04b50bc5-9c21-4313-9f41-e6f9e7ddd036.json

{
 "id": "04b50bc5-9c21-4313-9f41-e6f9e7ddd036",
 "disease": {
  "id": "H00079",
  "names": [
   "Asthma"
  ],
  "dbLinks": {
   "icd10": [
    "J45"
   ],
   "mesh": [
    "D001249"
   ]
  },
  "category": "Immune system disease",
  "description": "Asthma is a complex syndrome with many clinical phenotypes in both adults and children. Its major characteristics include a variable degree of airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Inhaled allergens encounter antigen presenting cells (APC) that line the airway. Upon recognition of the antigen and activation by APC, naive T cells differentiate into TH2 cells. Activated TH2 stimulate the formation of IgE by B cells. IgE molecules bind to IgE receptors located on mast cells. The crosslinking of mast-cell-bound IgE by allergens leads to the release of biologically active mediators (histamine, leukotrienes) by means of degranulation and, so, to the immediate symptoms of allergy. Mast cells also release chemotactic factors that contribute to the recruitment of inflammatory cells, particularly eosinophils, whose proliferation and differentiation from bone marrow progenitors is promoted by IL-5. The activation of eosinophils leads to release of toxic granules and oxygen free radicals that lead to tissue damage and promote the development of chronic inflammation."
 },
 "article": {
  "id": "22952297",
  "text": "RATIONALE:\nAlthough epidemiological studies suggest that exposure to maternal smoking during fetal and early life increases the risk of childhood wheezing and asthma, previous studies were not able to differentiate the effects of prenatal from postnatal exposure.\n\nOBJECTIVES:\nTo assess the effect of exposure to maternal smoking only during pregnancy on wheeze and asthma among preschool-age children.\n\nMETHODS:\nA pooled analysis was performed based on individual participant data from eight European birth cohorts. Cohort-specific effects of maternal smoking during pregnancy, but not during the first year, on wheeze and asthma at 4 to 6 years of age were estimated using logistic regression and then combined using a random effects model. Adjustments were made for sex, parental education, parental asthma, birth weight, and siblings.\n\nMEASUREMENTS AND MAIN RESULTS:\nAmong the 21,600 children included in the analysis, 735 children (3.4%) were exposed to maternal smoking exclusively during pregnancy but not in the first year after birth. In the pooled analysis, maternal smoking only during pregnancy was associated with wheeze and asthma at 4 to 6 years of age, with adjusted odds ratios of 1.39 (95% confidence interval, 1.08-1.77) and 1.65 (95% confidence interval, 1.18-2.31), respectively. The likelihood to develop wheeze and asthma increased statistically significantly in a linear dose-dependent manner in relation to maternal daily cigarette consumption during the first trimester of pregnancy.\n\nCONCLUSIONS:\nMaternal smoking during pregnancy appears to increase the risk of wheeze and asthma among children who are not exposed to maternal smoking after birth."
 },
 "questions": [
  {
   "id": "3f68731e-9e28-4e20-9f7c-784fbb742b2e",
   "text": "What are the risk factors of Asthma?",
   "answers": [
    {
     "answer_start": 1068,
     "text": "maternal smoking only during pregnancy"
    },
    {
     "answer_start": 1432,
     "text": "maternal daily cigarette consumption during the first trimester of pregnancy"
    },
    {
     "answer_start": 1524,
     "text": "Maternal smoking during pregnancy"
    }
   ]
  }
 ]
}