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      Prenatal Tobacco Smoke Exposure Is Associated with Childhood DNA CpG Methylation

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          Abstract

          Background

          Smoking while pregnant is associated with a myriad of negative health outcomes in the child. Some of the detrimental effects may be due to epigenetic modifications, although few studies have investigated this hypothesis in detail.

          Objectives

          To characterize site-specific epigenetic modifications conferred by prenatal smoking exposure within asthmatic children.

          Methods

          Using Illumina HumanMethylation27 microarrays, we estimated the degree of methylation at 27,578 distinct DNA sequences located primarily in gene promoters using whole blood DNA samples from the Childhood Asthma Management Program (CAMP) subset of Asthma BRIDGE childhood asthmatics (n = 527) ages 5–12 with prenatal smoking exposure data available. Using beta-regression, we screened loci for differential methylation related to prenatal smoke exposure, adjusting for gender, age and clinical site, and accounting for multiple comparisons by FDR.

          Results

          Of 27,578 loci evaluated, 22,131 (80%) passed quality control assessment and were analyzed. Sixty-five children (12%) had a history of prenatal smoke exposure. At an FDR of 0.05, we identified 19 CpG loci significantly associated with prenatal smoke, of which two replicated in two independent populations. Exposure was associated with a 2% increase in mean CpG methylation in FRMD4A (p = 0.01) and Cllorf52 (p = 0.001) compared to no exposure. Four additional genes, XPNPEP1, PPEF2, SMPD3 and CRYGN, were nominally associated in at least one replication group.

          Conclusions

          These data suggest that prenatal exposure to tobacco smoke is associated with reproducible epigenetic changes that persist well into childhood. However, the biological significance of these altered loci remains unknown.

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          Most cited references32

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          Prenatal and passive smoke exposure and incidence of asthma and wheeze: systematic review and meta-analysis.

          Exposure to passive smoke is a common and avoidable risk factor for wheeze and asthma in children. Substantial growth in the prospective cohort study evidence base provides an opportunity to generate new and more detailed estimates of the magnitude of the effect. A systematic review and meta-analysis was conducted to provide estimates of the prospective effect of smoking by parents or household members on the risk of wheeze and asthma at different stages of childhood. We systematically searched Medline, Embase, and conference abstracts to identify cohort studies of the incidence of asthma or wheeze in relation to exposure to prenatal or postnatal maternal, paternal, or household smoking in subjects aged up to 18 years old. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by using random effects model. We identified 79 prospective studies. Exposure to pre- or postnatal passive smoke exposure was associated with a 30% to 70% increased risk of incident wheezing (strongest effect from postnatal maternal smoking on wheeze in children aged ≤2 years, OR = 1.70, 95% CI = 1.24-2.35, 4 studies) and a 21% to 85% increase in incident asthma (strongest effect from prenatal maternal smoking on asthma in children aged ≤2 years, OR = 1.85, 95% CI = 1.35-2.53, 5 studies). Building upon previous findings, exposure to passive smoking increases the incidence of wheeze and asthma in children and young people by at least 20%. Preventing parental smoking is crucially important to the prevention of asthma.
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            Quantitative profiling of biomarkers related to B-vitamin status, tryptophan metabolism and inflammation in human plasma by liquid chromatography/tandem mass spectrometry.

            Vitamins B2 and B6 serve as cofactors in enzymatic reactions involved in tryptophan and homocysteine metabolism. Plasma concentrations of these vitamins and amino acids are related to smoking and inflammation, and correlate with other markers of immune activation. Large-scale studies of these relations have been hampered by lack of suitable analytical methods. The assay described includes riboflavin, five vitamin B6 forms (pyridoxal 5'-phosphate, pyridoxal, 4-pyridoxic acid, pyridoxine and pyridoxamine), tryptophan and six tryptophan metabolites (kynurenine, kynurenic acid, anthranilic acid, 3-hydroxykynurenine, xanthurenic acid and 3-hydroxyanthranilic acid), cystathionine, neopterin and cotinine. Trichloroacetic acid containing 13 isotope-labelled internal standards was added to 60 microL of plasma, the mixture was centrifuged, and the resulting supernatant used for analysis. The analytes were separated within 5 min on a stable-bond C8 column by a gradient-type mobile phase containing acetonitrile, heptafluorobutyric acid and high concentration (650 mmol/L) of acetic acid, and detected using electrospray ionization tandem mass spectrometry (ESI-MS/MS). The mobile phase ensured sufficient separation and high ionization efficiency of all analytes. Recoveries were 75-123% and within-day and between-day coefficients of variance (CVs) were 2.5-9.5% and 5.4-16.9%, respectively. Limits of detection ranged from 0.05 to 7 nmol/L. The method enables quantification of endogenous plasma concentrations of 16 analytes related to B-vitamin status and inflammation, and may prove useful in large-scale epidemiological studies. Copyright (c) 2009 John Wiley & Sons, Ltd.
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              Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children.

