Acute Effects of Walking Environment and GSTM1 Variants in Children With Asthma

Abstract

Background:Exercise in air polluted by traffic emissions may aggravate airway inflammation in children with asthma, particularly those who produce decreased glutathione-S transferase (GST) as a result of GSTM1 gene deletion. Objectives: This pilot crossover study investigated whether children with asthma experience more airway changes when exercising outdoors near roadways than when exercising indoors. It also examined differences in risk between children with and without GSTM1 deletion. Method: Children between the ages of 5 and 12 years were assigned to groups and walked daily for 1 week in each exercise condition. Airway inflammation indicated by exhaled nitric oxide (eNO) and pulmonary functions measured as forced expiratory volume in 1 s (FEV1) and mid-expiratory flow rate were measured at baseline and at three intervals during the walking program. Independent variables of interest included walking condition (place), time of walking, genotype, and particulate matter (PM) exposure. Results: A linear mixed models approach was used to investigate the contributions of targeted variables to respiratory outcomes. Results indicated that walking location and ambient level of ultrafine particulates during walking influenced function of small airways. Absence of one or both alleles for the GSTM1 gene did not influence airway function acutely. Discussion: Mid-expiratory flow (FEF_25-75) may be more informative than FEV1 in studies of acute lung function changes in children with asthma. Further study of the effects of varied environmental conditions on lower airway function of children is needed to optimize exercise experiences for urban children with asthma.

Keywords

asthma pollution exercise childhood asthma environment GST gene

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References

American Lung Association. (2007). State of lung disease in diverse communities: 2007. Retrieved from http://www.lungusa.org/assets/documents/publications/lung-disease-data/SOLDDC_2007.pdf

American Thoracic Society and European Respiratory Society. (2005). ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide. American Journal of Respiratory and Critical Care Medicine, 171, 912–930.

Arshad

S. H.

Kurukulaaratchy

R. J.

(2005). Early life risk factors for current wheeze, asthma, and bronchial hyperresponsiveness at 10 years of age. Chest, 127, 502–508.

Board

P. G.

(1981). Biochemical genetics of glutathione-S-transferase in man. American Journal of Human Genetics, 33, 36–43.

Brunekreef

Janssen

N. A. H.

de Hartog

Harssema

Knape

van Vliet

(1997). Air pollution from traffic and lung function in children living near motorways. Epidemiology, 8, 298–303.

Carroll

W. D.

Lenney

Jones

P. W.

Strange

R. C.

Child

Whyte

M. K.

Fryer

A. A.

(2005). Effects of glutathione S-transferase M1, T1 and P1 on lung function in asthmatic families. Clinical and Experimental Allergy, 35, 1155–1161. doi:10.1111/j.1365-2222.2005.02313.x

Centers for Disease Control and Prevention. (2004).Behavioral risk factor surveillance system (BRFSS) prevalence data Atlanta, GA: Author.

Ciccone

Forastiere

Agabiti

Biggeri

Bisanti

Chellini

Viegi

(1998). Road traffic and adverse respiratory effects in children. SIDRIA collaborative group. Occupational and Environmental Medicine, 55, 771–778.

Clark

N. A.

Demers

P. A.

Karr

C. J.

Koehoorn

Lencar

Tamburic

Brauer

(2010). Effect of early life exposure to air pollution on development of childhood asthma. Environmental Health Perspectives, 118, 284–290. doi:10.1289/ehp.0900916

10.

Cornelius

M. D.

Goldschmidt

Dempsey

D. A.

(2003). Environmental tobacco smoke exposure in low-income 6-year-olds: Parent report and urine cotinine measures. Nicotine & Tobacco Research, 5, 333–339.

11.

Delfino

R. J.

(2002). Epidemiologic evidence for asthma and exposure to air toxics: Linkages between occupational, indoor, and community air pollution research. Environmental Health Perspectives, 110, 573–589.

12.

Desqueyroux

Pujet

J. C.

Prosper

Squinazi

Momas

(2002). Short-term effects of low-level air pollution on respiratory health of adults suffering from moderate to severe asthma. Environmental Research, 89, 29–37.

13.

Duhme

Weiland

S. K.

Keil

Kraemer

Schmid

Stender

Chambless

(1996). The association between self-reported symptoms of asthma and allergic rhinitis and self-reported traffic density on street of residence in adolescents. Epidemiology, 7, 578–582.

14.

