Effects of endogenous sex hormones on lung function and symptom control in adolescents with asthma

BMC Pulmonary Medicine

Mark D. DeBoer, Brenda R. Phillips, David T. Mauger, Joe Zein, Serpil C. Erzurum, Anne M. Fitzpatrick, Benjamin M. Gaston, Ross Myers, Kristie R. Ross, James Chmiel, Min Jie Lee, John V. Fahy, Michael Peters, Ngoc P. Ly, Sally E. Wenzel, Merritt L. Fajt, Fernando Holguin, Wendy C. Moore, Stephen P. Peters, Deborah Meyers, Eugene R. Bleecker, Mario Castro, Andrea M. Coverstone, Leonard B. Bacharier, Nizar N. Jarjour, Ronald L. Sorkness, Sima Ramratnam, Anne-Marie Irani, Elliot Israel, Bruce Levy, Wanda Phipatanakul, Jonathan M. Gaffin and W. Gerald Teague Email author

Abstract

Background

Although pre-puberty asthma is more prevalent in males, after puberty through middle-age, asthma is more prevalent in females. The surge of sex hormones with puberty might explain this gender switch.

Methods

To examine the effects of sex hormones on lung function and symptoms with puberty, Tanner stage was assessed in 187 children 6–18 years of age (59% severe) enrolled in the NIH/NHLBI Severe Asthma Research Program (SARP). The effects of circulating sex hormones (n = 68; testosterone, dehydroepiandrosterone sulfate (DHEA-S), estrogen, and progesterone) on lung function and 4 week symptom control (ACQ6) in cross-section were tested by linear regression.

Results

From pre−/early to late puberty, lung function did not change significantly but ACQ6 scores improved in males with severe asthma. By contrast females had lower post-BD FEV1% and FVC% and worse ACQ6 scores with late puberty assessed by breast development. In males log DHEA-S levels, which increased by Tanner stage, associated positively with pre- and post-BD FEV1%, pre-BD FVC %, and negatively (improved) with ACQ6. Patients treated with high-dose inhaled corticosteroids had similar levels of circulating DHEA-S. In females, estradiol levels increased by Tanner stage, and associated negatively with pre-BD FEV1% and FVC %.

Conclusions

These results support beneficial effects of androgens on lung function and symptom control and weak deleterious effects of estradiol on lung function in children with asthma. Longitudinal data are necessary to confirm these cross-sectional findings and to further elucidate hormonal mechanisms informing sex differences in asthma features with puberty.

Trial registration

ClinicalTrials.gov registration number: NCT01748175.

Download PDF

(You must be logged in to add and reply comments)

Interasma on Twitter

Interasma RT @Aller_MD: Top story: Kaléo on Twitter: "Some bullies use words, others use food. Togeth… https://t.co/eOHOsmB43X, see more https://t.…
9hreplyretweetfavorite
Interasma RT @Aller_MD: “Epinephrine Nasal Spray for #Anaphylaxis Shows Promise as Potential Alternative to Auto-Injector” https://t.co/qVsbyMfDuL ht…
9hreplyretweetfavorite
Interasma RT @Aller_MD: “Stress-related disorders were significantly associated with risk of subsequent autoimmune disease” https://t.co/9YWUsJgHWp h…
9hreplyretweetfavorite
Interasma RT @Aller_MD: “A Teledermatology Scale-Up Framework and Roadmap for Sustainable Scaling: Evidence-Based Development” https://t.co/nqPSJpsyg
9hreplyretweetfavorite
Interasma RT @Aller_MD: “Tobacco Product Use Among Youths With and Without Lifetime #Asthmahttps://t.co/wnj8AyUM7Z https://t.co/ydFozighl5
9hreplyretweetfavorite

Editor: Juan C. Ivancevich, MD

Copyright © Interasma 2003-2017  •  Terms of Use  •  Privacy Policy  •  Contact Us  •  Sitemap

Powered by FREI SA

InterAsma