Differences in allergic sensitization by self-reported race and genetic ancestry

Yang, James; Burchard, Esteban G.; Choudhry, Shweta; Johnson, Christine Cole; Ownby, Dennis R.; Favro, David; Chen, Justin; Akana, Matthew; Ha, Connie; Kwok, Pui‐Yan; Krajenta, Richard; Havstad, Suzanne; Joseph, Christine L.M.; Seibold, Max A.; Shriver, Mark D.; Williams, L. Keoki

doi:10.1016/j.jaci.2008.07.044

Cited by 59 publications

(58 citation statements)

References 32 publications

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“…Moreover, the exact mechanisms involved in the hypersensitivity related to BZN are difficult to identify and may be mediated either by IgE-or non-IgE-dependent pathways (37). Recently, the same complexity in understanding immunological mechanisms was reported for drug allergy; however, race and genetics are increasingly appearing to be important in the predisposition to certain types of drug allergies (38,39).…”

Section: Discussionmentioning

confidence: 99%

A Clinical Adverse Drug Reaction Prediction Model for Patients with Chagas Disease Treated with Benznidazole

Silva

Mediano

Brasil

et al. 2014

Antimicrob Agents Chemother

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Benznidazole (BZN) is the main trypanocidal drug used to treat Chagas disease, and the evidence supporting the benefits of BZN use during the chronic phase of the disease will favor its use in millions of individuals. However, more than 30% of patients treated with BZN may suffer adverse drug reactions (ADRs), and the development of tools to identify those patients at risk is highly desirable. In the present study, we aimed to identify predictive factors for ADRs in Chagas disease patients treated with BZN. Among 195 patients included in the study, 48.7% experienced ADRs and 31.3% had ADRs that caused BZN treatment discontinuation. Overall ADRs and ADRs that caused BZN treatment discontinuation were more common among women and in those who graduated from elementary school. Overall ADRs were also less frequent among black individuals. Based on logistic regression analysis, female sex (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.5 to 5.4), graduation from elementary school (OR, 2.0; 95% CI, 1.1 to 3.8), and white (OR, 5.0; 95% CI, 1.0 to 24.1) and mulatto (OR, 5.6; 95% CI, 1.1 to 28.7) races were considered to predict overall ADRs, and female sex (OR, 2.3; 95% CI, 1.2 to 4.3) was considered to predict ADRs that caused BZN treatment discontinuation. Graduation from elementary school also presented a tendency to predict ADRs that caused BZN treatment discontinuation (OR, 1.8; 95% CI, 0.9 to 3.6). The logistic regression (LR) models to predict ADRs to BZN described in this study may become important tools to minimize ADRs and improve patients' compliance and thus assist physicians treating patients with Chagas disease with BZN. E ven 100 years after it was first reported (1), Chagas disease remains a serious public health problem in Latin America, with a high social and economic burden (2, 3). Moreover, the prevalence of Chagas disease is increasing, mainly due to migration, in countries where it is not endemic, such as the United States and European countries (4-7).Benznidazole (BZN) is the main trypanocidal drug used to treat Chagas disease (8, 9), and the parasitological cure rate when patients are treated with BZN during the acute phase of the disease is almost 80% (10, 11). Although BZN effectiveness during the chronic phase of the disease remains uncertain (12)(13)(14), there is compelling evidence supporting the beneficial use of BZN even during the chronic phase of Chagas disease (13, 15), and some international guidelines are now advocating the use of BZN even among adults with chronic disease (16-18). However, adverse drug reactions (ADRs) occur in 30% to 87% of the patients treated with BZN (19-21), and 12% to 29% of patients fail to complete their full course of treatment (19-21). Therefore, the development of tools to identify patients with high probabilities of developing ADRs to BZN is highly desirable, as this strategy would improve compliance to BZN treatment and minimize complications (21,22).Logistic regression (LR) is a method often used to predict outcomes in health studies (23,24), and...

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Section: Discussionmentioning

confidence: 99%

A Clinical Adverse Drug Reaction Prediction Model for Patients with Chagas Disease Treated with Benznidazole

Silva

Mediano

Brasil

et al. 2014

Antimicrob Agents Chemother

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“…However, the association of race/ethnicity with nocturnal symptoms was still present among individuals with BMI less than 25. Population-level differences in allergic sensitization by race/ethnicity are well described (44,45) and also could contribute to asthma severity (46,47). Therefore, future analyses could investigate these and other potential mechanisms (e.g., sleep studies, allergic sensitivity testing, and nocturnal spirometry).…”

Section: Nocturnal Asthma Rates Between Africanmentioning

confidence: 99%

Nocturnal Asthma and the Importance of Race/Ethnicity and Genetic Ancestry

Levin

Wang

Wells³

et al. 2014

Am J Respir Crit Care Med

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Rationale: Nocturnal asthma is a common presentation and is associated with a more severe form of the disease. However, there are few epidemiologic studies of nocturnal asthma, particularly in minority populations.Objectives: To identify factors associated with nocturnal asthma, including the contribution of self-identified race/ethnicity and genetic ancestry.Methods: The analysis included individuals from the Study for Asthma Phenotypes and Pharmacogenomic Interactions by Race-ethnicity (SAPPHIRE) cohort. Nocturnal asthma symptoms were assessed by questionnaire. Genome-wide genotype data were used to estimate genetic ancestry in a subset of African American participants. Logistic regression was used evaluate the association of various factors with nocturnal asthma, such as self-identified race/ethnicity and genetic ancestry. Measurement and Main Results:The study comprised 3,380 African American and 1,818 European Americans individuals with asthma. After adjusting for other potential explanatory variables, including controller medication use, African Americans were more than twice as likely (odds ratio, 2.56; 95% confidence interval, 2.24-2.93) to report nocturnal asthma when compared with European American individuals. Among the subset of African American participants with genome-wide genotype data (n = 1,040), estimated proportion of African ancestry was also associated with an increased risk of nocturnal asthma (P = 0.007). Differences in lung function explained a small, but statistically significant (P = 0.02), proportion of the relationship between genetic ancestry and nocturnal asthma symptoms.Conclusions: Both self-identified race/ethnicity and African ancestry appear to be independent predictors of nocturnal asthma. The mechanism by which genetic ancestry contributes to populationlevel differences in nocturnal asthma appears to be largely independent of lung function.

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“…11 African ancestry has been associated with higher total or allergen-specific IgEs in some but not all previous reports. 7,9,10,42 Of note, none of the studies referenced previously examined whether exposure to violence explains or modifies the observed association between African ancestry and asthma. Estimates obtained from multivariate models adjusted for age, sex, exposure to environmental tobacco smoke in utero or before 2 years of age, household income, maternal asthma, case-control status, and study site.…”

Section: Discussionmentioning

confidence: 99%