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1.
Br J Dermatol ; 169(3): 700-3, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23600999

RESUMO

BACKGROUND: The increased susceptibility of patients with atopic dermatitis (AD) to disseminated viral skin infections such as eczema herpeticum (ADEH+) is poorly understood. OBJECTIVES: The primary goal of the current study was to determine whether ADEH+ subjects have identifiable defects in cell-mediated immunity that reduce their ability to control viral infections. MATERIALS AND METHODS: In this study, we evaluated cytokine expression by various subsets of peripheral blood mononuclear cells from ADEH+ (n = 24) compared with AD without a history of viral infections (ADEH-) (n = 20) before and after treatment with herpes simplex virus (HSV). RESULTS: We found that interferon (IFN)-γ expression after HSV treatment was lower in the CD8+ T cells and monocytes from patients with ADEH+ compared with patients who are ADEH- or nonatopic. Given the induction of CD8+ T cells as the result of antigen presentation by human leucocyte antigen (HLA) class I, consistent with the findings described above we also found that the HLA B7 allele was significantly associated with risk of the ADEH+ phenotype (odds ratio = 1·91, P = 0·02, 125 ADEH+ and 161 ADEH- subjects). CONCLUSIONS: These data suggest that defects in viral-induced IFN-γ from CD8+ T cells contribute to the ADEH+ phenotype.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Dermatite Atópica/imunologia , Antígeno HLA-B7/imunologia , Imunidade Celular/fisiologia , Interferon gama/biossíntese , Erupção Variceliforme de Kaposi/imunologia , Linfócitos T CD8-Positivos/metabolismo , Estudos de Casos e Controles , Dermatite Atópica/complicações , Frequência do Gene , Antígeno HLA-B7/genética , Humanos , Erupção Variceliforme de Kaposi/complicações , Leucócitos Mononucleares/imunologia , Fenótipo
2.
Clin Exp Allergy ; 40(9): 1353-64, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20618347

RESUMO

BACKGROUND: Sensitization to cockroach allergen is one of the strongest predictors of asthma morbidity, especially among African Americans. OBJECTIVE: Our aims were to determine the genomic basis of cockroach sensitization and the specific response to cockroach antigen. METHODS: We investigated the Th1/Th2 cytokine profile of co-cultured plasmacytoid dendritic cells (pDCs) and CD4+ T cells and the 'transcript signature' of the immune response to cockroach antigen using high-throughput expression profiling of co-cultured cells. RESULTS: We observed significantly elevated levels of IL-13, IL-10, and TNF-alpha, but undetectable levels of IL-12p70 and IFN-alpha, when cultures were exposed to crude cockroach antigen. A significant difference was observed for IL-13 between cockroach-allergic and non-allergic individuals (P=0.039). Microarray analyses demonstrated a greater response at 48 h compared with 4 h, with 50 genes being uniquely expressed in cockroach antigen-treated cells, including CD14, S100A8, CCL8, and IFI44L. The increased CD14 expression was further observed in purified pDCs, human monocytic THP-1 cells, and the supernatant of co-cultured pDCs and CD4+ T cells on exposure to cockroach extract. Furthermore, the most differential expression of CD14 between cockroach allergy and non-cockroach allergy was only observed among individuals with the CC 'high-risk' genotype of the CD14-260C/T. Ingenuity Pathways Analysis analyses suggested the IFN signalling as the most significant canonical pathway. CONCLUSION: Our results suggest that these differentially expressed genes, particularly CD14, and genes in the IFN signalling pathway may be important candidates for further investigation of their role in the immune response to cockroach allergen.