Edwards

Walters

Griffiths

R. K.

(1994). Hospital admissions for asthma in preschool children: Relationship to major roads in Birmingham. Archives of Environmental Health, 49, 223–227.

15.

English

Neutra

Scalf

Sullivan

Waller

Zhu

(1999). Examining associations between childhood asthma and traffic flow using a geographic information system. Environmental Health Perspectives, 107, 761–767.

16.

Garte

Gaspari

Alexandrie

A. K.

Ambrosone

Autrup

J. L.

Taioli

(2001). Metabolic gene polymorphism frequencies in control populations. Cancer Epidemiology, Biomarkers & Prevention, 10, 1239–1248.

17.

Gauderman

W. J.

Vora

McConnell

Berhane

Gilliland

Thomas

Peters

(2007). Effect of exposure to traffic on lung development from 10 to 18 years of age: A cohort study. Lancet, 369, 571–577.

18.

Gent

J. F.

Triche

E. W.

Holford

T. R.

Belanger

Bracken

M. B.

Beckett

W. S.

Leaderer

B. P.

(2003). Association of low-level ozone and fine particles with respiratory symptoms in children with asthma. The Journal of the American Medical Association, 290, 1859–1867. doi:10.1001/jama.290.14.1859

19.

Gilliland

F. D.

Gauderman

W. J.

Vora

Rappaport

Dubeau

(2002). Effects of glutathione-S-transferase M1, T1, and P1 on childhood lung function growth. American Journal of Respiratory and Critical Care Medicine, 166, 710–716.

20.

Gilliland

F. D.

Y. F.

Dubeau

Berhane

Avol

McConnell

Peters

J. M.

(2002). Effects of glutathione S-transferase M1, maternal smoking during pregnancy, and environmental tobacco smoke on asthma and wheezing in children. American Journal of Respiratory and Critical Care Medicine, 166, 457–463.

21.

Gilliland

F. D.

Y. F.

Saxon

Diaz-Sanchez

(2004). Effect of glutathione-S-transferase M1 and P1 genotypes on xenobiotic enhancement of allergic responses: Randomised, placebo-controlled crossover study. Lancet, 363, 119–125. doi:10.1016/S0140-6736(03)15262-2

22.

Groner

J. A.

Hoshaw-Woodard

Koren

Klein

Castile

(2005). Screening for children’s exposure to environmental tobacco smoke in a pediatric primary care setting. Archives of Pediatrics & Adolescent Medicine, 159, 450–455. doi:10.1001/archpedi.159.5.450

23.

Hopp

R. J.

Townley

R. G.

Biven

R. E.

Bewtra

A. K.

Nair

N. M.

(1990). The presence of airway reactivity before the development of asthma. American Review of Respiratory Disease, 141, 2–8.

24.

Ivaschenko

T. E.

Sideleva

O. G.

Baranov

V. S.

(2002). Glutathione-S-transferase mu and theta gene polymorphisms as new risk factors of atopic bronchial asthma. Journal of Molecular Medicine, 80, 39–43.

25.

Jobsis

Raatgeep

H. C.

Hop

W. C. J.

de Jongste

J. C.

(2001). Controlled low flow offline sampling of exhaled nitric oxide in children. Thorax, 56, 285–289.

26.

Kabesch

Hoefler

Carr

Leupold

Weiland

S. K.

von Mutius

(2004). Glutathione S transferase deficiency and passive smoking increase childhood asthma. Thorax, 59, 569–573.

27.

Lebecque

Kiakulanda

Coates

A. L.

(2005). Spirometry in the asthmatic child: Is FEF25-75 a more sensitive test than FEV1/FVC?. Pediatric Pulmonology, 16, 19–22.

28.

Masoli

Fabian

Holt

Beasley

(2004). The global burden of asthma: Executive summary of the GINA dissemination committee report. Allergy, 59, 469–478.

29.

McConnell

Berhane

Gilliland

London

S. J.

Islam

Gauderman

W. J.

Peters

J. M.

(2002). Asthma in exercising children exposed to ozone: A cohort study. Lancet, 359, 386–391.

30.

Meng

Y. Y.

Rull

R. P.

Wilhelm

Lombardi

Balmes

Ritz

(2010). Outdoor air pollution and uncontrolled asthma in the San Joaquin Valley, California. Journal of Epidemiology and Community Health, 64, 142–147. doi:10.1136/jech.2009.083576

31.

Robinson

Choi

B. C.

F. C.

(1996). Analysis of prevalence, triggers, risk factors, and the related socio-economic effects of childhood asthma in the student lung health survey (SLHS) database, Canada 1996. International Journal of Adolescent Medicine and Health, 15, 349–358.

