The use of paracetamol in young children has been associated with an increased risk of asthma in adolescents with particular genetic makeup.
The use of paracetamol in young children is linked to an increased risk of asthma in adolescents, according to a new study presented at European Respiratory Society International Congress. In addition, genetic variants seem to play a role in a greater susceptibility to lung problems.
In France, around 4 million people suffer from asthma: there are nearly 60,000 hospitalizations (nearly 40,000 in children) and around 1,000 deaths each year. The first attacks usually occur in the first year of life in 10 to 50% of cases, before the fifth year in 65 to 95% of cases, or after 10 years, but this is rare.
Inflammation of the bronchi
Asthma is a chronic disease caused by inflammation of the bronchi which results in their hypersensitivity to different stimuli: cold, virus, tobacco, pollution … Bronchial inflammation causes “hyperreactivity” of the muscle wall with swelling of the wall internal bronchus, hypersecretion of mucus (normally produced in small amounts) and contraction of the muscles of the bronchial wall. In the end, all these phenomena result in the narrowing of the lumen of the bronchus, even in its obstruction, and in a gene to breathe.
Inflammation and hyperreactivity of the bronchial wall appear to be favored by risk factors: some are “endogenous”, ie specific to the patient, and others are “exogenous”, ie. say external to the patient (allergens, pollution, viruses, etc.). Among the “endogenous” risk factors, we find a family and especially personal allergic ground in nearly 9 out of 10 patients. These genetic factors predispose to developing asthma, but also to becoming allergic to substances which are breathed in on a daily basis, such as “mites”, indoor dust, animal hair or pollen. This predisposition is called “atopy”.
Genes of the Glutathione S-transferase (GST) family
The Xin Dai team (University of Melbourne, Australia) followed 620 children from birth to age 18. All had high risks of developing an allergic disease (asthma, eczema, hay fever, food allergy), having at least one member of their family (mother, father, brother or sister) who declared to suffer from it.
Paracetamol intake was assessed regularly by telephone. When the children turned 18, they all gave a blood or saliva sample to check for the presence of genes from the Glutathione S-transferase (GST) family: GSTT1, GSTM1 and GSTP1. The presence of asthma and the ability to inhale and exhale air were also measured.
The association between paracetamol consumption and asthma was strongest in adolescents with the GSTP1 gene. The GSTM1 gene has also been associated with reduced lung function. “We found that children with the GSTP1 variant were 1.8 times more likely to develop asthma before the age of 18 for every doubling of the days of paracetamol exposure compared to children who were less exposed. “Xin Dai says.
But paracetamol is not a candy, it is generally given to children in case of fever which is itself linked to a viral infection: it is not said that it is not the viral infection that is involved in this increase in asthma, paracetamol being a risk marker (viral infection), more than a real risk factor.
An antioxidant called “glutathione”
Genes in the GST family use an antioxidant called “glutathione” to absorb the effects of exposure to toxins in the body and lungs. “Paracetamol, on the other hand, consumes glutathione, which reduces the body’s ability to cope with toxic exposure,” explains the scientist. The GSTM1, GSTT1 and GSTP1 genes have already been linked to various diseases, including cancer, asthma, atherosclerosis, Alzheimer’s and Parkinson’s disease.
“Paracetamol is a safe and effective drug under normal conditions of use. But in the event of misuse, in particular by overdose by combining several products containing paracetamol and / or by non-compliance with their dosage, paracetamol can cause damage. serious liver problems in certain irreversible cases. The misuse of paracetamol is the leading cause of drug-induced liver transplantation in France “, recently indicated the ANSM, following the case of Naomie Musenga, who died as a result of intoxication with paracetamol.
The maximum dose of paracetamol
As a reminder, the maximum dose of paracetamol not to be exceeded is 3 grams per 24 hours, spacing out the catches. In addition, treatment with paracetamol should be as short as possible and strictly adapted to the duration of the symptoms. If the pain or fever lasts more than 3 days, it is best to see a doctor. In the event of consumption, it is also necessary to check the presence of paracetamol in the other drugs possibly used for pain, fever, allergies, cold symptoms or flu-like state. Certain populations must also have a particularly controlled relationship to the drug (-50kg, mild to moderate hepatic insufficiency, severe renal insufficiency, chronic alcoholism, AIDS, etc.).
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