| Summary: | 碩士 === 高雄醫學大學 === 公共衛生學研究所碩士班 === 95 === Background:
Asthma has the impact on individual health or family around the world. Besides, it
becomes a burden on the medical health care system and the government. Asthma is
relevant to the gene and the environment. And it is known that asthma patients show
the higher NO consideration; the NO production is relevant to NOS gene and ARG
gene. NOS gene enable to catalyze Arginine to produce endogenous NO while ARG
gene will compete with Arginine to decrease the NO production. It was still the rare
studies which are processed to explore the relation between Asthma and
polymorphism.
Objective：
Our research would like to realize the influence of ARG polymorphism on NO,
lung function and asthma, and the relation between the NO consideration and the
relevant symptom of asthma, and the correlation between the environmental factors
and asthma. We expect to sift out the acceptant gene relating to the asthma and the
environmental factors around life, and then prevent the allergen in advance and then
decreeing asthma to happen.
Materials and Methods：
Our study was taken by cross-sectional study in Kaohsiung City, Taiwan. 199
controls were selected from ribcage out-patient Kaohsiung Medical University
Chung-Ho Memorial Hospital and Sinshang community, Kaohsiung City. The amount
of subjects who were 18 years old and upward was 286, 87 subjects with asthma, and
the others without it. The control group was selected by matching age and gender,
and proportion was 1:1 ~ 1:3. We established and collected the questionnaires about
personal information and blood samples of all cases. And then, total IgE and
phadiatop were measured atopic index and genotyping.
Result：
The data which analyzed the asthmas under controlled situation showed that age,
BMI, career, smoking percentage and exposing to secondhand smoke had statistically
significant association .
In environmental factors, the data showed that cockroach and Chinese incense had
statistically significant association as well.
In allergic physique factors, the data showed allergic physique, allergic rhinitis, if a
parent was affected to asthma, the familial history of affecting asthma （one of the
parents was asthmatic）and if siblings were affected to asthma had statistically
significant association(p＜0.05).
In the relevant symptom of asthma factors, the total IgE consideration was higher
on average(325.81±653.19 kU/l and 128.07±358.94 kU/l). After transforming to log
number, it was still higher（2.08±0.66 and 1.59±0.63）.The original measure index
including FVE_b1, FVC_b and FVE1/ FVC_b were lower(FEV1_b：1.68±0.68 and
2.40±0.72L; FVC_b： 2.26±0.76L and 2.79±0.78L; FEV1/FVC_b：0.74±0.15 and
0.86±0.12). The index of lung function FEV1% and FVC% were lower（FEV1%:
68.33±19.84 and 91.22±19.46; FVC%:84.28±22.71 and 97.23±18.57;
FEV1/FVC%：0.83±0.21 and 0.94±0.14）. NO in the blood serum had high quantity
（27.54±24.45μmol/L and 20.27±14.79μmol/L）. In addition, the factors as above
had significant association on the difference between the asthmas and the controls.
The interaction between the high IgE concentration and the NO high
concentration was significant. The risk of Asthma in the group with higher NO and IgE
concentration was the multiplier of 4.699 than the group with low NO and high IgE
concentration（95%CI: 2.103-10.500，p=0.000）, and multiplier increases to 7.551
comparing the group with higher NO and IgE concentration and the lower
concentration group（95%CI: 3.064-18.606，p=0.000）. Take ARG-S1 gene and low
NO concentration as reference group, there is interaction between ARG-S1 gene
CT/TT type and high NO concentration, and the multiplier is 2.860 than reference
group with statistical signicance（95%CI: 1.119-7.309，p=0.028） . While take ARG-S1
gene CC type and low NO concentration as reference group, there is still interaction
and the multiplier is 11.112 than the reference group with statistical signicance
（95%CI:4.538-27.207，p=0.000）. Take ARG-S1 gene CC type and non-smoking
habits as reference group, theARG-S1 CT/TT type and smoking habits result in higher
risk of asthma up to 3.410 times to reference group and as well with statistical
significance. （95%CI:1.251-9.296，p=0.016）.
Conclusion：
In this research , the ARG polymorphism and the relative symptom （Lung
function decrease）had the significant relation which showed they played the important
role in the fateful crisis. And according to the result of interaction analysis, with the
ARG-S1 acceptable gene（CT/TT）and under the condition of high NO and Total IgE
at same time, the danger of asthma would also be higher. Moreover, there is still
interaction between NO and Total IgE with the habit of smoking. Thus, ARG
polymorphism could be one of the risk
factors of asthma. In the future, we can have advanced research on
polymorphism causing the difference in enzyme activity or other relevant
factors in phlogistic reaction.
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