Assuntos
Alérgenos/imunologia , Asma/genética , Baratas/imunologia , Citocinas/biossíntese , Perfilação da Expressão Gênica , Predisposição Genética para Doença , Interferon-alfa/imunologia , Receptores de Lipopolissacarídeos/genética , Adolescente , Adulto , Negro ou Afro-Americano , Animais , Asma/etnologia , Asma/imunologia , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/metabolismo , Técnicas de Cocultura , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Genótipo , Humanos , Interferon-alfa/metabolismo , Pessoa de Meia-Idade , Células Th2
3.
Allergy ; 65(12): 1566-75, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20560908

RESUMO

BACKGROUND: Single nucleotide polymorphisms (SNPs) in thymic stromal lymphopoietin (TSLP) have been associated with IgE (in girls) and asthma (in general). We sought to determine whether TSLP SNPs are associated with asthma in a sex-specific fashion. METHODS: We conducted regular and sex-stratified analyses of association between SNPs in TSLP and asthma in families of children with asthma in Costa Rica. Significant findings were replicated in whites and African-American participants in the Childhood Asthma Management Program, in African-Americans in the Genomic Research on Asthma in the African Diaspora study, in whites and Hispanics in the Children's Health Study, and in whites in the Framingham Heart Study (FHS). MAIN RESULTS: Two SNPs in TSLP (rs1837253 and rs2289276) were significantly associated with a reduced risk of asthma in combined analyses of all cohorts (P values of 2 × 10(-5) and 1 × 10(-5) , respectively). In a sex-stratified analysis, the T allele of rs1837253 was significantly associated with a reduced risk of asthma in males only (P = 3 × 10(-6) ). Alternately, the T allele of rs2289276 was significantly associated with a reduced risk of asthma in females only (P = 2 × 10(-4) ). Findings for rs2289276 were consistent in all cohorts except the FHS. CONCLUSIONS: TSLP variants are associated with asthma in a sex-specific fashion.


Assuntos
Asma/genética , Citocinas/genética , Predisposição Genética para Doença/genética , Caracteres Sexuais , População Negra/genética , Criança , Estudos de Coortes , Costa Rica , Feminino , Predisposição Genética para Doença/etnologia , Estudo de Associação Genômica Ampla , Genótipo , Hispânico ou Latino/genética , Humanos , Masculino , Polimorfismo de Nucleotídeo Único , Fatores de Risco , População Branca/genética , Linfopoietina do Estroma do Timo
4.
Eur Respir J ; 34(1): 103-10, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19196818

RESUMO

Only a fraction of all smokers develop chronic obstructive pulmonary disease (COPD), suggesting a large role for genetic susceptibility. The leptin receptor (LEPR) is present in human lung tissue and may play a role in COPD pathogenesis. The present study examined the association between genetic variants in the LEPR gene and lung function decline in COPD. In total, 429 European Americans were randomly selected from the National Heart Lung and Blood Institute Lung Health Study. 36 single nucleotide polymorphisms (SNPs) in LEPR were genotyped using the Illumina GoldenGate platform (Broad Institute, Cambridge, MA, USA). Mean annual decline in forced expiratory volume in 1 s % predicted over the 5-yr period was calculated using linear regression. Linear regression models were also used to adjust for potential confounders. In addition, in vivo expression of the receptor gene was assessed with immunohistochemistry on lungs from smoke-exposed inbred mice. We identified significant associations (p<0.05) between lung function decline and 21 SNPs. Haplotype analyses confirmed several of these associations seen with individual markers. Immunohistochemistry results in inbred mice strains support a potential role of LEPR in COPD pathogenesis. We identified genetic variants in the LEPR gene significantly associated with lung function decline in a population of smokers with COPD. Our results support a role for LEPR as a novel candidate gene for COPD.


Assuntos
Pulmão/fisiopatologia , Polimorfismo de Nucleotídeo Único , Doença Pulmonar Obstrutiva Crônica/sangue , Doença Pulmonar Obstrutiva Crônica/metabolismo , Receptores para Leptina/genética , Adulto , Alelos , Animais , Feminino , Regulação da Expressão Gênica , Genótipo , Humanos , Imuno-Histoquímica , Pulmão/metabolismo , Masculino , Camundongos , Pessoa de Meia-Idade
5.
J Thromb Haemost ; 5(8): 1617-23, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17663734

