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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Asthma and asthma-related disorders&#44; such as sinusitis and rhinitis&#44; are complex diseases with strong genetic and environmental components&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">1</span></a> Over the last decades their prevalence has been increasing worldwide&#44; with a significant economic impact on health services&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Asthma is a common chronic inflammatory disease of the lower airways&#44; characterized by reversible airflow obstruction&#44; inflammation&#44; persistent hyper-reactivity and airway remodeling&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">2</span></a> Rhinitis is an upper airways inflammatory disease&#44; often associated with asthma<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">3</span></a> and have been recognized as a risk factor for its development and severity&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Genetic contribution to these phenotypes may account for 50&#8211;60&#37;&#44;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">5&#44;6</span></a> so dissecting genetic susceptible profiles may provide insight into the pathogenesis&#44; allowing us to identify different sub-phenotypes and also contribute to finding new targeted therapies&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">An increasing number of asthma susceptibility loci are continuously being identified&#44; either by candidate gene studies or&#44; more recently&#44; by microarray-based whole genome approach&#44; the genome-wide association &#40;GWA&#41; studies&#46; Results are hampered by difficulties common to other complex diseases&#58; inconsistent replication of results&#44; functional association between identified loci and phenotype is not obvious&#44; and most of all&#44; allele penetrance is low and phenotype variance largely remains to be explained&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">7&#8211;10</span></a> Most marker SNPs &#40;single nucleotide polymorphisms&#41; are localized in or near-by genes encoding proteins directly or indirectly involved in immunologic response&#46; Recently&#44; GWAs have revealed that different allergic diseases with common immunological physiopathology&#44; also share susceptibility loci&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Interleukin-4 &#40;IL4&#41; mediates important pro-inflammatory functions in allergic phenotypes and has principle responsibility for the IgE isotype switch by B lymphocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">11</span></a> IL4 is also involved in T helper type 2 &#40;TH2&#41; lymphocytes activation&#44; induction of endothelium modifications&#44; hypersecretion of mucus and with lung remodeling in chronic asthma&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">11</span></a> IL4 action is mediated through activation of its receptor IL4R&#44; a cell-surface heterodimeric complex&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Interleukin-13 &#40;IL13&#41; is one of the cytokines released by IL4 mediated Th2 induced cells and shares most of IL4 functions&#46; IL13 production in the airway promotes the survival and migration of eosinophils&#44; activation of macrophages&#44; increased permeability and mucus production by airway epithelial cells and stimulates airways hyperresponsiveness&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">12</span></a> Huang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">13</span></a> found that asthmatic and rhinitis patients submitted to allergen-challenge had a significant enhancement of <span class="elsevierStyleItalic">IL13</span> gene expression at mRNA and protein levels in bronchoalveolar lavage samples compared with the saline-challenged control sites&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Interleukin-17A &#40;IL17A&#41; is the best studied member of IL17 family of cytokines&#46; It is mainly produced by activated T cells&#46; Signaling through activation NF-kappaB and mitogen-activated protein kinases&#44; IL17A regulates local tissue inflammation inducing the expression of pro-inflammatory cytokines&#44; neutrophil-recruiting chemokines&#44; cyclooxygenase-2 &#40;COX2&#41; and nitric oxide &#40;NO&#41;&#46; IL17A may also modulate the activation and proliferation of B cells&#44; thus enhancing IgE production and has been associated with airway hyperresponsiveness and remodeling&#46;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">SNPs from <span class="elsevierStyleItalic">IL4</span>&#44; <span class="elsevierStyleItalic">IL4R</span> and <span class="elsevierStyleItalic">IL13</span> genes are among the polymorphisms most frequently implicated in susceptibility to asthma&#44; rhinitis and allergic phenotypes in general&#44;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">16</span></a> with some of these SNPs being associated with increased serum IgE levels&#46;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">17&#44;18</span></a> Up to now few studies are available on the association with genetic polymorphisms of IL17A family members&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">19&#8211;21</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Reactive oxygen and nitrogen species&#44; originated from air pollutants or released by inflammatory cells and stressed bronchial epithelia&#44; are major contributors to asthma and asthma related phenotypes&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">22</span></a> Glutathione-S-transferases &#40;GSTs&#41; are enzymes involved in the cellular detoxification of free radicals&#46; A missense SNP in Glutathione S-transferase P1 &#40;<span class="elsevierStyleItalic">GSTP1</span>&#41;&#44; rs1695 &#40;p&#46;Ile105Val&#41;&#44; has been associated with differences in enzyme activity and susceptibility to environmental-induced diseases&#44; including asthma&#44; but results remain controversial&#46;<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">23&#44;24</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Frequencies of DNA polymorphisms vary between populations of diverse ethnical origins&#44; as their contributions to complex diseases&#44; therefore&#44; it is important to study different populations&#46; In this study we evaluate the role of <span class="elsevierStyleItalic">IL4R</span> rs1805015&#44; <span class="elsevierStyleItalic">IL13</span> rs20541&#44; <span class="elsevierStyleItalic">IL17A</span> rs2275913 and <span class="elsevierStyleItalic">GSTP1</span> rs1695 in the susceptibility to asthma and rhinitis in an adult population of Portuguese ancestry&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Clinical samples</span><p id="par0055" class="elsevierStylePara elsevierViewall">This case&#8211;control study comprises 424 non related Caucasian Portuguese individuals&#44; including 232 patients and 192 controls&#44; randomly selected from a larger sample that answered a home inquiry about symptoms of asthma&#44; rhinitis and sinusitis&#46; Individuals willing to participate were than observed at the Immunoallergology Department of Coimbra University Hospitals&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The patient population was subdivided into two groups&#44; according to the clinical diagnosis&#44; using ARIA &#40;Allergic Rhinitis and Its Impact On Asthma&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">4</span></a> GINA &#40;Global Initiative for Asthma&#41;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">2</span></a> and EP3OS &#40;European Position Paper on Rhinosinusitis and Nasal Polyps 2007&#41;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">25</span></a> criteria&#58; one group including patients with rhinitis but no asthma and another group including patients with persistent asthma&#44; which could also have rhinitis&#46; As explained in &#8220;Results&#8221; section&#44; patients with both rhinitis and asthma were grouped with those who only had asthma&#46; Controls had no symptoms related to respiratory system and no history of any allergic disease&#46; Other known inflammatory or chronic conditions&#44; including cancer&#44; were exclusion criteria for both patients and controls&#46; A skin prick test for 17 different inhalant allergens&#44; selected according to the recommendations of the GA2LEN &#40;Global Asthma and Allergy European Network&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">26</span></a> was performed on all patients and those who had at least one positive result were considered allergic&#46; The test was considered positive when wheal diameter was &#8805;3<span class="elsevierStyleHsp" style=""></span>mm and controls showed sufficient reaction&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">26</span></a> Participants were considered allergic only in the presence of both symptoms and a positive skin prick test&#46; The local ethics committee approved the study and patients provided informed consent&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Genotyping</span><p id="par0065" class="elsevierStylePara elsevierViewall">DNA was extracted from 5<span class="elsevierStyleHsp" style=""></span>ml of frozen peripheral blood by standard methods&#46; Characterization of the four SNPs was achieved by real time polymerase chain reaction &#40;PCR&#41; using the TaqMan assays &#40;Applied Biosystems&#41;&#44; iQTM Supermix &#40;Bio-Rad Laboratories&#41; and 10&#8211;30<span class="elsevierStyleHsp" style=""></span>ng of DNA&#44; in a 7500 Fast Real-Time PCR System &#40;Applied Biosystems&#41;&#46; As positive controls&#44; we used samples previously genotyped by automatic sequencing in an AbiPrism 3130 Genetic Analyser using BD v1&#46;1 &#40;Applied Biosystems&#41; and Sequencing Analysis Software v5&#46;2&#46; The description of the four SNPs&#44; the primers used in sequencing and TaqMan assay references are depicted in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Statistical analysis</span><p id="par0070" class="elsevierStylePara elsevierViewall">Statistical analysis was developed using the IBM<span class="elsevierStyleSup">&#174;</span> program SPSS<span class="elsevierStyleSup">&#174;</span> &#40;Statistical Package for Social Sciences&#41; version 20&#46; Fisher exact-test&#44; <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> was applied to analyze the difference between the three groups&#46; Logistic regression models were used to control for potential confounders and to evaluate the associations between the risk of disease and genetic polymorphisms&#46; All odds ratios &#40;ORs&#41; with 95&#37; confidence intervals &#40;CI&#41; were adjusted for age&#44; sex and smoking habits and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was considered statistically significant&#46; When comparing rhinitis and asthma patients&#44; ORs were also adjusted for atopy&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">A preliminary analysis revealed that for distribution of SNP variants&#44; smoking habits and atopy &#40;positive skin prick test results&#41;&#44; there