Comment le trouble du spectre de l'autisme affecte-t-il le risque et la gravité de l'asthme chez l'enfant?

Aperçu: G.M.

Chez les enfants souffrant d'asthme, la TSA concomitante est associée à de meilleurs résultats liés à l'asthme, mais à un taux de traitement plus élevé. En outre, les données ne supportent pas les TSA comme facteur de risque d'asthme incident.

Ann Allergy Asthma Immunol. 2017 May;118(5):570-576. doi: 10.1016/j.anai.2017.02.020.

How does autism spectrum disorder affect the risk and severity of childhood asthma?

Jónsdóttir U¹, Lang JE².

Author information

1

Faculty of Medicine, University of Iceland, Reykjavík, Iceland.

2

Division of Pulmonary and Sleep Medicine, Nemours Children's Hospital, Orlando, Florida; Division of Allergy/Immunology and Pulmonary Medicine, Duke University School of Medicine, Durham, North Carolina. Electronic address: Jason.Lang@Duke.edu.

Abstract

BACKGROUND:

Autism spectrum disorder (ASD) and asthma are among the most common chronic disorders in childhood. Both are associated with altered immune regulation and share several risk factors. The effects of ASD on risk for later asthma and asthma severity remain unclear.

OBJECTIVE:

To determine whether ASD in children increases the risk of incident asthma and worsens asthma severity.

METHODS:

We performed 2 distinct analytic designs (case-control and retrospective longitudinal cohort) using a multistate electronic health records database to assess the odds of new asthma and asthma severity among children with ASD. In both designs, children with ASD were matched with children without ASD according to sex, age, race, ethnicity, location, and insurance status. Pulmonary function, controller medication prescriptions, asthma exacerbations, and asthma-related hospitalizations were collected. The effects of ASD on asthma risk and severity were assessed using multivariable linear and logistic regression.

RESULTS:

Among children with asthma, ASD was associated with reduced exacerbations (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.54-0.92), better forced expiratory volume in 1 second/forced vital capacity ratio (0.876 vs 0.841, P < .001), and lower odds of airflow obstruction (OR, 0.53; 95% CI, 0.31-0.90) but had higher odds of asthma controller prescription (OR, 2.18; 95% CI, 1.62-2.93). In a longitudinal analysis of children without asthma, ASD was found to be protective for new asthma (OR, 0.44; 95% CI, 0.26-0.74).

CONCLUSION:

Among children with asthma, concomitant ASD is associated with better asthma-related outcomes but a higher controller treatment burden. In addition, our data did not support ASD as a risk factor for incident asthma.

Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

PMID:28477788

DOI:10.1016/j.anai.2017.02.020

Les modèles primates naturels des processus psychosociaux

Traduction: G.M.

ILAR J. 2017 May 2:1-9. doi: 10.1093/ilar/ilx012.

Naturally Occurring Nonhuman Primate Models of Psychosocial Processes

Capitanio JP¹.

Author information

1

John P. Capitanio, PhD, is a Research Psychologist in the Department of Psychology, and a Core Scientist at the California National Primate Research Center, at the University of California in Davis, California.

Abstract

La recherche humaine sur les processus psychologiques tels que l'anxiété, la dépression ou la solitude implique habituellement des cas où le phénomène auquel on s'intéresse se produit naturellement, puis on compare un tel échantillon avec des cas témoins. En revanche, la recherche animale conçue pour modéliser des processus similaires pour tester des hypothèses mécanistes implique typiquement d'induire le phénomène d'intérêt par une procédure administrée de manière exogène (c'est-à-dire humaine).  
Dans l'analyse actuelle, l'auteur propose que les modèles animaux naturels peuvent compléter les modèles induits dans la compréhension des phénomènes psychologiques complexes. Les avantages et les inconvénients des modèles naturels versus induits sont décrits et des exemples détaillés de trois modèles naturels - pour la solitude et la santé, l'inhibition du comportement et l'asthme, le fonctionnement social et l'autisme - sont décrits, ainsi qu'un programme formel (le programme BioBehavioral Assessment ) au Centre national de recherches sur les primates de Californie, conçu pour quantifier la variation des processus bio-comportementaux dans les macaques Rhésus bébés afin de faciliter le développement de modèles naturels. On soutient qu'en raison de la similitude dans les processus comportementaux et psychologiques complexes entre les macaques et les humains, les modèles naturels de primates fournissent un pont entre les études humaines et les modèles de primates induits et ont le potentiel d'identifier de nouveaux modèles pour la recherche translationnelle.

