رسالة جامعية
Gender Based Precision Care in Asthma
| العنوان: | Gender Based Precision Care in Asthma |
|---|---|
| المؤلفون: | Zein, Joe Georges |
| بيانات النشر: | Case Western Reserve University School of Graduate Studies / OhioLINK, 2020. |
| سنة النشر: | 2020 |
| المجموعة: | Ohiolink ETDs |
| Original Material: | http://rave.ohiolink.edu/etdc/view?acc_num=case1585768141945515Test |
| مصطلحات موضوعية: | Medicine, Asthma, severity, Precision, therapy, sex-hormones, gender differences |
| الوصف: | Asthma is more common and severe - that is, symptomatic and glucocorticoid-refractory - in adult women compared to men. Although sex hormones have been implicated, the mechanisms underlying this gender disparity remain unknown. To examine potential genetic and environmental determinants of the sex discrepancy, we utilized data from the Severe Asthma Research Program (SARP) (n=1659), Cleveland Clinic (n=32,527) and the National Health and Nutrition Examination Survey (n=2,629). Our analysis of these cohorts showed greater asthma prevalence, severity and healthcare utilization in women compared to men. We also found that sex hormone levels were lower in SARP patients with severe asthma. In SARP, higher DHEA-S levels positively correlated with percent predicted forced expiratory volume in 1 second (FEV1PP) in women (R2=0.106; p10% improvement in FEV1PP only in premenopausal women [OR (95%CI) = 2.96 (1.21; 7.51)]. To investigate the role of androgens in GC resistance, the association between FEV1PP and HSD3B1(1245) genotypes was evaluated in SARPIII patients on daily GCs compared to those not on daily glucocorticoids (noGC) (n=318). HSD3B1 encodes for 3β-hydroxysteroid dehydrogenase-1 (3β-HSD1), which catalyzes peripheral conversion of DHEA to potent androgens and can have a missense-encoding polymorphism. The adrenal restrictive HSD3B1(1245A) allele limits conversion, whereas the adrenal permissive HSD3B1(1245C) allele increases DHEA metabolism to potent androgens. Patients homozygous for HSD3B1(1245A) allele on GCs had lower FEV1PP compared with noGC (54.3% vs. 75.1%; p |
| Original Identifier: | oai:etd.ohiolink.edu:case1585768141945515 |
| نوع الوثيقة: | Text |
| اللغة: | English |
| الإتاحة: | http://rave.ohiolink.edu/etdc/view?acc_num=case1585768141945515Test |
| حقوق: | unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
| رقم الانضمام: | edsndl.OhioLink.oai.etd.ohiolink.edu.case1585768141945515 |
| قاعدة البيانات: | Networked Digital Library of Theses & Dissertations |
| الوصف غير متاح. |