were no statistically significant differences between patients associating asthma and rhinitis and patients only with asthma &#40;Supplementary Table 1&#41;&#46; For this reason&#44; and because asthma is considered a more aggressive phenotype&#44; the two groups were joined together&#44; so patients were further on classified as having rhinitis or asthma&#44; as described in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The cohort of 83 patients with rhinitis had a mean age of 48&#46;50 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#46;17&#41; and 63&#46;9&#37; females&#46; The group of 149 asthmatic patients was younger&#44; with a mean age of 39&#46;32 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#46;04&#41; and 66&#46;4&#37; were females&#46; The control group had a mean age of 56&#46;06 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#46;48&#41; and 52&#46;1&#37; females&#46; According to results of skin prick test&#44; allergy was more frequent among asthmatic patients &#40;78&#46;5&#37;&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The Hardy&#8211;Weinberg equilibrium was verified for the four polymorphisms &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; The frequency of <span class="elsevierStyleItalic">GSTP1</span> rs1695 AA genotype was significantly higher in patients with asthma than in controls &#40;49&#46;0&#37; vs&#46; 33&#46;9&#37;&#59; OR &#8211; 1&#46;96&#44; 95&#37; CI &#8211; 1&#46;18 to 3&#46;25&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;010&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; When only considering patients with allergic asthma &#40;data not shown&#41; results were similar &#40;OR &#8211; 2&#46;17&#44; 95&#37; CI &#8211; 1&#46;23 to 3&#46;80&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#46; <span class="elsevierStyleItalic">IL13</span> rs20541 GG genotype was significantly less prevalent in asthma cases &#40;62&#46;6&#37;&#41; than in controls &#40;70&#46;8&#37;&#41; &#40;OR &#8211; 0&#46;55&#44; 95&#37; CI &#8211; 0&#46;33 to 0&#46;94&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;028&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Among patients&#44; <span class="elsevierStyleItalic">IL13</span> rs20541 GG genotype was less frequently associated with asthma than with rhinitis &#40;OR &#8211; 0&#46;48&#44; 95&#37; CI &#8211; 0&#46;25 to 0&#46;93&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;031&#41;&#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; The <span class="elsevierStyleItalic">IL17A</span> rs2275913 AA genotype was also significantly less frequent in asthmatic patients &#40;5&#46;4&#37;&#41; than in rhinitis patients &#40;16&#46;9&#37;&#41;&#40;OR &#8211; 0&#46;20&#44; 95&#37; CI &#8211; 0&#46;07 to 0&#46;56&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">For <span class="elsevierStyleItalic">IL4R</span> rs1805015&#44; there were no significant differences in the distribution of allelic and genotypic frequencies between patients and controls &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41; or between the two disease phenotypes &#40;data not shown&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">In this work we evaluate the role of polymorphisms of four genes&#44; <span class="elsevierStyleItalic">IL4R</span>&#44; <span class="elsevierStyleItalic">IL13</span>&#44; <span class="elsevierStyleItalic">IL17A</span>&#44; and <span class="elsevierStyleItalic">GSTP1</span> in the susceptibility to two related phenotypes&#44; asthma and rhinitis&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">As expected&#44;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">27</span></a> patients were mostly of female gender&#46; In agreement with previous studies&#44;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">28</span></a> our results suggest that most patients with asthma have allergen sensitization&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Comparing patients and controls&#44; <span class="elsevierStyleItalic">GSTP1</span> rs1695 AA genotype conferred about twofold risk for developing asthma and allergic asthma&#46; These results of a Portuguese population are in accordance with previous studies that have associated the A variant with a higher risk&#44;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">29</span></a> or the G &#40;Val&#41; variant with a lower risk<a class="elsevierStyleCrossRefs" href="#bib0410"><span class="elsevierStyleSup">30&#44;31</span></a> to develop asthma and allergic phenotypes&#46; Yet a meta-analysis<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">23</span></a> only suggested a possible&#44; weak protective effect of the G &#40;Val&#41; allele&#46; Like other authors&#44; we found no evidence of a correlation between <span class="elsevierStyleItalic">GSTP1</span> SNP and rhinitis&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">32</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">GSTs play important roles in airway antioxidant defenses<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">33</span></a> and <span class="elsevierStyleItalic">GSTP1</span> enzyme contributes to more than 90&#37; of GST-derived enzyme activity in human lung epithelium&#46;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">34</span></a> The rs1695 SNP has been associated with differences in GSTP1 substrate affinities&#46;<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">35</span></a> A recent study<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">36</span></a> showed that asthma patients who have