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1.  Genetic Biomarkers of Health-Related Quality of Life in Pediatric Asthma 
The Journal of pediatrics  2011;159(1):21-26.e1.
Objectives
To determine the relationship between single nucleotide polymorphisms (SNPs) in candidate genes associated with multiple asthma phenotypes and HRQOL (HRQOL).
Study design
A cross-sectional study was conducted with 275 school-aged children diagnosed with asthma and their caregiver receiving care at a pediatric hospital. Genomic DNA was obtained from children, and caregivers completed a measure of their child’s HRQOL. ANOVA was used to investigate the association between SNPs and HRQOL.
Results
Children homozygous for the major variant at IL-4RA rs 1805010 evidenced significantly better HRQOL than their counterparts. Significant associations with pulmonary function were not observed.
Conclusion
Genes associated with asthma phenotype can be associated with HRQOL at least partly independently from pulmonary function.
doi:10.1016/j.jpeds.2010.12.017
PMCID: PMC3115404  PMID: 21324477
2.  The Greater Cincinnati Pediatric Clinic Repository: A Novel Framework for Childhood Asthma and Allergy Research 
Background
Allergic disorders, including asthma, allergic rhinitis, atopic dermatitis, eosinophilic esophagitis, and food allergy, are a major global health burden. The study and management of allergic disorders is complicated by the considerable heterogeneity in both the presentation and natural history of these disorders. Biorepositories serve as an excellent source of data and biospecimens for delineating subphenotypes of allergic disorders, but such resources are lacking.
Methods
In order to define subphenotypes of allergic disease accurately, we established an infrastructure to link and efficiently utilize clinical and epidemiologic data with biospecimens into a single biorepository called the Greater Cincinnati Pediatric Clinic Repository (GCPCR). Children with allergic disorders as well as healthy controls are followed longitudinally at hospital clinic, emergency department, and inpatient visits. Subjects' asthma, allergy, and skin symptoms; past medical, family, social, diet, and environmental histories; physical activity; medication adherence; perceived quality of life; and demographics are ascertained. DNA is collected from all participants, and other biospecimens such as blood, hair, and nasal epithelial cells are collected on a subset.
Results
To date, the GCPCR has 6,317 predominantly Caucasian and African American participants, and 93% have banked DNA. This large sample size supports adequately powered genetic, epidemiologic, environmental, and health disparities studies of childhood allergic diseases.
Conclusions
The GCPCR is a unique biorepository that is continuously evaluated and refined to achieve and maintain rigorous clinical phenotype and biological data. Development of similar disease-specific repositories using common data elements is necessary to enable studies across multiple populations of comprehensively phenotyped patients.
doi:10.1089/ped.2011.0116
PMCID: PMC3377950  PMID: 22768387
3.  Functional Variant in the Autophagy-Related 5 Gene Promotor is Associated with Childhood Asthma 
PLoS ONE  2012;7(4):e33454.
Rationale and Objective
Autophagy is a cellular process directed at eliminating or recycling cellular proteins. Recently, the autophagy pathway has been implicated in immune dysfunction, the pathogenesis of inflammatory disorders, and response to viral infection. Associations between two genes in the autophagy pathway, ATG5 and ATG7, with childhood asthma were investigated.
Methods
Using genetic and experimental approaches, we examined the association of 13 HapMap-derived tagging SNPs in ATG5 and ATG7 with childhood asthma in 312 asthmatic and 246 non-allergic control children. We confirmed our findings by using independent cohorts and imputation analysis. Finally, we evaluated the functional relevance of a disease associated SNP.
Measurements and Main Results
We demonstrated that ATG5 single nucleotide polymorphisms rs12201458 and rs510432 were associated with asthma (p = 0.00085 and 0.0025, respectively). In three independent cohorts, additional variants in ATG5 in the same LD block were associated with asthma (p<0.05). We found that rs510432 was functionally relevant and conferred significantly increased promotor activity. Furthermore, Atg5 expression was increased in nasal epithelium of acute asthmatics compared to stable asthmatics and non-asthmatic controls.
Conclusion
Genetic variants in ATG5, including a functional promotor variant, are associated with childhood asthma. These results provide novel evidence for a role for ATG5 in childhood asthma.
doi:10.1371/journal.pone.0033454
PMCID: PMC3335039  PMID: 22536318
4.  Identification of KIF3A as a Novel Candidate Gene for Childhood Asthma Using RNA Expression and Population Allelic Frequencies Differences 
PLoS ONE  2011;6(8):e23714.
Background
Asthma is a chronic inflammatory disease with a strong genetic predisposition. A major challenge for candidate gene association studies in asthma is the selection of biologically relevant genes.
