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Asthma Genomics

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Welcome to the Public Health Perspective Series, the National Office of Public Health Genomics’s highlights page. Each Public Health Perspective focuses on a single topic and contains information and commentary on discoveries of genetic variants, related disease outcomes, and the complex social, legal, and ethical issues surrounding genetic discoveries. Topics are examined from a public health perspective, and readers are encouraged to participate in an ongoing discussion in the reader’s forum. This Public Health Perspective examines the topic of Asthma Genomics:  Implications for Public Health: A Public Health Perspective.
"The asthma genetics field has advanced considerably in recent years, with new information being generated that has led to improved understanding of the pathobiology underlying this complex disorder."
Halapi E, Hakonarson H
Curr Opin Pulm Med 2004;10(1):22-30

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This Public Health Perspective: Asthma Genomics was a collaborative effort by members of the University of Washington Center for Genomics and Public Health This reference links to a non-governmental website and the CDC’s National Office of Public Health Genomics
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arrow The Public Health Perspective (all links last accessed 2/2008)

Advances in asthma genomics are occurring rapidly. While these advances have not yet caused a change in the methods of asthma prevention, diagnosis, or treatment, new strategies to prevent and manage asthma are likely to be developed within the near future. For these strategies to provide optimal benefit to populations, public health expertise is needed. Public health involvement in the genomics discourse can help ensure that public health concepts are incorporated into areas of genomics research and that genomics applications are utilized to support public health goals. For more detailed examples of how genomics may impact asthma, see the report, Asthma Genomics: Implications for Public Health. This reference links to a non-governmental website 
 
arrow What is Asthma? (all links last accessed 2/2008)

Asthma is a chronic inflammatory disease of the airways associated with a narrowing of the airway passages, bronchial hyperresponsiveness, and reversible airway obstruction, and characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and cough. Many different features of the disease are used to identify asthma patients for studies or as phenotypes in genetic association studies. For example, genetic association studies have evaluated evidence for susceptibility to eosinophilia, elevated immunoglobulin E levels, bronchial hyperresponsiveness, wheeze, and atopy. The variability in disease definition among genetic studies can make interpretation and comparison of study findings difficult.

For more information about asthma visit MEDLINEplus, an information resource compiled by the National Library of Medicine, or websites of the Asthma Organizations.
 
arrow The Burden of Asthma (all links last accessed 2/2008)

Asthma is a significant public health problem, causing considerable morbidity and, in some cases, death. It is also a disease of considerable economic burden.

  • Approximately 20.3 million (7.2%) US adults had current asthma in 2001 and an estimated 31.3 million people had been diagnosed with asthma during their lifetime.
  • In 2001, asthma caused approximately 2 million emergency department visits, 465,000 hospitalizations, and nearly 4,500 deaths.
  • Collectively, people who have asthma experience well over 100 million days of restricted activity each year, and asthma is believed to be one of the most common reasons that students miss school.
  • The combined direct and indirect costs for asthma in United States rose from approximately $10.7 billion in 1994 to approximately $12.7 billion in 1998.

For more statistics visit the CDC National Center for Environmental Health pages on asthma and National Center for Health Statistics Fast Stats on asthma.

 
arrow Risk Factors for Asthma

Both genetic and environmental factors are known to play a role in asthma development and expression, although the exact “causes” of asthma are still unknown. Many factors have been hypothesized to affect the development and exacerbation of asthma. Some environmental risk factors that have been shown to be associated with asthma development and/or exacerbation include:

  • Exposure to air pollutants such as ozone, particulate matter, sulfur dioxide, nitrogen dioxide, diesel particulates, traffic-related pollution, building products, and combustion byproducts
  • Exposure to all allergens produced by dust mites, cockroaches, fungi & dampness, and animal dander
  • Exposure to environmental tobacco smoke
  • Ingestion of non-steroidal anti-inflammatory drugs (NSAIDS), including aspirin
  • Viral infection

 
 
arrow Evidence of a Genetic Component to Asthma (all links last accessed 2/2008)

Evidence from numerous studies, including some dating back to the 1920s, indicate that asthma is passed down in families, suggesting at least a partial genetic component to the disease. For a review of studies assessing family history of asthma, view the following article. Burke W, Fesinmeyer M, Reed K, et al. Family history as a predictor of asthma risk Am J Prev Med 2003;24:160-9. More recent studies provide stronger evidence for genetic susceptibility to asthma (see Selected Journal Articles). For example, several chromosomal regions and candidate genes have been linked or associated with asthma. The specific effects of these genes have yet to be determined and their impact on public health has yet to be defined. However, genomics research into mechanisms of disease pathogenesis and the recognition of asthma as a chronic inflammatory disease of the airways has allowed for opportunities to better understand the effects of standard therapies and is likely to lead to new therapeutic approaches to asthma.

Asthma is a complex disease in which multiple genes with variable involvement interact with environmental factors. The considerable increase in knowledge of asthma genomics has not yet resulted in changes in strategies to prevent, diagnose, or treat asthma, but it is likely that there will be applications available in the near future. Potential applications include pharmacogenomics, targeted lifestyle and environment modifications for affected individuals, improved disease classification, and identification of unaffected individuals at risk for asthma, concurrent with prevention efforts. The first practical use of asthma genomics is mostly likely to occur in the field of pharmacogenomics. Public Health can play an important role in ensuring that discoveries from the “genomics revolution” are applied appropriately to populations.

  • Pharmacogenomics
    Pharmacogenomics refers to the use of genomic techniques to enhance drug development and guide drug treatment choices.
  • What can Public Health do?
    Asthma clinical and public health efforts do not currently incorporate genomic information because the genetic components of asthma are only just being discovered.
 
arrow Selected Resources (all links last accessed 2/2008)
 
arrow Selected Journal Articles (all links last accessed 2/2008)

The following articles are reviews of asthma genomics. Click on the titles below to read the article abstract in PubMed. To download a listing of additional selected
articles, view "Selected Journal Articles"

 

Keep Updated on Activities in Public Health Genomics and Asthma:

This reference links to a non-governmental website
  Provides link to non-governmental sites and does not necessarily represent the views of the Centers  for Disease Control and Prevention.
Page last reviewed: June 8, 2007 (archived document)
Page last updated: November 27, 2007
Content Source: National Office of Public Health Genomics