RESUMO

BACKGROUND: Variations in platelet function among individuals may be related to differences in platelet-related genes. The major goal of our study was to estimate the contribution of inheritance to the variability in platelet function in unaffected individuals from white and African American families with premature coronary artery disease. METHODS: Platelet reactivity, in the absence of antiplatelet agents, was assessed by in vitro aggregation and the platelet function analyzer closure time. Heritability was estimated using a variance components model. RESULTS: Both white (n = 687) and African American (n = 321) subjects exhibited moderate to strong heritability (h(2)) for epinephrine- and adenosine diphosphate-induced aggregation (0.36-0.42 for white and >0.71 for African American subjects), but heritability for collagen-induced platelet aggregation in platelet-rich plasma was prominent only in African American subjects. Platelet lag phase after collagen stimulation was heritable in both groups (0.47-0.50). A limited genotype analysis demonstrated that the C825T polymorphism of GNB3 was associated with the platelet aggregation response to 2 muM epinephrine, but the effect differed by race. CONCLUSIONS: Considering the few and modest genetic effects reported to affect platelet function, our findings suggest the likely existence of undiscovered important genes that modify platelet reactivity, some of which affect multiple aspects of platelet biology.


Assuntos
Plaquetas/fisiologia , Doença da Artéria Coronariana/sangue , Adulto , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/etnologia , Saúde da Família , Feminino , Fibrinogênio/metabolismo , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Agregação Plaquetária , Polimorfismo Genético , Trombose/complicações , Trombose/diagnóstico , Tromboxano B2/sangue , Fator de von Willebrand/metabolismo
6.
Ann Hum Genet ; 72(Pt 1): 115-25, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18042270

RESUMO

The Regression of Offspring on Mid-Parent (ROMP) method is a test of association between a quantitative trait and a candidate locus. ROMP estimates the trait heritability and the heritability attributable to a locus and requires genotyping the offspring only. In this study, the theory underlying ROMP was revised (ROMP(rev)) and extended. Computer simulations were used to determine the type I error and power of the test of association, and the accuracy of the locus-specific heritability estimate. The ROMP(rev) test had good power at the 5% significance level with properly controlled type I error. Locus-specific heritability estimates were, on average, close to simulated values. For non-zero locus-specific heritability, the proposed standard error was downwardly biased, yielding reduced coverage of 95% confidence intervals. A bootstrap approach with proper coverage is suggested as a second step for loci of interest. ROMP(rev) was applied to a study of cardiovascular-related traits to illustrate its use. An association between polymorphisms within the fibrinogen gene cluster and plasma fibrinogen was detected (p < 0.005) that accounted for 29% of the estimated fibrinogen heritability. The ROMP(rev) method provides a computationally fast and simple way of testing for association and obtaining accurate estimates of locus-specific heritability while minimizing the genotyping required.


Assuntos
Doenças Cardiovasculares/genética , Núcleo Familiar , Pais , Locos de Características Quantitativas , Projetos de Pesquisa , Simulação por Computador , Fibrinogênio/genética , Humanos , Coreia (Geográfico) , Família Multigênica , Polimorfismo Genético , Análise de Regressão
7.
Eye (Lond) ; 21(3): 395-401, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16440015

RESUMO

PURPOSE: The main objective of this study was to evaluate if the -429T/C, -374T/A and 63 bp deletion polymorphisms in the RAGE gene are associated with diabetic retinopathy (DR) among Type 2 diabetic subjects in a clinic-based population from South India. METHODS: We screened 149 normal glucose tolerant subjects (NGT), 189 Type 2 diabetes subjects without retinopathy (DM) and 190 subjects with DR for these polymorphisms using the PCR-RFLP method. DR was diagnosed by grading color fundus photography. Logistic regression models were used to evaluate the association of individual polymorphisms with DR. Expectation-maximization algorithms were implemented in haplotype tests of association to examine the combined effects of -429T/C and -374T/A polymorphisms on DR. RESULTS: The allelic frequencies of -429T are 0.83 in NGT, 0.84 in DM and 0.85 in DR subjects, and that of -374T are 0.93 in NGT, 0.92 in DM and 0.88 in DR subjects. The -374 polymorphism was found to be associated with non-proliferative retinopathy when this subgroup was compared to the DM group (OR=1.814, 95% CI=1.005-3.273). However, this association was not obvious when both the subphenotypes of DR (the nonproliferative and proliferative DR groups) were studied jointly. We found no evidence for associations between the -429T/C polymorphism and the DR phenotype. Finally, extension to a 2-SNP haplotype did not reveal any significant statistical difference between the groups (P=0.668). CONCLUSION: In this study, we found a modest association with the -374T/A polymorphism in the nonproliferative DR subgroup.