32.

Morawska

(2003). Particle concentration levels and size distribution characteristics in residential and non-residential workplace environments. In Morawska

Salthammer

(Eds.), Indoor environment: Airborne particles and settled dust Weinheim, Germany: Wiley-VCH Verlag GmbH & Co. KGaA.

33.

Morkjaroenpong

Rand

C. S.

Butz

A. M.

Huss

Eggleston

Malveaux

F. J.

Bartlett

S. J.

(2002). Environmental tobacco smoke exposure and nocturnal symptoms among inner-city children with asthma. Journal of Allergy and Clinical Immunology, 110, 147–153.

34.

Nadeem

Chhabra

S. K.

Masood

Raj

H. G.

(2003). Increased oxidative stress and altered levels of antioxidants in asthma. Journal of Allergy and Clinical Immunology, 111, 72–78.

35.

National Asthma Education and Prevention Panel. (2009). Expert panel report 3: Guidelines for the diagnosis and management of asthma (No. 08-5846) Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health.

36.

Newcomb

(2008). Predicting admissions for childhood asthma based on proximity to major roadways. Journal of Nursing, 40, 319–325. doi:10.1111/j.1547-5069.2008.00245.x

37.

Pershagen

Rylander

Norberg

Eriksson

Nordvall

S. L.

(1995). Air pollution involving nitrogen dioxide exposure and wheezing bronchitis in children. International Journal of Epidemiology, 24, 1147–1153.

38.

Pijnenburg

M. W.

Lissenberg

E. T.

Hofhuis

Ghiro

W. C.

Holland

W. P.

de Jongste

J. C.

(2002). Exhaled nitric oxide measurements with dynamic flow restriction in children aged 4-8 yrs. European Respiratory Journal, 20, 919–924.

39.

Qian

Lin

H. M.

Chinchilli

V. M.

Lehman

E. B.

Duan

Craig

T. J.

Bascom

(2009). Interaction of ambient air pollution with asthma medication on exhaled nitric oxide among asthmatics. Archives of Environmental & Occupational Health, 64, 168–176. doi:10.1080/19338240903240616

40.

Qian

Lin

Chinchilli

V. M.

Lehman

E. B.

Stewart

W. F.

Shah

Bascom

(2009). Associations between air pollution and peak expiratory flow among patients with persistent asthma. Journal of Toxicology and Environmental Health, 72, 39–46. doi: 10.1080/15287390802445517

41.

Schatz

Sorkness

C. A.

J. T.

Marcus

Murray

J. J.

Nathan

R. A.

Jhingran

(2006). Asthma control test: Reliability, validity, and responsiveness in patients not previously followed by asthma specialists. Journal of Allergy and Clinical Immunology, 117, 549–556. doi:10.1016/j.jaci.2006.01.011

42.

Studnicka

Hackl

Pischinger

Fangmeyer

Haschke

Kuhr

Frischer

(1997). Traffic-related NO2 and the prevalence of asthma and respiratory symptoms in seven year olds. European Respiratory Journal, 10, 2275–2278.

43.

Tamer

Calikoglu

Ates

N. A.

Yildirim

Ercan

Saritas

Atik

(2004). Glutathione-S-transferase gene polymorphisms (GSTT1, GSTM1, GSTP1) as increased risk factors for asthma. Respirology, 9, 493–498. doi:10.1111/j.1440-1843.2004.00657.x

44.

Townley

R. G.

Hopp

R. J.

Bewtra

A. K.

Nair

N. M.

(1990). Predictive value of airway reactivity. Journal of Allergy and Clinical Immunology, 86, 650–652.

45.

Tsukagoshi

Shimizu

Iwamae

Hisada

Ishizuka

Iizuka

Mori

(2000). Evidence of oxidative stress in asthma and COPD: Potential inhibitory effect of theophylline. Respiratory Medicine, 94, 584–588. doi:10.1053/rmed.2000.0785

46.

Weiland

S. K.

Mundt

K. A.

Ruckman

Keil

(1994). Self-reported wheezing and allergic rhinitis in children and traffic density on street of residence. Annals of Epidemiology, 4, 243–247.

47.

Wheeler

B. W.

Ben-Shlomo

(2005). Environmental equity, air quality, socioeconomic status, and respiratory health: A linkage analysis of routine data from the health survey for England. Journal of Epidemiology and Community Health, 59, 948–954.