Proximity to a Major Road, Vitamin D Insufficiency, and Severe Asthma Exacerbations in Puerto Rican Children

Vitamin D Counteracts an IL-23–Dependent IL-17A+IFN-γ+ Response Driven by Urban Particulate Matter

“…Furthermore, the synthetic corticosteroid dexamethasone was similarly capable of reducing the expression of NIST-driven maturation markers on CD1c 1 DCs, both alone and more prominently when added in combination with 1,25(OH) 2 D3 (Figure 4) Figure E3). These results might help to explain previous observations: for example, one study reported that vitamin D-insufficient children in Puerto Rico living close to a major road, and therefore to traffic-related air pollution, have an elevated risk of severe asthma exacerbations (34). Notably, in the European Study of Cohorts for Air Pollution Effects, the relative effect of air pollution on health outcomes differed between cohorts, with Scandinavian groups often being more sensitive despite having lower levels of ambient PM (35).…”

Folate Deficiency, Atopy, and Severe Asthma Exacerbations in Puerto Rican Children

“…with our results, may be explained by effects of vitamin D on viral illnesses (and thus viral-induced exacerbations), response to inhaled corticosteroids, or antioxidant effects (22,33).…”

“…For the multivariate analysis, we used negative binomial regression to analyze the degree of atopy (given the distribution of the number of skin tests) and logistic regression to analyze one or more severe asthma exacerbations in the previous year. Because of their potential correlation with plasma folate and atopy or severe asthma exacerbations, the following covariates were examined in bivariate analyses: age, sex, parental education (at least one parent completed high school vs. none), household income (, vs. > $15,000 [near the median income for households in Puerto Rico in 2008-2009]) (20), body mass index as z-score (based on CDC 2000 growth charts [21]), parental (paternal or maternal) history of asthma, current exposure to ETS, FEV 1 and FEV 1 /FVC, vitamin D insufficiency (22), and use of inhaled corticosteroids (ICS) in the previous 6 months. A stepwise approach was used to build the multivariate models.…”

Exposure to gun violence and asthma among children in Puerto Rico

“…Logistic regression was used to examine the relation between exposure to gun violence and asthma while adjusting for potential confounders. Because of their potential correlation with gun violence and asthma, the following covariates were examined in bivariate analyses: age, gender, parental history of asthma (paternal or maternal), parental education (at least one parent completed high school vs. none), household income (< vs. ≥ $15,000 [near the median income for households in Puerto Rico in 2008-2009])[11], prematurity[18], distance from the child’s residence to a major road (a marker of traffic-related air pollution)[19], exposure to ETS in early life ( in utero or before age 2 years), current exposure to ETS [20], and being afraid of leaving the home because of violence (from the perceived neighborhood safety questionnaire). A stepwise approach was used to build the multivariate models.…”