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Cotinine Level Is Associated with Asthma Severity in Passive Smoker Children

Abstract

Asthma environmental triggers play important roles in severity of disease. Passive smoking could exacerbate asthma symptoms and enhance the decrease in lung function. Cotinine levels could be a reflection of passive exposure to the cigarette both in adults and pediatrics. The aim of this study was to determine degree of association of asthma severity and cotinine level as a marker of passive smoking. In a cross-sectional study, 100 pediatric patients (under 10 years old) with asthma were enrolled, 50 of whom, had been exposed to passive smoking and 50 others included as controls. A complete clinical history, lab exam, and spirometry were performed. A sample of urine, serum and saliva was collected from all attendant patients and controls in the study after confirmation of diagnosis and determination of severity of asthma. The results revealed that age, sex, age of onset of asthma, family history and allergic history were not significantly different between two groups of patients. According to GINA classification, percentage of patients with severe asthma was significantly higher in passive smoker group (p=0.001). Cotinine was significantly higher in passive smoker group compared to control group in serum (p=001), saliva (p=0.001), and urine (p=0.0014). In passive smoker group, cotinine levels were significantly higher in serum (p=0.001), urine (p=0.007), and saliva (p=0.01) of patients with severe asthma than moderate and mild asthma. Serum cotinine (OR: 1.81, 95% CI: 1.35-2.32, p=0.024), urine cotinine (OR: 3.56,95% CI = 1.29-5.53, p=0.01) and saliva cotinine (OR: 1.66, 95% CI: 1.23-1.98, p=0.031) were also significantly associated with higher risk of severe asthma. Cotinine levels were higher in passive smokers compared to non-passive smokers. Besides, cotinine was a predictive risk factor for severe asthma.

1. Safa M, Mehrian P, Hassanzad M. Prevalence of depression in children with asthma. J Comp Ped 2014May; 4(2):e17327.
2. Safa M, Ghasem Boroujerdi F. Psychiatric problems in mothers of asthmatic children. J Comp Ped 2014Feb;4(1):e17086.
3. Safa M, Khalilzadeh S, Talischi F, Alizadeh S.Correlation of anxiety-depression and sleep quality in mothers of children with Cystic Fibrosis and Asthma.TANAFFOS 2012; 11(1): 44-8.
4. Thomson NC, Chaudhuri R. Asthma in smokers:challenges and opportunities. CurrOpinPulm Med 2009;15(1):39-45.
5. Larsson ML, Frisk M, Hallström J, Kiviloog J, Lundbäck B.Environmental tobacco smoke exposure during childhood is associated with increased prevalence of asthma in adults. chest 2001; 120(3):711-7.
6. Irvine L, Crombie IK, Clark RA, Slane PW, Goodman KE, Feyerabend C, et al. What determines levels of passive smoking in children with asthma? Thorax1997;52(9):766-9.
7. Farber HJ, Knowles SB, Brown NL, Caine L, Luna V, Qian Y, et al. Secondhand and tobacco smoke in children with asthma. Chest 2008; 133(6):1367-74.
8. Mannino DM1, Homa DM, Redd SC. Involuntary Smoking and asthma severity in children: data from the third national health and nutrition examination survey. Chest 2002; 122(2):409-15.
9. Carlsten C, Dimich-Ward H, DyBuncio A, Becker AB, Chan-Yeung M. Cotinine versus questionnaire: early-life environmental tobacco smoke exposure and incident asthma. BMC Pediatr 2012; 12:187.
10. Hsieh SJ, Ware LB, Eisner MD, Yu L, Jacob P 3rd, Havel C, et al. Biomarkers increase detection of active smoking and secondhand smoke exposure in critically ill patients. Crit Care Med 2011; 39(1):40-5.
11. Schick SF, van den Vossenberg G, Luo A, Whitlatch A, Jacob P 3rd, Balmes J, et al. Thirty minute-exposure to aged cigarette smoke increases nasal congestion in nonsmokers. J Toxicol Environ Health A 2013;76(10):601-13.
12. Seccareccia F, Zuccaro P, Pacifici R, Meli P, Pannozzo F, Freeman KM, et al. Serum cotinine as a marker of environmental tobacco smoke exposure in epidemiological studies: the experience of the MATISS project. Eur J Epidemiol 2003; 18(6):487-92.
13. Global Initiative for Asthma (GINA). The global strategy for asthma management and prevention. Updated 2012. Available from: http://www.ginasthma.org.
/>14. Mannino DM, Homa DM, Redd SC. Involuntary smoking and asthma severity in children: data from the Third National Health and Nutrition Examination Survey. Chest 2002; 122(2):409-15.
15. Brunst KJ, Ryan PH, Lockey JE, Bernstein DI, McKay RT, Khurana Hershey GK, et al. Unraveling the relationship between aeroallergen sensitization, gender, second-hand smoke exposure, and impaired lung function. Pediatr Allergy Immunol 2012; 23(5):479-87.
16. Comhair SA, Gaston BM, Ricci KS, Hammel J, Dweik RA, Teague WG, et al. Detrimental effects of environmental tobacco smoke in relation to asthma severity. PLoS One 2011; 6(5):e18574.
17. Butz AM, Halterman JS, Bellin M, Tsoukleris M, Donithan M, Kub J, et al. Factors associated with second-hand smoke exposure in young inner-city children with asthma. J Asthma 2011; 48(5):449-57.
18. Zielińska-Danch W, Wardas W, Sobczak A, Szołtysek- Bołdys I. Estimation of urinary cotinine cut-off points distinguishing non-smokers, passive and active smokers. Biomarkers 2007; 12(5):484-96.
19. Smith JJ, Robinson RF, Khan BA, Sosnoff CS, Dillard DA. Estimating Cotinine Associations and a Saliva Cotinine Level to Identify Active Cigarette Smoking in Alaska Native Pregnant Women. Matern Child Health J 2013; 18(1):120-8.
20. Etter JF, Vu Duc T, Perneger TV. Saliva cotinine levels in smokers and nonsmokers. Am J Epidemiol 2000;151(3):251-8.

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IssueVol 14, No 1 (2015) QRcode
SectionArticles
Keywords
Asthma Child Cotinine
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1.
Hassanzad M, Khalilzadeh S, Eslampanah Nobari S, Bloursaz M, Sharifi H, Mohajerani SA, Tashayoie Nejad S, Velayati AA. Cotinine Level Is Associated with Asthma Severity in Passive Smoker Children. Iran J Allergy Asthma Immunol. 1;14(1):67-73.