New risk factors for adult-onset incident asthma: A nested case-control study of host antioxidant defense

Emma K. Larkin, Yu Tang Gao, Tebeb Gebretsadik, Terryl J. Hartman, Pingsheng Wu, Wanqing Wen, Gong Yang, Chunxue Bai, Meiling Jin, L. Jackson Roberts, Myron Gross, Xiao O. Shu, Tina V. Hartert

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Rationale: Host antioxidant defense, consisting of enzymatic antioxidant activity and nonenzymatic antioxidant micronutrients, is implicated in asthma pathogenesis. Studies of antioxidant defense and adult incident asthma have either used measures of antioxidants estimated from questionnaires or not considered enzymatic aspects of host defense. Objectives: We conducted the first study designed and powered to investigate the association of antioxidant defenses on adult incident asthma. Methods: In a nested case-control study, we followed Shanghai women (aged 40-70 years) without prevalent asthma at baseline, over 8 years. Subjects with incident asthma were ascertained prospectively by gold standard testing of symptomatic women and matched to two asymptomatic control subjects. Measurements and Main Results: Baseline urinary F2-isoprostanes, plasma concentrations of antioxidant micronutrients (tocopherols, xanthines, carotenes, and lycopene), and antioxidant enzyme activity (platelet-activating factor acetylhydrolase [PAF-AH] and superoxide dismutase) were measured from samples collected before disease onset. Among 65,372 women, 150 (0.24%) developed asthma. F2-isoprostane levels before asthma onset were not different between cases and control subjects. Doubling of α-tocopherol concentrations and PAF-AH activity was associated with 50 and 37% decreased risk of incident asthma (α-tocopherol: adjusted odds ratio = 0.52; 95% confidence interval, 0.32-0.84; PAF-AH: adjusted odds ratio = 0.63; 95% confidence interval, 0.42-0.93). Conclusions: In this prospective study, α-tocopherol, within normal reference ranges, and PAF-AH enzymatic activity were associated with decreased asthma development. These modifiable risk factors may be an effective strategy to test for primary asthma prevention.

Original languageEnglish (US)
Pages (from-to)45-53
Number of pages9
JournalAmerican journal of respiratory and critical care medicine
Issue number1
StatePublished - Jan 1 2015

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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