Ethnic disparities in asthma burden and gut bacteriome profiles of children with moderate-to-severe asthma in Europe

<bold>Background:</bold> Ethnic minorities have worse health outcomes, but the relationship between ethnicity, disease burden, and gut bacteriome in children with moderate-to-severe asthma/wheezing remains unclear. <bold>Methods:</bold> Pooled analysis was performed using 3 pediatric study populations (U-BIOPRED, SysPharmPediA, and PUFFIN) with moderate-to-severe asthma/wheezing. Self-reported ethnic groups were compared in asthma burden based on exacerbations requiring hospitalizations, ICU/ER visits, and (c)ACT/PA(C)QLQ questionnaire z-scores. Gut bacteriome was analyzed in feces by metagenomics in 2 populations (SysPharmPediA, PUFFIN), comparing ethnic groups in α- and β-diversities, and whether α-diversity has a mediating link between race and disease burden. All analyses were adjusted for potential confounders. <bold>Results:</bold> Non-white children (n=95/420, mean age=9.8±3.7, 55% male) exhibited a higher risk for hospitalizations/ER-visits (adj OR=2.8, 95%CI=1.5-5.2) and lower (c)ACT/PA(C)QLQ z-scores (adj β =-0.40, 95%CI=-0.63,-0.17, and −0.31, 95%CI=-0.54,-0.09, respectively). They (n=37/180) also showed distinct gut bacteriome composition compared to White patients with lower Shannon diversity (adj β=-0.41, 95%CI=-0.68,-0.15) and significantly different β-diversity (R<sup>2</sup>=0.01, p<0.05). Shannon diversity partially mediated the link between race and hospitalizations/ER-visits (proportion mediated=0.17, 95%CI=0.01, 0.55), but not to asthma control or quality of life. <bold>Conclusion:</bold> Ethnic minorities have a higher asthma burden and lower gut bacterial diversity. However, the gut bacteriome diversity only showed a modest association between race and asthma burden, suggesting that additional factors play a role.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa4457
Primary Topic
Gut microbiota and health
Type
article
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article

Ethnic disparities in asthma burden and gut bacteriome profiles of children with moderate-to-severe asthma in Europe

Susanne Harner, Jonathan Thorsen, Klaus Bønnelykke, Berber Kapitein et al.
Gut microbiota and health
article

Ethnic disparities in asthma burden and gut bacteriome profiles of children with moderate-to-severe asthma in Europe

Susanne Harner, Jonathan Thorsen, Klaus Bønnelykke, Berber Kapitein, Corinna Bang, Simone Hashimoto, Gerard H. Koppelman, Louise Fleming, Mahmoud I. Abdel‐Aziz, Mariëlle W. Pijnenburg, Mario Gorenjak, Anke H. Maitland‐van der Zee, Olaia Sardón‐Prado, Anne H. Neerincx, Aruna T. Bansal, Susanne J. H. Vijverberg, Antoaneta A. Toncheva, Gunilla Hedlin, Jakob Stokholm, Paula Corcuera, Kian Fan Chung, Paul Brinkman, Florian Singer, Aletta D. Kraneveld, Maria Pino‐Yanes, Susanne Brandstetter, Urs Frey, Clare Murray, Elise M. A. Slob, Andrew Bush, Ian Michael Adcock, Christine Wolff, Michael Kabesch, Graham Roberts, Lieke Noij, Elin T.G. Kersten, Björn Nordlund, Yoni Van Dijk, Uroš Potočnik, A R Sousa, Leyre López‐Fernández, Wim van Aalderen, Peter J. Sterk
article en

Abstract

<bold>Background:</bold> Ethnic minorities have worse health outcomes, but the relationship between ethnicity, disease burden, and gut bacteriome in children with moderate-to-severe asthma/wheezing remains unclear. <bold>Methods:</bold> Pooled analysis was performed using 3 pediatric study populations (U-BIOPRED, SysPharmPediA, and PUFFIN) with moderate-to-severe asthma/wheezing. Self-reported ethnic groups were compared in asthma burden based on exacerbations requiring hospitalizations, ICU/ER visits, and (c)ACT/PA(C)QLQ questionnaire z-scores. Gut bacteriome was analyzed in feces by metagenomics in 2 populations (SysPharmPediA, PUFFIN), comparing ethnic groups in α- and β-diversities, and whether α-diversity has a mediating link between race and disease burden. All analyses were adjusted for potential confounders. <bold>Results:</bold> Non-white children (n=95/420, mean age=9.8±3.7, 55% male) exhibited a higher risk for hospitalizations/ER-visits (adj OR=2.8, 95%CI=1.5-5.2) and lower (c)ACT/PA(C)QLQ z-scores (adj β =-0.40, 95%CI=-0.63,-0.17, and −0.31, 95%CI=-0.54,-0.09, respectively). They (n=37/180) also showed distinct gut bacteriome composition compared to White patients with lower Shannon diversity (adj β=-0.41, 95%CI=-0.68,-0.15) and significantly different β-diversity (R<sup>2</sup>=0.01, p<0.05). Shannon diversity partially mediated the link between race and hospitalizations/ER-visits (proportion mediated=0.17, 95%CI=0.01, 0.55), but not to asthma control or quality of life. <bold>Conclusion:</bold> Ethnic minorities have a higher asthma burden and lower gut bacterial diversity. However, the gut bacteriome diversity only showed a modest association between race and asthma burden, suggesting that additional factors play a role.

University Medical Center Groningen (NL), Karolinska University Hospital (SE), Universidad de La Laguna (ES), St. John's College of Nursing (US), GlaxoSmithKline (United Kingdom) (GB), Utrecht University (NL), Manchester Academic Health Science Centre (GB), Royal Brompton & Harefield NHS Foundation Trust (GB), Erasmus MC (NL), University Hospital Regensburg (DE), Christian-Albrechts-Universität zu Kiel (DE), University of Maribor (SI), Emma Kinderziekenhuis (NL), Biogipuzkoa Health Research Institute (ES), Amsterdam Neuroscience (NL), NIHR Southampton Respiratory Biomedical Research Unit (GB), Beatrix Kinderziekenhuis (NL), Pharmo Institute (NL), University Children’s Hospital Bern (CH), Copenhagen Prospective Studies on Asthma in Childhood (DK), University Children’s Hospital Basel (CH), NIHR Manchester Biomedical Research Centre (GB), Amsterdam University of Applied Sciences (NL), University of Amsterdam (NL)
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Gut microbiota and health
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