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Previous tuberculosis infection associated with increased frequency of asthma and respiratory symptoms in a Nordic-Baltic multicentre population study

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  • Sanjay Gyawali, University of Bergen
  • ,
  • Juan Pablo López-Cervantes, University of Bergen
  • ,
  • Nils Oskar Jõgi, Haukeland Universitetssjukehus
  • ,
  • Tehmina Mustafa, University of Bergen
  • ,
  • Ane Johannessen, University of Bergen
  • ,
  • Christer Janson, Uppsala University
  • ,
  • Mathias Holm, University of Gothenburg
  • ,
  • Lars Modig, Umeå University
  • ,
  • Christine Cramer
  • Thorarinn Gislason, Landspitali University Hospital
  • ,
  • Cecilie Svanes, University of Bergen
  • ,
  • Rajesh Shigdel, University of Bergen

BACKGROUND: Tuberculosis (TB) infection induces profound local and systemic, immunological and inflammatory changes that could influence the development of other respiratory diseases; however, the association between TB and asthma is only partly understood. Our objective was to study the association of TB with asthma and respiratory symptoms in a Nordic-Baltic population-based study.

METHODS: We included data from the Respiratory Health in Northern Europe (RHINE) study, in which information on general characteristics, TB infection, asthma and asthma-like symptoms were collected using standardised postal questionnaires. Asthma was defined based on asthma medication usage and/or asthma attacks 12 months prior to the study, and/or by a report of ≥three out of five respiratory symptoms in the last 12 months. Allergic/nonallergic asthma were defined as asthma with/without nasal allergy. The associations of TB with asthma outcomes were analysed using logistic regressions with adjustments for age, sex, smoking, body mass index and parental education.

RESULTS: We included 8379 study participants aged 50-75 years, 61 of whom reported having had TB. In adjusted analyses, participants with a history of TB had higher odds of asthma (OR 1.99, 95% CI 1.13-3.47). The associations were consistent for nonallergic asthma (OR 2.17, 95% CI 1.16-4.07), but not for allergic asthma (OR 1.20, 95% CI 0.53-2.71).

CONCLUSION: We found that in a large Northern European population-based cohort, persons with a history of TB infection more frequently had asthma and asthma symptoms. We speculate that this may reflect long-term effects of TB, including direct damage to the airways and lungs, as well as inflammatory responses.

TidsskriftERJ Open Research
StatusUdgivet - maj 2023

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Copyright ©The authors 2023.

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