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KMID : 0191120140290050662
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Journal of Korean Medical Science
2014 Volume.29 No. 5 p.662 ~ p.668
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Association between Recent Acetaminophen Use and Asthma: Modification by Polymorphism at TLR4
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Lee Seung-Hwa
Kang Mi-Jin
Yu Ho-Sung
Hong Kyung-Mo
Jung Young-Ho
Kim Hyung-Young
Seo Ju-Hee
Kwon Ji-Won
Kim Byoung-Ju
Kim Ha-Jung
Kim Young-Joon
Kim Hee-Suk
Kim Hyo-Bin
Park Kang-Seo
Lee So-Yeon
Hong Soo-Jong
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Abstract
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The risk of asthma has been increasing in parallel with use of acetaminophen, which is a potential source of oxidative stress. Toll-like receptor 4 (TLR4) plays a critical role not only in innate immunity, but also in mediating reactive oxygen species induced inflammation. Therefore, we investigated associations between acetaminophen usage and TLR4 polymorphism on asthma and bronchial hyperresponsiveness (BHR). The number of 2,428 elementary school children in Seoul and Jeongeup cities was recruited. Subjects who used acetaminophen with a family history of asthma had an increased risk of both asthma diagnosis ever and current asthma. Individuals with CT+TT genotypes at the TLR4 polymorphism, in combination with acetaminophen usage, also demonstrated an increased risk of asthma diagnosis ever (aOR, 2.08; 95% confidence interval [CI], 1.10-3.92). Family history of asthma and acetaminophen usage were risk factors for BHR. Although TLR4 was not an independent risk factor for BHR, individuals with CT+TT genotypes at the TLR4 polymorphism had an increased risk of BHR when combined with acetaminophen usage (aOR, 1.74; 95% CI, 1.03-2.94). In conclusion, acetaminophen usage may be associated with asthma and BHR in genetically susceptible subjects. This effect may be modified by polymorphism at TLR4.
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KEYWORD
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Acetaminophen, Asthma, Bronchial Hyperresponsiveness, Toll-Like Receptor 4, Gene-Environment Interaction
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