Assuntos
Diabetes Mellitus Tipo 2/genética , Retinopatia Diabética/genética , Polimorfismo Genético/genética , Receptores Imunológicos/genética , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Retinopatia Diabética/sangue , Retinopatia Diabética/epidemiologia , Feminino , Deleção de Genes , Frequência do Gene/genética , Haplótipos , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fenótipo , Polimorfismo de Nucleotídeo Único/genética , Regiões Promotoras Genéticas/genética , Receptor para Produtos Finais de Glicação Avançada
8.
Genes Immun ; 7(1): 27-35, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16355111

RESUMO

Proinflammatory and immunoregulatory products from C3 play a major role in phagocytosis, respiratory burst, and airways inflammation. C3 is critical in adaptive immunity; studies in mice deficient in C3 demonstrate that features of asthma are significantly attenuated in the absence of C3. To test the hypothesis that the C3 gene on chromosome 19p13.3-p13.2 contains variants associated with asthma and related phenotypes, we genotyped 25 single nucleotide polymorphism (SNP) markers distributed at intervals of approximately 1.9 kb within the C3 gene in 852 African Caribbean subjects from 125 nuclear and extended pedigrees. We used the multiallelic test in the family-based association test program to examine sliding windows comprised of 2-6 SNPs. A five-SNP window between markers rs10402876 and rs366510 provided strongest evidence for linkage in the presence of linkage disequilibrium for asthma, high log[total IgE], and high log[IL-13]/[log[IFN-gamma] in terms of global P-values (P = 0.00027, 0.00013, and 0.003, respectively). A three-SNP haplotype GGC for the first three of these markers showed best overall significance for the three phenotypes (P = 0.003, 0.007, 0.018, respectively) considering haplotype-specific tests. Taken together, these results implicate the C3 gene as a priority candidate controlling risk for asthma and allergic disease in this population of African descent.


Assuntos
Asma/genética , População Negra , Complemento C3/genética , Predisposição Genética para Doença , Barbados/etnologia , População Negra/etnologia , Região do Caribe/etnologia , Variação Genética , Genótipo , Humanos , Fenótipo , Polimorfismo de Nucleotídeo Único
9.
Genet Epidemiol ; 21 Suppl 1: S198-203, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11793669

RESUMO

The goal of this study is to determine the linkage relationship between IgE levels and the 269 microsatellite markers using the Genetic Analysis Workshop 12 Busselton data set. Analyses were carried out using both traditional and new Haseman-Elston methods, the maximum likelihood quantitative trait locus estimation (MLE QTL) method and the nonparametric (NP QTL) method. Our analyses confirmed some of the signals reported by Daniels et al. [Nature 383:247-50, 1996]. We also observed that several significant signals reported in the original report became insignificant (D6S76 and D11S96) and several new signals showed up after the data were reanalyzed using the new Haseman-Elston method, the MLE QTL method, and the NP QTL method. Based on the original and the current analyses, we recommend that follow-up studies of three regions including D7S2250, FCER1B, D11S901, and six markers on chromosome 16 be given higher priority.