Methodology/Principal Findings
Using epithelial RNA expression arrays, HapMap allele frequency variation, and the literature, we identified six possible candidate susceptibility genes for childhood asthma including ADCY2, DNAH5, KIF3A, PDE4B, PLAU, SPRR2B. To evaluate these genes, we compared the genotypes of 194 predominantly tagging SNPs in 790 asthmatic, allergic and non-allergic children. We found that SNPs in all six genes were nominally associated with asthma (p<0.05) in our discovery cohort and in three independent cohorts at either the SNP or gene level (p<0.05). Further, we determined that our selection approach was superior to random selection of genes either differentially expressed in asthmatics compared to controls (p = 0.0049) or selected based on the literature alone (p = 0.0049), substantiating the validity of our gene selection approach. Importantly, we observed that 7 of 9 SNPs in the KIF3A gene more than doubled the odds of asthma (OR = 2.3, p<0.0001) and increased the odds of allergic disease (OR = 1.8, p<0.008). Our data indicate that KIF3A rs7737031 (T-allele) has an asthma population attributable risk of 18.5%. The association between KIF3A rs7737031 and asthma was validated in 3 independent populations, further substantiating the validity of our gene selection approach.
Conclusions/Significance
Our study demonstrates that KIF3A, a member of the kinesin superfamily of microtubule associated motors that are important in the transport of protein complexes within cilia, is a novel candidate gene for childhood asthma. Polymorphisms in KIF3A may in part be responsible for poor mucus and/or allergen clearance from the airways. Furthermore, our study provides a promising framework for the identification and evaluation of novel candidate susceptibility genes.
doi:10.1371/journal.pone.0023714
PMCID: PMC3166061  PMID: 21912604
5.  Differences in Candidate Gene Association between European Ancestry and African American Asthmatic Children 
PLoS ONE  2011;6(2):e16522.
Background
Candidate gene case-control studies have identified several single nucleotide polymorphisms (SNPs) that are associated with asthma susceptibility. Most of these studies have been restricted to evaluations of specific SNPs within a single gene and within populations from European ancestry. Recently, there is increasing interest in understanding racial differences in genetic risk associated with childhood asthma. Our aim was to compare association patterns of asthma candidate genes between children of European and African ancestry.
Methodology/Principal Findings
Using a custom-designed Illumina SNP array, we genotyped 1,485 children within the Greater Cincinnati Pediatric Clinic Repository and Cincinnati Genomic Control Cohort for 259 SNPs in 28 genes and evaluated their associations with asthma. We identified 14 SNPs located in 6 genes that were significantly associated (p-values <0.05) with childhood asthma in African Americans. Among Caucasians, 13 SNPs in 5 genes were associated with childhood asthma. Two SNPs in IL4 were associated with asthma in both races (p-values <0.05). Gene-gene interaction studies identified race specific sets of genes that best discriminate between asthmatic children and non-allergic controls.
Conclusions/Significance
We identified IL4 as having a role in asthma susceptibility in both African American and Caucasian children. However, while IL4 SNPs were associated with asthma in asthmatic children with European and African ancestry, the relative contributions of the most replicated asthma-associated SNPs varied by ancestry. These data provides valuable insights into the pathways that may predispose to asthma in individuals with European vs. African ancestry.
doi:10.1371/journal.pone.0016522
PMCID: PMC3046166  PMID: 21387019
6.  Comparison of Anthropometric Measures of Obesity in Childhood Allergic Asthma: Central Obesity is Most Relevant 
Background
Established indicators of central obesity include waist circumference, waist to height ratio and the conicity index. Studies utilizing such measures (as opposed to body mass index (BMI) percentiles) to characterize the association between obesity and asthma are lacking despite the fact that these measures have been shown to be most relevant for many other chronic diseases.
Objectives
To examine measures assessing the distribution of obesity in the context of childhood allergic rhinitis and asthma, and to elucidate the association of obesity, including central obesity, with allergic asthma in children.
Methods
Children with allergic rhinitis with (cases) or without (controls) asthma were recruited. BMI percentiles were derived using national growth charts. Waist circumference, waist to height ratio, and conicity index were obtained.
Results
Central obesity was associated with asthma, asthma severity, lower lung function, and reduced atopy in asthmatics.
Conclusion
Measures of central obesity are more associated with the presence of asthma and asthma severity in children with allergic rhinitis when compared to standard BMI measures.
Clinical Implication
Current practices of measuring weight and height in pediatric clinics that treat children with allergic rhinitis should include waist circumference measurements to better assess obesity and asthma risk.
doi:10.1016/j.jaci.2009.03.023
PMCID: PMC2771544  PMID: 19439348
Asthma; Obesity; Children; BMI percentiles; Waist circumference

Results 1-6 (6)