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Genetic Susceptibility, Maternal Smoking, and Environmental Tobacco Smoke All Contribute to Asthma in Children

Frank Gilliland, W. James Gauderman, and John M. Peters
University of Southern California Keck School of Medicine
P01ES09581 and P30ES07048

Background: Over the past 25 years, the incidence of asthma in children has grown exponentially in the U.S. and other industrialized countries. Many theories based on a plethora of research have been offered for this uncontrolled growth including environmental factors and genetic susceptibility. The evidence that both genetics and the environment play roles in asthma development further suggests changes in specific exposures among genetically susceptible individuals are responsible.

One possible genetic factor is the polymorphic gene for the enzyme glutathione S-transferase (GST) M1. GSTM1 is involved in the detoxification of reactive tobacco smoke metabolic intermediates and reactive oxygen species. In some individuals, the gene for GSTM1 is completely lacking and thus the enzyme is not produced. In an epidemiologic study of 2,950 children in Southern California, this research team investigated the effects of maternal smoking during pregnancy, exposure to environmental tobacco smoke, and the GSTM1 genotype on the development of asthma and children.

Advance: In children lacking the gene for GSTM1, in utero exposure to maternal smoking was associated with an increased prevalence of early onset asthma, persistent asthma, lifetime wheezing, wheezing while exercising, and emergency room visits for asthma symptoms in the previous year. Among children with the GSTM1 gene, in utero exposure to maternal smoking was not associated with asthma or wheezing.

Implication: This study has identified a genetically susceptible population of children at high risk for the development of asthma in response to maternal smoking. Since maternal smoking and the susceptible genotype are common, this study illustrates the need for interventions, such as smoking cessation programs, for the mothers of children in this high risk group.

Citation: Gilliland FD, Li YF, Dubeau L, Berhane K, Avol E, McConnell R, Gauderman WJ, Peters JM. Effects of Glutathione S-Transferase M1, Maternal Smoking during Pregnancy, and Environmental Tobacco Smoke on Asthma and Wheezing in Children. Am J Respir Crit Care Med. 2002 Aug 15;166(4):457-63.

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Last Reviewed: May 15, 2007