nor related distress was associated with T2-low/T17-low asthma.
Exposure to violence or related distress was associated with T2-high asthma and T17-high asthma, but not T2-low/T17-low asthma in Puerto Rican youth, a minoritized population with high asthma burden.
暴力暴露与青少年哮喘及更差的哮喘预后相关，但尚无研究检验暴力暴露与特定哮喘内型（包括2型辅助性T细胞（Th2）低表达内型）之间的关联。我们旨在确定暴力暴露是否与Th2高表达、17型辅助性T细胞（Th17）高表达以及Th2低表达/Th17低表达内型相关。
我们分析了波多黎各青少年表观遗传学变异与儿童哮喘研究（EVA-PR）中9至20岁患哮喘（病例）和未患哮喘（对照）的波多黎各青少年的数据。利用鼻腔（气道）上皮转录组谱，将哮喘患者分为Th2高表达、Th17高表达或Th2低表达/Th17低表达内型。我们感兴趣的暴露因素为终生暴力暴露（ETV）、过去一年的ETV、枪支暴力暴露（使用经过验证的ETV量表问卷进行评估）以及使用经过验证的儿童痛苦症状清单问卷评估的暴力相关痛苦，而哮喘内型是我们感兴趣的结局。
共有236例病例（69例（29%）为Th2高表达，82例（35%）为Th17高表达，85例（36%）为Th2低表达/Th17低表达）和243例对照。在多变量分析中，ETV与Th17高表达哮喘相关（比值比[OR]=1.13，95%置信区间[CI]=1.002-1.274），枪支暴力暴露与Th2高表达哮喘（OR=2.49，95%CI=1.22-5.08）和Th17高表达哮喘（OR=1.99，95%CI=1.05-3.74）均相关，暴力相关痛苦与Th2高表达哮喘相关（OR=1.69，95%CI=1.11-2.59）。暴力暴露及相关痛苦均与Th2低表达/Th17低表达哮喘无关。
在哮喘负担较高的少数族裔波多黎各青少年中，暴力暴露或相关痛苦与Th2高表达哮喘和Th17高表达哮喘相关，但与Th2低表达/Th17低表达哮喘无关。
