HealthWatch: Asthma and the Gender Connection

News

 Asthma affects more than 26 million Americans. Now new research shows that a certain group of people may have a higher chance of getting asthma than most. 
Nancy Wickersham has suffered from asthma since she was eight years old. But in her 20’s, her symptoms became much worse. 
“My reactions were a lot stronger and it seemed to react to more things, and as I got older there are more things I put on the list,” Nancy shared.
Cats, exercise, cold weather, seasonal allergies, are all things that trigger Nancy’s asthma symptoms. New research from Vanderbilt and Johns Hopkins Universities has found that her hormones may be to blame for her asthma symptoms. Researchers drew blood samples from people with asthma and those without.
Dawn Newcomb, PhD, Assistant Professor of Medicine at Vanderbilt University, says, “What we found was that women had more of these proteins that are made that are associated with asthma.”
So much so, that even women who don’t have asthma had more of these proteins than men without asthma. The reason?
“Testosterone acts on one set of pathways to decrease airway inflammation, where the ovarian hormones act on a different set of pathways to increase the airway inflammation,” Dr. Newcomb continued. 
Making asthma symptoms even worse in women. The researchers also found that testosterone decreases the ability of inflammatory cells to multiply and divide and produce more cells in the airways. This research calls for a closer look at how therapies impact men and women differently, which can help women like Nancy find relief.  
Interestingly, before puberty boys are more likely to have asthma than girls. In adulthood, it switches and adult women are two times more likely than men to have severe asthma. 
Contributors to this news report include: Milvionne Chery, Field Producer; Roque Correa, Editor and Videographer.


ASTHMA AND THE GENDER CONNECTION
REPORT #2618

BACKGROUND: Asthma causes swelling of the airways. This results in narrowing of the airways that carry air from the nose and mouth to the lungs. Allergens or irritating things entering the lungs trigger asthma symptoms. Symptoms can include trouble breathing, wheezing, or coughing and tightness in the chest. Asthma can be deadly. According to the Centers for Disease Control and Prevention (CDC), 1 in 13 people have asthma and more than 26 million Americans have asthma. This makes up 8.3 percent of adults and 8.3 percent of children. Asthma has been increasing since the early 1980s in all age, sex and racial groups. It is more common in adult women than adult men. Asthma is the leading chronic disease in children and is more common in children than adults. Currently, there are about 6 million children under the age of 18 with asthma. It is the top reason for missed school days with about 13.8 million missed school days reported in 2013. 
(Source: https://www.aafa.org/asthma-facts/) 

GENDER AND ASTHMA: According to the OECD, in Europe, asthma is more common in females (4.3%) than in males (3.3%) ages fifteen and older with the exception of Slovenia. In childhood, boys have twice the rate of asthma as girls, but they are more likely to grow out of it. However, the rates reverse once girls reach puberty.  Research has found that gender differences in asthma manifest at the early stages of puberty. In adulthood, more women suffer from asthma than men. Women in the age group twenty to fifty are especially affected. Female hormones have a large impact on asthma, affecting 40% of women and can have almost as much of an impact as triggers such as allergens. Fluctuation in levels of estrogen can lead to airway inflammation. Thus, asthma attacks are more likely to occur right before a women’s menstrual cycle when her estrogen is low. Most hospitalizations from asthma occur at the peri-menstrual state. In particular, girls during puberty can find that their asthma worsens before their cycle, though the frequency and severity may decrease with age. Scientists believe that genetic differences may impact the gender differences in asthma rates and severity. Certain specific genes are correlated with asthma in women but not in men.  
(Source: https://eurohealth.ie/sex-and-gender-in-asthma/) 

NEW ASTHMA TREATMENT: Reducing the need for corticosteroids with alternative treatments is preferable for asthma, since these medications are associated with serious side effects from prolonged use. Dr. Parameswaran Nair, staff respirologist at St. Joseph’s Healthcare Hamilton and professor of medicine at McMaster University, along with a team of researchers found that an antibody called, dupilumab, is effective in treating severe asthma in place of high doses of prednisone. “The ability of dupilumab to increase lung function as markedly as it did in this study, even in the face of corticosteroid withdrawal, indicates that it appears to be inhibiting key drivers of lung inflammation,” the researchers noted. Dupilumab works to treat asthma by blocking two specific proteins that are associated with inflammation of the airways. Unlike the previous studies, dupilumab was shown to be effective regardless of patients’ eosinophil levels. Despite the reduced prednisone dose, patients in this study not only experienced a decrease in asthma exacerbations, but their lung function also improved significantly.
(Source: https://www.sciencedaily.com/releases/2018/05/180522170052.htm) 

? For More Information, Contact:

Dawn Newcomb, PhD                    Kristin Smart, Media Relations
Dawn.newcomb@vanderbilt.edu        kristin.t.smart@vumc.org     

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