Assuntos
Asma/genética , Mapeamento Cromossômico/estatística & dados numéricos , Característica Quantitativa Herdável , Adulto , Asma/epidemiologia , Criança , Feminino , Frequência do Gene , Marcadores Genéticos/genética , Genética Populacional , Humanos , Imunoglobulina E/sangue , Funções Verossimilhança , Masculino , Repetições de Microssatélites/genética , Fenótipo , Austrália Ocidental
10.
Am J Phys Anthropol ; 112(1): 29-38, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10766941

RESUMO

In this study we describe inbreeding in a large pedigree from Tangier Island, Virginia, in which we compare two commonly used methods to estimate inbreeding in humans: pedigree and isonymy (identical surnames of spouses). Genealogical data on 3,512 individuals dating back to 1722 were used. Using the pedigree method, we determined an average inbreeding coefficient (F) of 0.00873 for the community as a whole, and 0.018 for inbred individuals. Analysis of temporal trends showed that inbreeding began around 1800 and peaked at 0.0109 in 1824-1849 and 1875-1899. Thereafter, inbreeding steadily declined to 0.00565 in 1975-1997. Analysis of pedigree structure complexity over time showed that close consanguinity contributes to inbreeding in the earlier cohorts, and remote consanguinity accounts for much of the inbreeding in the later cohorts. The number of common ancestors increases over time, as does the number of paths connecting inbred individuals to these common ancestors. Inbreeding estimates based on the isonymy approach yielded a 2.2-fold higher value of F (0.01945) compared to the pedigree method. Total isonymy estimates over 25-year cohorts overestimated inbreeding values from pedigree data between 1. 5-8-fold. We speculate that the overestimation is probably due to the inability of our data to satisfy the method's assumption of monophyletic origin of each surname. In conclusion, inbreeding in the Tangier Island population is consistent with the isolated nature of its population, and temporal trends reflect patterns in emigration and a breakdown in isolation over time.


Assuntos
Consanguinidade , Genética Populacional , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Emigração e Imigração , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Nomes , Linhagem , Virginia
11.
Genet Epidemiol ; 17 Suppl 1: S193-8, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10597435

RESUMO

Multipoint linkage analysis was used to screen for evidence of linkage between alcoholism and five alcoholism-related quantitative traits. The results suggest that a susceptibility locus that influences monoamine oxidase activity and P300 amplitude at the Pz lead, and increases the risk of alcohol dependence may be linked to markers in the 12q24 region. Furthermore, the susceptibility for alcoholism may be associated with allele 3 (allele size 144) of D12S392.


Assuntos
Alcoolismo/genética , Cromossomos Humanos Par 12 , Potenciais Evocados P300/genética , Ligação Genética , Monoaminoxidase/genética , Alcoolismo/enzimologia , Alcoolismo/epidemiologia , Alcoolismo/fisiopatologia , Mapeamento Cromossômico , Marcadores Genéticos , Testes Genéticos , Genoma , Humanos , Escore Lod , Característica Quantitativa Herdável , Estatísticas não Paramétricas
12.
Genet Epidemiol ; 17 Suppl 1: S643-8, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10597507

RESUMO

The effect of inclusion of environmental risk factors on the power of sib-pair linkage methods was tested for a qualitative trait. It was found that inclusion of an environmental variable did not increase the power of the Haseman-Elston (H-E) sib-pair nonparametric linkage analysis test. However, a significant increase in power was observed for both the H-E and affected-sib-pair tests, even in small samples, when persons unexposed to the environmental risk factor were coded as unknown.


Assuntos
Meio Ambiente , Ligação Genética , Modelos Genéticos , Predisposição Genética para Doença , Testes Genéticos , Genoma , Genótipo , Humanos , Núcleo Familiar , Característica Quantitativa Herdável
13.
Clin Exp Allergy ; 34(5): 736-44, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15144465

