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

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 MeyersEugene 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, W. Gerald Teague

Research output: Contribution to journalArticle

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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 FEV 1 % 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 FEV 1 %, 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 FEV 1 % 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.

Original languageEnglish (US)
Article number58
JournalBMC Pulmonary Medicine
Volume18
Issue number1
DOIs
StatePublished - Apr 10 2018

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Gonadal Steroid Hormones
Puberty
Asthma
Lung
Dehydroepiandrosterone Sulfate
Estradiol
National Heart, Lung, and Blood Institute (U.S.)
Dehydroepiandrosterone
Sex Characteristics
Androgens
Progesterone
Testosterone
Linear Models
Adrenal Cortex Hormones
Estrogens
Breast
Research

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

DeBoer, M. D., Phillips, B. R., Mauger, D. T., Zein, J., Erzurum, S. C., Fitzpatrick, A. M., ... Gerald Teague, W. (2018). Effects of endogenous sex hormones on lung function and symptom control in adolescents with asthma. BMC Pulmonary Medicine, 18(1), [58]. https://doi.org/10.1186/s12890-018-0612-x
DeBoer, Mark D. ; Phillips, Brenda R. ; Mauger, David T. ; Zein, Joe ; Erzurum, Serpil C. ; Fitzpatrick, Anne M. ; Gaston, Benjamin M. ; Myers, Ross ; Ross, Kristie R. ; Chmiel, James ; Lee, Min Jie ; Fahy, John V. ; Peters, Michael ; Ly, Ngoc P. ; Wenzel, Sally E. ; Fajt, Merritt L. ; Holguin, Fernando ; Moore, Wendy C. ; Peters, Stephen P. ; Meyers, Deborah ; Bleecker, Eugene R. ; Castro, Mario ; Coverstone, Andrea M. ; Bacharier, Leonard B. ; Jarjour, Nizar N. ; Sorkness, Ronald L. ; Ramratnam, Sima ; Irani, Anne Marie ; Israel, Elliot ; Levy, Bruce ; Phipatanakul, Wanda ; Gaffin, Jonathan M. ; Gerald Teague, W. / Effects of endogenous sex hormones on lung function and symptom control in adolescents with asthma. In: BMC Pulmonary Medicine. 2018 ; Vol. 18, No. 1.
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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 FEV 1 {\%} 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 FEV 1 {\%}, 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 FEV 1 {\%} 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.",
author = "DeBoer, {Mark D.} and Phillips, {Brenda R.} and Mauger, {David T.} and Joe Zein and Erzurum, {Serpil C.} and Fitzpatrick, {Anne M.} and Gaston, {Benjamin M.} and Ross Myers and Ross, {Kristie R.} and James Chmiel and Lee, {Min Jie} and Fahy, {John V.} and Michael Peters and Ly, {Ngoc P.} and Wenzel, {Sally E.} and Fajt, {Merritt L.} and Fernando Holguin and Moore, {Wendy C.} and Peters, {Stephen P.} and Deborah Meyers and Bleecker, {Eugene R.} and Mario Castro and Coverstone, {Andrea M.} and Bacharier, {Leonard B.} and Jarjour, {Nizar N.} and Sorkness, {Ronald L.} and Sima Ramratnam and Irani, {Anne Marie} and Elliot Israel and Bruce Levy and Wanda Phipatanakul and Gaffin, {Jonathan M.} and {Gerald Teague}, W.",
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DeBoer, MD, Phillips, BR, Mauger, DT, Zein, J, Erzurum, SC, Fitzpatrick, AM, Gaston, BM, Myers, R, Ross, KR, Chmiel, J, Lee, MJ, Fahy, JV, Peters, M, Ly, NP, Wenzel, SE, Fajt, ML, Holguin, F, Moore, WC, Peters, SP, Meyers, D, Bleecker, ER, Castro, M, Coverstone, AM, Bacharier, LB, Jarjour, NN, Sorkness, RL, Ramratnam, S, Irani, AM, Israel, E, Levy, B, Phipatanakul, W, Gaffin, JM & Gerald Teague, W 2018, 'Effects of endogenous sex hormones on lung function and symptom control in adolescents with asthma', BMC Pulmonary Medicine, vol. 18, no. 1, 58. https://doi.org/10.1186/s12890-018-0612-x

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

In: BMC Pulmonary Medicine, Vol. 18, No. 1, 58, 10.04.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of endogenous sex hormones on lung function and symptom control in adolescents with asthma

AU - DeBoer, Mark D.

AU - Phillips, Brenda R.

AU - Mauger, David T.

AU - Zein, Joe

AU - Erzurum, Serpil C.

AU - Fitzpatrick, Anne M.

AU - Gaston, Benjamin M.

AU - Myers, Ross

AU - Ross, Kristie R.

AU - Chmiel, James

AU - Lee, Min Jie

AU - Fahy, John V.

AU - Peters, Michael

AU - Ly, Ngoc P.

AU - Wenzel, Sally E.

AU - Fajt, Merritt L.

AU - Holguin, Fernando

AU - Moore, Wendy C.

AU - Peters, Stephen P.

AU - Meyers, Deborah

AU - Bleecker, Eugene R.

AU - Castro, Mario

AU - Coverstone, Andrea M.

AU - Bacharier, Leonard B.

AU - Jarjour, Nizar N.

AU - Sorkness, Ronald L.

AU - Ramratnam, Sima

AU - Irani, Anne Marie

AU - Israel, Elliot

AU - Levy, Bruce

AU - Phipatanakul, Wanda

AU - Gaffin, Jonathan M.

AU - Gerald Teague, W.

PY - 2018/4/10

Y1 - 2018/4/10

N2 - 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 FEV 1 % 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 FEV 1 %, 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 FEV 1 % 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.

AB - 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 FEV 1 % 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 FEV 1 %, 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 FEV 1 % 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.

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