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The role of paracetamol in the pathogenesis of asthma
Author(s) -
Farquhar H.,
Stewart A.,
Mitchell E.,
Crane J.,
Eyers S.,
Weatherall M.,
Beasley R.
Publication year - 2010
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/j.1365-2222.2009.03378.x
Subject(s) - asthma , medicine , medical prescription , inhaled corticosteroids , epidemiology , allergy , randomized controlled trial , population , pediatrics , immunology , environmental health , pharmacology
Summary Paracetamol use represents a putative risk factor for the development of asthma. There is convincing epidemiological evidence that the risk of asthma may be increased with exposure to paracetamol in the intrauterine environment, infancy, later childhood and adult life. A dose‐dependent association has also been observed in these different age groups in different populations world‐wide. An association has also been shown between paracetamol use in both rhinoconjunctivitis and eczema. There is biological plausibility with paracetamol use leading to decreased glutathione levels resulting in increased oxidant‐induced inflammation and potentially enhanced T‐helper type 2 responses. At the population level, patterns of paracetamol use might explain, to some extent, the world‐wide variation in the prevalence of asthma and related disorders, particularly the high rates in English‐speaking countries, which have high per capita prescription and over‐the‐counter use of paracetamol. A temporal association also exists between the international trends of increasing paracetamol use and increasing prevalence of asthma over recent decades. Further research is urgently required, in particular randomized‐controlled trials (RCTs) into the long‐term effects of frequent paracetamol use in childhood, to determine the magnitude and characteristics of any such risk. Importantly, RCTs will also enable evidence‐based guidelines for the recommended use of paracetamol to be developed. Cite this as : H. Farquhar, A. Stewart, E. Mitchell, J. Crane, S. Eyers, M. Weatherall and R. Beasley, Clinical & Experimental Allergy , 2010 (40) 32–41.