Exposure to violence and asthma in Puerto Rican youth with high Th2 immunity

Pediatr Pulmonol. 2023 Aug;58(8):2289-2297. doi: 10.1002/ppul.26483. Epub 2023 May 16.

Abstract

Background: Little is known about the determinants of asthma among youth with high T helper 2 (Th2) immunity. We hypothesized that exposure to violence (ETV) and violence-related distress are associated with asthma in children and adolescents with high Th2 immunity.

Methods: We analyzed data from Puerto Ricans with high Th2 immunity aged 9-20 years in the Puerto Rico Genetics of Asthma and Lifestyle (PR-GOAL) and the Epigenetic Variation of Childhood Asthma in Puerto Ricans (EVA-PR) studies, and in a prospective study (PROPRA). High Th2-immunity was defined as ≥1 positive allergen-specific IgE and/or a total IgE ≥ 100 IU/mL and/or an eosinophil count ≥ 150 cells/μL. Asthma was defined as physician-diagnosed asthma and current wheeze. ETV and violence-related distress were assessed with the validated ETV Scale and Checklist of Children's Distress Symptoms (CCDS) questionnaires, respectively.

Results: In multivariable analyses, each 1-point increment in ETV score was significantly associated with 1.13-1.17 times increased odds of asthma in PR-GOAL and in EVA-PR (both at p ≤ 0.01), and each 1-point increment in CCDS score was significantly associated with 1.53-1.54 increased odds of asthma in PR-GOAL and in EVA-PR (both at p ≤ 0.03). Further, a persistently high ETV score was significantly associated with asthma in PROPRA (odds ratio [OR] = 2.83, 95% confidence interval [CI] = 1.10-7.29). Similar results were obtained in a sensitivity analysis using an eosinophil count ≥ 300 cells/μL instead of ≥150 cells/μL to define high Th2 immunity.

Conclusions: ETV during childhood is associated with increased risk of persistent or new-onset asthma in youth with high Th2 immunity.

Keywords: childhood asthma; high Th2 immunity; violence.

MeSH terms

  • Adolescent
  • Asthma* / epidemiology
  • Asthma* / etiology
  • Asthma* / immunology
  • Child
  • Eosinophils / immunology
  • Exposure to Violence* / ethnology
  • Hispanic or Latino
  • Humans
  • Immunoglobulin E / analysis
  • Immunoglobulin E / immunology
  • Prospective Studies
  • Psychological Distress
  • Puerto Rico / epidemiology
  • Th2 Cells / immunology
  • Violence
  • Young Adult

Substances

  • Immunoglobulin E