RESUMO

BACKGROUND: The inflammatory functions of complement component 5 (C5) are mediated by its receptor, C5R1, which is expressed on bronchial, epithelial, vascular endothelial and smooth muscle cells. A susceptibility locus for murine allergen-induced airway hyper-responsiveness was identified in a region syntenic to human chromosome 19q13, where linkage to asthma has been demonstrated and where the gene encoding C5R1 is localized. OBJECTIVE: The aim of this study was to screen for novel polymorphisms in the C5R1 gene and to determine whether any identified polymorphisms are associated with asthma and/or atopy and whether they are functional. METHODS: Single-nucleotide polymorphism (SNP) detection in the gene encoding C5R1 was performed by direct sequencing. Genotyping was performed in three populations characterized for asthma and/or atopy: (1) 823 German children from The Multicenter Allergy Study; (2) 146 individuals from Tangier Island, Virginia, a Caucasian isolate; and (3) asthma case-parent trios selected from 134 families (N=783) in Barbados. Functional studies were performed to evaluate differences between the wild-type and the variant alleles. RESULTS: We identified a novel SNP in the promoter region of C5R1 at position -245 (T/C). Frequency of the -245C allele was similar in the German (31.5%) and Tangier Island (36.3%) populations, but higher in the Afro-Caribbean population (53.0%; P=0.0039 to <0.0001). We observed no significant associations between the -245 polymorphism and asthma or atopy phenotypes. Upon examination of the functional consequences of the -245T/C polymorphism, we did not observe any change in promoter activity. CONCLUSION: This new marker may provide a valuable tool to assess the risk for C5a-associated disorders, but it does not appear to be associated with asthma and/or atopy.


Assuntos
Asma/genética , Cromossomos Humanos Par 19 , Hipersensibilidade/genética , Proteínas de Membrana/genética , Mutação Puntual , Regiões Promotoras Genéticas/genética , Receptores de Complemento/genética , Asma/etnologia , Asma/imunologia , Barbados , Sequência de Bases , População Negra , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Expressão Gênica , Frequência do Gene , Alemanha , Humanos , Hipersensibilidade/etnologia , Hipersensibilidade/imunologia , Lactente , Recém-Nascido , Masculino , Dados de Sequência Molecular , Receptor da Anafilatoxina C5a , Transfecção/métodos , Células U937 , Estados Unidos , População Branca
14.
Genomics ; 71(2): 246-51, 2001 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-11161818

RESUMO

Genetic heterogeneity has been proposed as a hallmark feature of allergic disease. To test the hypothesis that total IgE levels are jointly influenced by a locus on chromosome 12q21.1-q21.31 and a locus on 17q11.2-q21.2, we conducted multipoint allele-sharing analyses using nonparametric linkage (NPL) methods on Afro-Caribbean families from Barbados to test for evidence of gene-gene interactions. Significant correlations were observed between NPL scores at D12S1052 and both D17S1293 and D17S1299 for a dichotomized phenotype of total IgE. An analysis of family-specific NPL scores revealed that evidence for interaction was being driven largely by one multiplex pedigree (NPL = 12.01, 12.23, and 12.16 at D12S1052, D17S1293, and D17S1299, respectively). Using the programs SIMWALK (v2.0) and GOLD, a different set of haplotypes in this influential family was observed around D12S1052 and the 17q loci compared to the other Barbados pedigrees. Our findings are a classic example of founder effect, provide evidence for sensitivity of this type of linkage analysis to unusual pedigrees, and highlight an element of genetic heterogeneity that has been given little attention in the study of complex traits.


Assuntos
Heterogeneidade Genética , Ligação Genética/genética , Imunoglobulina E/genética , Asma/epidemiologia , Barbados/epidemiologia , Cromossomos Humanos Par 12/genética , Cromossomos Humanos Par 17/genética , Saúde da Família , Feminino , Regulação da Expressão Gênica/genética , Marcadores Genéticos , Predisposição Genética para Doença , Haplótipos , Humanos , Hipersensibilidade/genética , Imunoglobulina E/metabolismo , Masculino , Linhagem , Fenótipo
15.
J Allergy Clin Immunol ; 104(4 Pt 1): 791-6, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10518823

