Abstract:
Asthma is a chronic inflammatory disorder characterized by wheezing,
breathlessness, chest tightness and cough. The inflammation is responsible for
bronchial hyperresponsiveness which renders the patient susceptible to certain
environmental stimuli. The environmental factors alone are not responsible for
these changes as they have an intricate interaction with genetic factors. In this
study we determined the spectrum of symptoms and their correlation with serum
IgE levels in asthmatic patients since no such data could be found for indigenous
population. Cortisol and ACTH levels were determined to ascertain the status of
hypothalamic pituitary adrenal axis. Interleukin 13 gene polymorphisms and their
association with asthma and serum IgE levels were investigated. For the present
study a detailed history was taken and peak expiratory flow measured on 164
asthmatic and 50 controls. Seventy five randomly selected patients underwent
serology and SNP genotyping. Serum was analyzed for total IgE, cortisol and
ACTH levels. Six SNPs of interleukin 13 gene were studied by PCR-RFLP. Four
polymorphisms were from the promoter region C-1512A, T-1112C, A-646G and
C-469T, one nonsynonymous polymorphism from the exon 4 A2044 G (Arg to
Gln) and a 3’UTR polymorphism A2525G. The results of this research revealed
that majority of patients belonged to moderate intermittent to severe persistent
group. Exposure to dust was the most common triggering factor in our population.
Serum IgE levels were directly proportional to the severity of asthma and were
significantly correlated with history of allergy. However, no correlation was
found between IgE levels and family history of asthma. Adrenal functions were
© Dr Afia Hasnain 2008
xviiPhD Thesis
Dr Afia Hasnain
normal when compared with the control group. Two SNPs T-1112C and A2044G
showed strong association with serum IgE levels and both the presence and the
severity of asthma. C-1512A showed association with asthma and its severity and
was the only polymorphism that showed an association with the family history of
asthma. While A2525G had a weak association with serum IgE levels only. The
other two polymorphisms were in very low frequency in our population and hence
no association with phenotypes could be ascertained. It could be concluded from
the present investigation that exposure to dust could be the most common
precipitating factor of asthma in our population. The two previously studied SNPs
T-1112C and A2044G are strongly associated with serum IgE levels and both
presence and severity of asthma in our population sample.