              The effects of maternal smoking during pregnancy and childhood environmental tobacco smoke (ETS) exposure on asthma and wheezing were investigated in 5,762 school-aged children residing in 12 Southern California communities. Responses to a self- administered questionnaire completed by parents of 4th, 7th, and 10th grade students were used to ascertain children with wheezing or physician-diagnosed asthma. Lifetime household exposures to tobacco smoke were assessed using responses about past and current smoking histories of household members and any history of maternal smoking during pregnancy. Logistic regression models were fitted to cross-sectional data to estimate the effects of in utero exposure to maternal smoking and previous and current ETS exposure on the prevalence of wheezing and physician-diagnosed asthma. In utero exposure to maternal smoking without subsequent postnatal ETS exposure was associated with increased prevalence of physician-diagnosed asthma (OR, 1.8; 95% CI, 1.1 to 2.9), asthma with current symptoms (OR, 2.3; 95% CI, 1.3 to 4.0), asthma requiring medication use in the previous 12 mo (OR, 2.1; 95% CI, 1.2 to 3.6), lifetime history of wheezing (OR, 1.8; 95% CI, 1.2 to 2.6), current wheezing with colds (OR, 2.1; 95% CI, 1.3 to 3.4) and without colds (OR, 2.5; 95% CI, 1.4 to 4.4), persistent wheezing (OR, 3.1; 95% CI, 1.6 to 6.1), wheezing with exercise (OR, 2.4; 95% CI; 1.3 to 4.3), attacks of wheezing causing shortness of breath (OR, 2.4; 95% CI, 1.3 to 4.4) or awakening at night in the previous 12 mo (OR, 3.2; 95% CI, 1.7 to 5.8), and wheezing requiring medication (OR, 2.1; 95% CI, 1.2 to 3.7) or emergency room visits during the previous year (OR, 3.4; 95% CI, 1.4 to 7.8). In contrast, current and previous ETS exposure was not associated with asthma prevalence, but was consistently associated with subcategories of wheezing. Current ETS exposure was associated with lifetime wheezing (OR, 1.3; 95% CI, 1.1 to 1.5), current wheezing with colds (OR, 1.6; 95% CI, 1.3 to 2.0) and without colds (OR, 1.5; 95% CI, 1.1 to 1.9), wheezing with exercise (OR, 1.7; 95% CI, 1.3 to 2.2), attacks of wheezing causing shortness of breath (OR, 1.6; 95% CI, 1.2 to 2.1) or awakening at night (OR, 1.5; 95% CI, 1.1 to 2.0), and wheezing requiring medication (OR, 1.4; 95% CI, 1.1 to 1.8) or emergency room visits within the previous year (OR, 1.9; 95% CI, 1.2 to 3.0). The effects of current ETS exposure on subcategories of wheezing were most pronounced among children exposed to two or more smokers and remained significant after adjusting for maternal smoking during pregnancy. We conclude that maternal smoking during pregnancy increases the occurrence of physician-diagnosed asthma and wheezing during childhood. In contrast, current ETS exposure is associated with wheezing, but not physician-diagnosed asthma. Taken together, our findings support the hypothesis that ETS operates as a cofactor with other insults such as intercurrent infections as a trigger of wheezing attacks, rather than as a factor that induces asthma, whereas in utero exposure acts to increase physician-diagnosed asthma
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                25 June 2014
                : 9
                : 6
                : e99716
                Affiliations
                [1 ]Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
                [2 ]Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, Research Triangle Park, North Carolina, United States of America
                [3 ]Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
                [4 ]Norwegian Institute of Public Health, Oslo, Norway
                [5 ]University of Chicago, Chicago, Illinois, United States of America
                [6 ]Johns Hopkins University, Baltimore, Maryland, United States of America
                [7 ]Arizona Respiratory Center, University of Arizona, Arizona, United States of America
                [8 ]National Jewish Health, Denver, Colorado, United States of America
                [9 ]University of Wisconsin, Madison, Wisconsin, United States of America
                [10 ]Washington University School of Medicine, St. Louis, Montana, United States of America
                Cleveland Clinic Foundation, United States of America
                Author notes

                ¶ Membership for extended Asthma BRIDGE consortium authorship list in File S1.

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: CVB FG BR. Performed the experiments: WN SEH FG BR. Analyzed the data: CVB KDS BRJ XW WQ SL FG BR. Contributed reagents/materials/analysis tools: VC WN SEH CO DN KCB FM AL RL RS SW SL FG BR. Wrote the paper: CVB KDS FG SL BR.

                Article
                PONE-D-14-08307
                10.1371/journal.pone.0099716
                4070909
                24964093
                b8c70db9-5158-47ff-903d-350ddb7092fa
                Copyright @ 2014

                This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

                History
                : 21 February 2014
                : 18 May 2014
                Page count
                Pages: 9
                Funding
                The CAMP Genetics Ancillary Study is supported by U01 HL075419, U01 HL65899, P01 HL083069 R01 HL 086601, from the National Heart, Lung and Blood Institute, National Institutes of Health. The methylation data described here was funded by 5RC2HL101543-02 and NIEHS grants 5P30ES007048 and 1K01ES017801. Also supported in part by the Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, US. The Norwegian Mother and Child Cohort Study is supported by the Norwegian Ministry of Health and the Ministry of Education and Research, NIH/NIEHS (contract no NO-ES-75558), NIH/NINDS (grant no.1 UO1 NS 047537-01), and the Norwegian Research Council/FUGE (grant no. 151918/S10). KCB was supported in part by the Mary Beryl Patch Turnbull Scholar Program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Genetics
                Epigenetics
                Medicine and Health Sciences
                Epidemiology
                Environmental Epidemiology
                Genetic Epidemiology
                Lifecourse Epidemiology
                Health Care
                Environmental Health
                Public and Occupational Health
                Tobacco Control
                Pulmonology
                Asthma

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