RESUMO

BACKGROUND: Defining the phenotype is critical for investigating the genetic etiology of asthma. As part of the Collaborative Study on the Genetics of Asthma (CSGA), the primary objective of which is to identify asthma susceptibility loci, an algorithm was designed to determine diagnoses of definite asthma, probable asthma, less than probable asthma, or no asthma. A respiratory questionnaire was designed to assist in the process of characterizing the asthma phenotype. OBJECTIVE: This study was designed to determine the validity of the CSGA algorithm for the diagnosis of asthma, to determine agreement in assessing an asthma diagnosis between the information obtained by the CSGA questionnaire versus a patient interview by a panel of specialist physicians, and to determine the degree to which objective tests would alter the questionnaire-based certainty of asthma diagnosis. METHODS: An expert panel of asthma clinicians (n = 4) indicated to what degree they were certain that a subject (n = 48) had asthma as determined by using a 6-point Likert scale based on a 20-minute interview (phase I), a review of the CSGA questionnaire (phase II), a review of the questionnaire plus skin test and peripheral blood eosinophilia data (phase III), and a review of phase III information plus pulmonary data (spirometry and methacholine-reversibility testing; IV). Intraclass correlation coefficients (ICCs) were calculated between the physicians' interpretation of the likelihood of asthma based on the information they received during each of the phases and between the CSGA algorithm and each of the phases. RESULTS: Interjudge reliability with regard to the degree of certainty with which an asthma diagnosis could be made by interview was excellent (ICC, 98; 95% confidence intervals [95% CIs], 0.87-0.99). We also found that the agreement between the physicians' interview with the patients (phase I) and the CSGA algorithm was good and at least as good with the addition of the CSGA questionnaire data and objective data (ICC, 0. 65-0.75). Good agreement was also observed between the average certainty score from the interview and the CSGA questionnaire (ICC, 92; 95% CI, 0.76-0.93), and ICCs determining the agreement on asthma diagnosis between phase I and phases III and IV, in which objective data were introduced, did not change from the ICCs comparing phase I with phase II (ICC of 0.93 [95% CI, 0.79-0.96] and ICC of 0.91 [95% CI 0.73-0.95], respectively). CONCLUSION: We conclude that the CSGA algorithm is a valid tool for which the diagnosis of asthma can be made at an acceptable level of certainty and that the CSGA questionnaire, interpreted by an asthma specialist, is a useful tool for the diagnosis of asthma in clinical or epidemiologic studies.


Assuntos
Algoritmos , Asma/diagnóstico , Entrevistas como Assunto , Inquéritos e Questionários , Asma/genética , Eosinofilia/diagnóstico , Prova Pericial , Feminino , Humanos , Contagem de Leucócitos , Masculino , Variações Dependentes do Observador , Médicos , Reprodutibilidade dos Testes , Testes Cutâneos
16.
Genet Epidemiol ; 20(3): 340-55, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11255243

RESUMO

Variance components models were used to analyze total IgE levels in families ascertained though the Collaborative Study of the Genetics of Asthma (CSGA) using a genome-wide array of polymorphic markers. While IgE levels are known to be associated with clinical asthma and recognized to be under strong genetic control (here the heritability was estimated at 44-60% in the three racial groups), specific genes influencing this trait are still largely unknown. Multipoint analysis of 323 markers yielded little indication of specific regions containing a trait locus controlling total serum IgE levels (adjusted for age and gender). Although a number of regions showed LOD statistics above 1.5 in Caucasian families (chromosome 4) and in African-American families (chromosomes 2 and 4), none yielded consistent evidence in all three racial groups. Analysis of total IgE adjusted for gender, age and Allergy Index (a quantitative score of skin test sensitivity to 14 common aeroallergens) was conducted on these data. In this analysis, a much stronger signal for a trait locus controlling adjusted log[total IgE] was seen on the telomeric end of chromosome 18, but only in Caucasian families. This region accounted for most of the genetic variation in log[total IgE], and may represent a quantitative trait locus for IgE levels independent of atopic response. Oligogenic analysis accounting simultaneously for the contribution of this locus on chromosome 18 and other chromosomal regions showing some evidence of linkage in these Caucasian families (on chromosomes 2, 4 and 20) failed to yield significant evidence for interaction.


Assuntos
Asma/genética , Mapeamento Cromossômico/métodos , Imunoglobulina E/genética , Modelos Genéticos , Marcadores Genéticos/genética , Genoma Humano , Genótipo , Humanos , Imunoglobulina E/sangue , Testes Cutâneos
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