Inflammation and "Stress" in Asthma and Allergy : are Oxidative State and Cortisol Levels Involved?
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- Institutt for klinisk medisin [10814]
Abstract
Allergic diseases, such as asthma and allergic rhinitis may be mediated by oxidative stress. Stress in chronic disease is possibly associated with lower secretion of cortisol, with increased production of proinflammatory cytokines typically counter-regulated by cortisol. The aim of this study, in the discipline of allergy and pulmonology, was to investigate the role of oxidative stress and cortisol levels in allergic disease. The thesis was based on two different asthma study populations; a European multicentre-study and the Oslo Environment and Childhood Asthma birth cohort study. Asthma and allergy outcomes were assessed through questionnaires and clinical investigations, allergy and lung-function testing, and measurement of exhaled nitric oxide. Levels of the plasma antioxidant selenium varied throughout Europe, being lowest in the Norwegian children, but with no overall significant association with asthma. Reduced levels of the major serum antioxidant albumin were found in asthmatic children, and reduced albumin was associated with increased nitric oxide, a marker of allergic inflammation. Children with both asthma and allergic rhinitis had reduced albumin levels and increased serum levels of the oxidant ferritin. In poorly controlled asthma we found reduced blood levels of the antioxidants vitamin E and transferrin. Exposure to the pre-oxidant paracetamol in pregnancy was associated with allergic rhinitis at 10 years. The risk of a history of asthma, but not current asthma at 10 years was increased after paracetamol use between 0-6 months age, even in view of concomitant airway infections. Allergic sensitization was associated with infant paracetamol use in female offspring only. Reduced levels of salivary cortisol were found in children with co-morbidity of asthma and allergic rhinitis. The present thesis suggests a significant association between oxidative state and allergic diseases, and salivary cortisols levels are associated with allergic disease.List of papers
Paper I. Burney P, Potts J, Makowska J, Kowalski M, Phillips J, Gnatiuc L, Shaheen S, Joos G, Van Cauwenberge P, van Zele T, Verbruggen K, van Durme Y, Derudder I, Wohrl S, Godnic-Cvar J, Salameh B, Skadhauge L, Thomsen G, Zuberbier T, Bergmann KC, Heinzerling L, Renz H, Al-Fakhri N, Kosche B, Hildenberg A, Papadopoulos NG, Xepapadaki P, Zannikos K, Gjomarkaj M, Bruno A, Pace E, Bonini S, Bresciani M, Gramiccioni C, Fokkens W, Weersink EJ, Carlsen KH, Bakkeheim E, Loureiro C, Villanueva CM, Sanjuas C, Zock JP, Lundback B, Janson C. A case-control study of the relation between plasma selenium and asthma in European populations: a GAL2EN project. Allergy 2008: 63(7) 865-71. The paper is removed from the thesis in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1111/j.1398-9995.2008.01716.x |
Paper II. Bakkeheim E., Mowinckel P., Carlsen KH., Burney P, Lødrup Carlsen KC. Altered oxidative state in schoolchildren with asthma. Pediatric Allergy and Immunology 2011: 22(2) 178-185. The paper is removed from the thesis in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1111/j.1399-3038.2010.01092.x |
Paper III. Bakkeheim E., Mowinckel P., Carlsen KH., Håland G., Lødrup Carlsen KC. Paracetamol in early infancy; the risk of childhood allergy and asthma. Acta Paediatrica 2010: 100(1) 90-96. The paper is removed from the thesis in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1111/j.1651-2227.2010.01942.x |
Paper IV. Bakkeheim E., Mowinckel P., Carlsen KH., Burney P, Lødrup Carlsen KC. Reduced basal salivary cortisol in children with asthma and allergic rhinitis. Acta Paediatrica 2010: 99(11) 1705-1711. The paper is removed from the thesis in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1111/j.1651-2227.2009.01598.x |