Acetaminophen, Childhood Asthma Linked
Children given acetaminophen to reduce fever during their first
year of life are more prone to developing asthma as they get
older, according to study findings reported in the September
20, 2008, issue of The Lancet. For the study, the researchers
collected data on 205,487 children from 31 countries around
the world. The children participated in the International Study
of Asthma and Allergies in Childhood.
The researchers learned that children had a 46% increased
risk of developing asthma when they were 6 to 7 years old.
Furthermore, children given high doses of acetaminophen
within the past year had a >3 times increased risk of developing
the condition. The children given medium doses faced a
61% increased risk of developing asthma. Acetaminophen
use also was linked with a greater risk of severe asthma of
approximately 22% to 38%, found the researchers.
The researchers concluded that acetaminophen use in large
amounts is unnecessary. "It should be limited to high fevers,"
said lead researcher Richard Beasley, MBChB, FRACP.
Day Care May Lead to Lower Asthma Risk
Children who attend day care may have a
lower risk of developing asthma later on,
according to a study reported recently
in the Journal of Allergy and Clinical Immunology.
For the study, the researchers followed
1085 children from birth to age 5.
The results indicated that children who
went to day care had a lower risk of
wheezing by the time they were 5 years
old, compared with children who stayed
at home or with a babysitter.
The risk was especially low among
children who entered day care when
they were between the ages of 6 and 12
months. This group was 75% less likely to
develop a wheezing problem, compared
with children cared for at home.
Children who attended day care after
12 months had a 35% lower risk of
Steroids Less Effective in
Glucocorticoids (steroids) are 40% less
effective in overweight and obese asthma
patients, compared with normal-weight
individuals. The researchers looked at 45
nonsmoking adults and measured the
responses of cells to the steroid dexamethasone.
Steroids interfere with inflammatory
signaling pathways by raising the level
of MAP kinase phosphatase-1 (MKP-1).
When the researchers applied dexamethasone
to the cultures of the participants?
blood cells, they found that steroids
did not increase MKP-1 as effectively in
overweight and obese patients with asthma,
compared with thinner patients with
the condition. The steroid increased the
levels of MKP-1 by 5.27 times in cultured
blood cells from slimmer patients with
asthma, compared with an increase of
only 3.11 times in overweight and obese
patients with asthma. The findings were
reported in the October 1, 2008, issue of
the American Journal of Respiratory and
Critical Care Medicine.
Mortality Higher for Poor Asthma
A study of 865 adults admitted to Kaiser
Permanente hospitals for asthma found
that greater asthma severity and poorer
perceived asthma control are linked
with an increased risk of death in adult
patients in this patient population.
The study's purpose was to examine
the mortality risk factors among these
patients. Sociodemographic data, asthma
history and severity, health status,
and scores on measures of perceived
asthma control were recorded and the
impact of each factor on mortality was
assessed. During the 781 days patients
were followed, 123 patients died.
When the researchers factored in other
potential influences, the researcher found
an association between higher initial
severity of asthma scores combined with
lower perceived asthma control scores
and a greater risk of all-cause mortality.
The findings were reported in the
August 2008 issue of the Annals of
Allergy, Asthma, and Immunology.
Older women with asthma who use
inhaled steroids are considerably less
likely to die from any cause, compared
with women not using the medication.
The findings are based on responses
from a 1998 supplementary asthma questionnaire
submitted by 2671 women with
persistent asthma participating in the
Nurses' Health Study. Of the participants,
54% reported inhaled steroid use in 1998.
During the next 5 years, 87 women died
(22 from cardiovascular disease, 31 from
cancer, and 34 from "other" causes).
The researchers found that use of
inhaled steroids at the outset was linked
with a 42% reduced risk of dying from
any cause and a 65% reduced likelihood
of dying from a heart-related cause. The
study was reported in Chest (September
F A S T F A C T: Approximately
15% to 23% of asthma cases in
the United States are due to