Childhood Exposure to Violence, Abuse Increases Risk for Asthma in Youth, Adults

Childhood exposure to violence (ETV) and maltreatment is associated with an increased risk an increased risk for youth/adult asthma in those with positive biomarkers of high T helper 2 (Th2) immunity, according to study findings presented at the American Thoracic Society (ATS) 2023 International Conference, held in Washington, DC, May 19 to 24.

To date, there is no certainty of what causes asthma in individuals with high Th2 immunity. Investigators aimed to determine whether an association exists between childhood exposure to violence or maltreatment and asthma in youth and adults with high Th2 immunity. Asthma diagnosed by a physician in the previous year that included wheezing was the primary endpoint.

The researchers conducted numerous analyses, including retrospective analyses of data from 53,066 adults in the United Kingdom Biobank (UKB), 336 individuals aged 9 to 20 years in the Puerto Rico Genetics of Asthma and Lifestyle (PR-GOAL) study, and 406 individuals in the Epigenetic Variation of Childhood Asthma in Puerto Ricans (EVA-PR) study. Additionally, the investigators also analyzed data from the prospective PROPRA study, which included 193 individuals in Puerto Rico who had participated in both PR-GOAL and EVA-PR studies.

The investigators used varying definitions of high Th2 for the various data sets analyzed. In the PR-GOAL, EVA-PR, and PROPRA studies, high Th2 was defined as at least 1 positive allergen-specific immunoglobulin E (IgE) and/or total IgE of at least 100IU/mL and/or eosinophil count of at least 150 cells/µL. For the UKB data base, which did not include IgE data, high Th2 was defined by an eosinophil count of at least 150 cells/µL. 

The validated ETV Scale and Checklist of Children’s Distress Symptoms (CCDS) questionnaires were used to assess ETV and violence-related distress in the Puerto Rican studies, and the validated Childhood Trauma Screener questionnaire was used to assess maltreatment in the UKB.

A “persistently high ETV or CCDS score” was defined as scores equal to at least the median at the baseline and follow-up-visit ETV and CCDS scores in PROPRA. In sensitivity analyses, the investigators used alternative definitions of the Th2-high immunity of at least 1 positive allergen-specific IgE and/or total IgE of at least 100 IU/mL and/or eosinophil count of at least 300 cells/µL in the Puerto Rican studies and an eosinophil count of at least 300 cells/µL in the UKB.

The researchers found that in the EVA-PR and PR-GOAL studies, each 1-point increment in ETV score was associated with 1.13 to 1.18 times increased odds of asthma in multivariable analyses. Additionally, each 1-point increment in CCDS score associated with 1.45 to 1.54 times increased odds of asthma (all P <.05).

A persistently high ETV score was significantly associated with asthma in PROPRA with multivariable analyses (P =.03); however, a persistently high CCDS score was not significantly associated (P =.09).

Any child maltreatment in the UKB data was associated with 1.26 times increased odds of asthma (P <.01), and similar results were found in sub-analyses in those who formerly smoked and those who never smoked. Similar results were found in sensitivity analyses.

“Our findings suggest that ETV, violence-related distress, and maltreatment during childhood are associated with increased risk of asthma in youth and adults with positive biomarkers of T helper 2-high immunity,” the investigators concluded.

This article originally appeared on Pulmonology Advisor