Human research into psychological processes such as anxiety, depression, or loneliness typically involves accruing cases in which the phenomenon of interest is naturally occurring, and then comparing such a sample with control cases. In contrast, animal research designed to model similar processes to test mechanistic hypotheses typically involves inducing the phenomenon of interest via some exogenously (i.e., human) administered procedure. In the present review, the author proposes that naturally occurring animal models can complement induced models in understanding complex psychological phenomena. Advantages and disadvantages of naturally occurring versus induced models are described, and detailed examples of three naturally occurring models-for loneliness and health, behavioral inhibition and asthma, and social functioning and autism-are described, along with a formal program (the BioBehavioral Assessment program) at the California National Primate Research Center, that is designed to quantify variation in biobehavioral processes in infant rhesus macaques to facilitate development of naturally occurring models. It is argued that, because of the similarity in complex behavioral and psychological processes between macaques and humans, naturally occurring primate models provide a bridge between human studies and induced primate models and have the potential to identify new models for translational research.

© The Author 2017. Published by Oxford University Press on behalf of the Institute for Laboratory Animal Research. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PMID: 28472500

DOI:10.1093/ilar/ilx012

L'exposition prénatale aux agonistes β2-adrénergiques et le risque de trouble du spectre de l'autisme chez les descendants

Aperçu: G.M.
L'étude a à examiner le risque de troubles du spectre de l'autisme (TSA) dans la progéniture qui ont été exposés à une utilisation maternelle de l'agoniste β2-adrénergique (β2AA) pendant la grossesse.
Les résultats montrent un risque accru de TSA chez les enfants exposés (IRR = 1.28, 1.11-1.47), en particulier pour ceux qui ont été exposés au cours de la deuxième période (IRR = 1.38, 1.14-1.67). Toutefois, lorsqu'on a prolongé la durée du temps d'exposition à 1 an avant la grossesse, l'étude montre une association similaire chez les enfants nés de femmes qui ont reçu un traitement β2AA pendant la grossesse (IRR = 1.33, 1.11-1.59) à celui des enfants nés chez les femmes qui ont reçu un traitement β2AA, 1 an avant la grossesse
Notre constat a suggéré que les enfants nés de femmes qui ont utilisé β2AA pendant la grossesse ont un risque accru de TSA plus tard, ce qui est plus susceptible d'être dû aux maladies maternelles sous-jacentes que l'exposition à β2AA elle-même.

Pharmacoepidemiol Drug Saf. 2017 Apr 19. doi: 10.1002/pds.4214.

Prenatal exposure to β2-adrenoreceptor agonists and the risk of autism spectrum disorders in offspring

Su X¹, Yuan W², Chen J², Miao M², Olsen J³, Pedersen LH⁴, Liang H², Li J³.

Author information

1

Department of Women and Children's Health Care, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.

2

Key Lab of Reproductive Regulation of NPFPC, SIPPR; IRD, Fudan University, Shanghai, China.

3

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.

4

Department of Clinical Medicine, Obstetrics and Gynecology, Aarhus University, Aarhus, Denmark.

Abstract

PURPOSE:

We aimed to examine the risk of autism spectrum disorders (ASDs) in the offspring who were exposed to maternal use of β2-adrenoreceptor agonist (β2AA) during pregnancy.

METHODS:

This is a population-based cohort study including all live singleton births in Denmark from 1 January 1997 to 31 December 2008. Children born to mothers who used β2AA during pregnancy were categorized as exposed, and all other children were included in the unexposed group. Cases of ASDs were identified from the Danish Psychiatric Central Register and the Danish Patient Register. Incidence rate ratio (IRR) and 95% confidence interval were estimated by Poisson regression models.

RESULTS:

Among 751 888 children in the cohort, 9098 (1.21%) received a diagnosis of ASDs. We observed an increased risk of ASDs in the exposed children (IRR = 1.28, 1.11-1.47), especially for those who were exposed during the second trimester period (IRR = 1.38, 1.14-1.67). However, when extending the exposure time window to 1 year prior to pregnancy, we observed a similar association in children born to women who received β2AA treatment during pregnancy (IRR = 1.33, 1.11-1.59) to that in children born to women who received β2AA treatment 1 year prior to pregnancy (IRR = 1.35, 1.17-1.56).

CONCLUSION:

Our finding suggested that children born to women who used β2AA during pregnancy have an increased risk of ASDs in later life, which is more likely due to underlying maternal diseases rather than the exposure to β2AA itself. However, further study, which would better differentiate the effects between indication and medicine, is needed to corroborate the finding. Copyright © 2017 John Wiley & Sons, Ltd.

Copyright © 2017 John Wiley & Sons, Ltd.

PMID: 28422339

DOI: 10.1002/pds.4214