Severe Asthma: Pathogenesis and Clinical Management (Lung by Stanley J Szefler, Donald Y. M. Leung

By Stanley J Szefler, Donald Y. M. Leung

Supplying accomplished insurance of the pathophysiology, pharmacology, and administration of bronchial asthma from a multidisciplinary viewpoint, this completely revised and up-to-date reference studies the latest breakthroughs in antiinflammatory cures, natural medicinal drugs, airway home improvement, and ailment prevention thoughts.

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Several genome-wide screens for asthma susceptibility genes have been completed which have identified a large number of loci linked to both complex Table 1 Summary of Studies of Polymorphisms in Candidate and Association with Measures of Asthma Severity Gene Polymorphism Interleukin-4 (IL-4) C-589T Interleukin-4 receptor-α (IL-4RA) β 2-Adrenergic receptor (ADR-β 2 ) Tumor necrosis factor-α (TNF-α) Leukotriene C 4 synthase (LTC4S) Intron-2 repeat Q576R R16G A-308G A-444C Associated phenotype Reference FEV1 Ͻ 50% Fatal/near-fatal asthma Asthma severity (NAEPP) Asthma severity (NAEPP) Severe airway obstruction Nocturnal asthma Steroid-dependent asthma Severe asthma Not associated with fatal/nearfatal asthma Not associated with fatal/nearfatal asthma Aspirin-intolerant asthma (AIA) (41) (43) (42) (53) (43) (58) (66) (67) (87) (76) (88) 26 Holloway et al.

Eur J Respir Dis 1987; 70:171–179. 26. Hospers JJ, Postma DS, Schouten JP, Weiss ST, Rijcken B. Histamine airway hyperresponsiveness predicts mortality from COPD in a general population sample. Lancet. In press. 27. Wang X, Dockery DW, Wypij D, Fay ME, Ferris BG Jr. Pulmonary function between 6 and 18 years of age. Pediatr Pulmonol 1993; 15:75–88. 28. Rijcken, B. Bronchial Responsiveness and COPD Risk: an Epidemiological Study. Postdoctoral dissertation. 29. Stein RT, Holberg CJ, Morgan WJ, Wright AL, Lombardi E, Taussig L, Martinez FD.

There have been several other studies of familial correlation with asthma severity. 04). Wilson et al. identified that a positive family history of asthma was the only significant predictor of asthma severity in a study of children age 5 with a history of severe wheeze in childhood (23). , in a study of factors relating to asthma and severity in adolescents, concluded that genetic factors may contribute to severity by altering susceptibility to environmental factors, such as sensitization to allergens.

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