Acetaminophen and the risk of asthma: the epidemiologic and pathophysiologic evidence.
The prevalence of asthma has increased worldwide. The reasons for this rise remain unclear. Various studies have reported an association between acetaminophen, a widely used analgesic, and diagnosed asthma. In a prospective cohort study, the rate of newly diagnosed asthma was 63% higher among frequent acetaminophen users than nonusers in multivariate analyses. Studies of patients with asthma suggest that acetaminophen challenge can precipitate a decline in FEV(1) > 15% among sensitive individuals. Plausible mechanisms to explain this association include depletion of pulmonary glutathione and oxidative stress. This article reviews the existing literature and evaluates the epidemiologic and pathophysiologic evidence underlying a possible link between acetaminophen and asthma.
Eneli
Ihuoma
I
Department of Pediatrics and Human Development, Michigan State University, B220 Clinical Center Bldg, East Lansing, MI 48824-1313, USA. Eneli@msu.edu
Sadri
Katayoun
K
Camargo
Carlos
C
Barr
R Graham
RG
D000082:Acetaminophen / Q000009:adverse effects* / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use; D001249:Asthma / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D005978:Glutathione / Q000378:metabolism; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008168:Lung / Q000187:drug effects / Q000503:physiopathology; D018384:Oxidative Stress / Q000502:physiology; D011446:Prospective Studies; D011451:Prostaglandin-Endoperoxide Synthases / Q000502:physiology; D012306:Risk
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen; D007073:Immunoglobulin E; D011451:Prostaglandin-Endoperoxide Synthases; D005978:Glutathione