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Dissecting Complex Diseases in Complex Populations

Asthma in Latino Americans

¹ Department of Medicine, ² The Institute for Human Genetics, and ³ Department of Biopharmaceutical Sciences, University of California, San Francisco, San Francisco, California; ⁴ Department of Epidemiology, Mailman School of Public Health, College of Dental Medicine, Columbia University, New York, New York; ⁵ Department of Genetics, Stanford University, Stanford, California; ⁶ Jacobi Medical Center and Department of Pediatrics at Albert Einstein College of Medicine, Bronx, New York; ⁷ Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico; ⁸ University of Puerto Rico School of Medicine, San Juan, Puerto Rico; ⁹ Centro de Neumologia Pediatrica, CSP, San Juan, Puerto Rico; ¹⁰ Division of Allergy-Immunology, Northwestern University, Chicago, Illinois; ¹¹ Veterans Caribbean Health Care System, San Juan, Puerto Rico; and ¹² Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California

Correspondence and requests for reprints should be addressed to Esteban González Burchard, M.D., M.P.H., UCSF/Lung Biology Center, University of California, San Francisco, San Francisco, CA 94143–2911. E-mail: esteban{at}sfgh.ucsf.edu

ABSTRACT

Asthma is a common but complex respiratory ailment; current data indicate that interaction of genetic and environmental factors lead to its clinical expression. In the United States, asthma prevalence, morbidity, and mortality vary widely among different Latino ethnic groups. The prevalence of asthma is highest in Puerto Ricans, intermediate in Dominicans and Cubans, and lowest in Mexicans and Central Americans. Independently, known socioeconomic, environmental, and genetic differences do not fully account for this observation. One potential explanation is that there may be unique and ethnic-specific gene–environment interactions that can differentially modify risk for asthma in Latino ethnic groups. These gene–environment interactions can be tested using genetic ancestry as a surrogate for genetic risk factors. Latinos are admixed and share varying proportions of African, Native American, and European ancestry. Most Latinos are unaware of their precise ancestry and report their ancestry based on the national origin of their family and their physical appearance. The unavailability of precise ancestry and the genetic complexity among Latinos may complicate asthma research studies in this population. On the other hand, precisely because of this rich mixture of ancestry, Latinos present a unique opportunity to disentangle the clinical, social, environmental, and genetic underpinnings of population differences in asthma prevalence, severity, and bronchodilator drug responsiveness.

Key Words: genes • environments • Latinos • Hispanics • asthma

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