homozygosity for A &#40;Ile&#41; allele are more likely to be affected by air pollutants&#46; These findings substantiate the functional relevance of the SNP&#44;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">37</span></a> and support our results&#46; Yet&#44; we are aware that this genetic effect can be affected by environment-induced epigenetic modifications that influence gene expression and ultimately&#44; the level of enzymatic activity&#46;<a class="elsevierStyleCrossRefs" href="#bib0450"><span class="elsevierStyleSup">38&#44;39</span></a> Epigenetic regulation is tissue-specific and may account for some of the differences in GSTP1 role between upper and lower airways&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">For <span class="elsevierStyleItalic">IL13</span> SNP&#44; our results suggest that homozygosity for G allele&#44; corresponding to arginine &#40;Arg&#41; variant&#44; may decrease susceptibility to asthma&#46; <span class="elsevierStyleItalic">IL13</span> polymorphisms have repeatedly being associated with increased IgE serum levels&#44; allergy and asthma&#46;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">16&#44;40</span></a> The association of rs20541 with allergic rhinitis was reported in a recent meta-analysis of an Asian population&#46;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">41</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">IL13</span> rs20541 &#40;C<span class="elsevierStyleBold">A</span>G&#62;C<span class="elsevierStyleBold">G</span>G&#41; results in the non-conservative replacement of a neutral glutamine &#40;Gln&#41; for a positively charged arginine &#40;Arg&#41; in the IL13 &#945; helix of D domain&#44; the region that is thought to interact with IL4R&#945;&#47;IL13R&#945;1 heterodimers&#46;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">42</span></a> The A allele has been associated with increased IL13 expression<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">43</span></a> and a lower affinity for the IL13 receptor &#945;2 chain &#40;IL13R&#945;2&#41;&#44; which is a decoy receptor that antagonizes inflammation and tissue remodeling&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">44</span></a> These observations point to a lower inflammatory activity of arginine variant &#40;G allele&#41; comparing with glutamine &#40;A allele&#41;&#44; supporting the association with a decreased susceptibility to asthma&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">In contrast to other studiess&#44;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">17&#44;41</span></a> we could not confirm the same correlations for rhinitis&#46; The difference in results may be explained by the fact that upper airways patency is largely influenced by vascular tone&#44; whereas in the lower airways&#44; smooth muscle function is determinant&#46;<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">45</span></a> IL13 was shown to directly interfere with airway smooth muscle cell responsiveness by enhancing agonist-induced contractility and calcium signals&#44; a mechanism that may be mediated by stromal interaction molecule-1 &#40;STIM1&#41;&#44; a sarcoplasmic reticulum protein involved in the regulation of intracellular Ca<span class="elsevierStyleSup">2&#43;</span> concentrations&#46;<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">46</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Comparing both groups of patients&#44; <span class="elsevierStyleItalic">IL17A</span> rs2275913 AA genotype was less frequently associated with asthma than with rhinitis&#44; reinforcing the difference between the genetic profiles of these phenotypes&#46; This SNP is located in 5&#8242; regulatory region&#44; within a binding motif for the nuclear factor of activated T cells &#40;NFAT&#41;&#44; which is a critical regulator of the <span class="elsevierStyleItalic">IL17A</span> promoter&#46; Peripheral blood level determination and gene reporter assays showed that the A variant was associated with increased levels of IL17A expression and displayed a higher affinity for NFAT&#46;<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">47</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">For rhinitis&#44; our data concur with the functional relevance of A variant&#46; IL17A is known to be a proinflammatory&#44; leukocyte-derived cytokine that targets epithelial cells<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">48</span></a> and that seems to play a central role in rhinitis&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">14</span></a> IL17A expression in the nasal mucosa was associated with the pathophysiology of allergic rhinitis&#44; including disease severity and local eosinophilia&#46;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">49</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">In asthma&#44; increased expression of IL17A has been described mainly in severe and non-allergic forms&#46;<a class="elsevierStyleCrossRefs" href="#bib0510"><span class="elsevierStyleSup">50&#44;51</span></a> The majority of patients included in our study had moderate asthma&#44; which may account for the negative association observed with the higher inflammatory activity A allele&#46; Reinforcing our results&#44; Lei et al&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">52</span></a> describe similar serum levels of IL-17A between asthmatic and normal controls&#46; Globally&#44; controversial results have been published&#44; with studies suggesting that different polymorphisms of <span class="elsevierStyleItalic">IL17A</span> and <span class="elsevierStyleItalic">IL17F</span> may contribute both to susceptibility or resistance to asthma or allergic rhinitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">19&#8211;21</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">No significant association was observed between <span class="elsevierStyleItalic">IL4R</span> rs1805015 polymorphism with rhinitis or asthma&#46; Although this association was confirmed in recent GWA studies&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">9</span></a> contradictory reports exist and results frequently differ between populations&#46;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">16&#44;18</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">The difference in results between our data and some previous reports is a common issue in complex disease research&#46; Differences in population genetic backgrounds&#44; in sample size and selection&#44; phenotype classification&#44; in environmental exposure and epigenetic mechanisms&#44; contribute to the results divergence&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">To overcome limitations of this study&#44; in future work it will be important to enlarge the population samples to be analyzed and to define more specific and homogeneous phenotypes&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclusions</span><p id="par0160" class="elsevierStylePara elsevierViewall">We describe the existence of a significant association between <span class="elsevierStyleItalic">GSTP1 rs1695</span> and <span class="elsevierStyleItalic">IL13</span> rs20541 polymorphisms&#44; respectively with higher and reduced susceptibility to asthma&#46; For patients that develop reactive inflammatory respiratory diseases&#44; <span class="elsevierStyleItalic">IL17A</span> rs2275913 and <span class="elsevierStyleItalic">IL13</span> rs20541 polymorphisms influence the predominant upper airways &#40;rhinitis&#41; or lower airways &#40;asthma&#41; clinical pattern&#46; These results also support the hypothesis that the genetic susceptibility profiles of asthma and isolate chronic rhinitis are not equivalent&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Ethical disclosures</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Protection of human and animal subjects</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Confidentiality of data</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Right to privacy and informed consent</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">None of the authors have any conflicts of interest to declare&#46;</p></span></span>"
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            0 => "Asthma"
            1 => "Rhinitis"
            2 => "Allergy"
            3 => "IL4R"
            4 => "IL13"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Asthma and rhinitis have a complex etiology&#44; depending on multiple genetic and environmental risk factors&#46; An increasing number of susceptibility genes are currently being identified&#44; but the majority of reported associations have not been consistently replicated across populations of different genetic backgrounds&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Purpose</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To evaluate whether polymorphisms of <span class="elsevierStyleItalic">IL4R</span> &#40;rs1805015&#41;&#44; <span class="elsevierStyleItalic">IL13</span> &#40;rs20541&#41;&#44; <span class="elsevierStyleItalic">IL17A</span> &#40;rs2275913&#41; and <span class="elsevierStyleItalic">GSTP1</span> &#40;rs1695&#41; genes are associated with rhinitis and&#47;or asthma in adults of Portuguese ancestry&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">192 unrelated healthy individuals and 232 patients&#44; 83 with rhinitis and 149 with asthma&#44; were studied&#46; All polymorphisms were detected by real time polymerase chain reaction &#40;PCR&#41; using TaqMan assays&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Comparing to controls&#44; significant association with asthma was observed for <span class="elsevierStyleItalic">GSTP1</span> rs1695 AA genotype &#40;odds ratio &#40;OR&#41; &#8211; 1&#46;96&#59; 95&#37; CI &#8211; 1&#46;18 to 3&#46;25&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;010&#41;&#46; The association sustains for allergic asthma &#40;OR &#8211; 2&#46;17&#59; 95&#37; CI &#8211; 1&#46;23 to 3&#46;80&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#46; <span class="elsevierStyleItalic">IL13</span> rs20541 GG genotype was associated with less susceptibility to asthma &#40;OR &#8211; 0&#46;55&#44; 95&#37; CI &#8211; 0&#46;33 to 0&#46;94&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;028&#41;&#46; Among patients&#44; <span class="elsevierStyleItalic">IL17A</span> rs2275913 AA genotype was less associated with asthma than with rhinitis &#40;OR &#8211; 0&#46;20&#59; 95&#37; CI of 0&#46;07 to 0&#46;56&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#46; A similar association was found for <span class="elsevierStyleItalic">IL13</span> rs20541 GG genotype &#40;OR &#8211; 0&#46;48&#59; 95&#37; CI of 0&#46;25 to 0&#46;93&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;031&#41;&#46; There were no significant differences in the distribution of allelic and genotypic frequencies between patients and controls for the <span class="elsevierStyleItalic">IL4R</span> polymorphism&#8217; analyzed&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">These results support the existence of a significant association between <span class="elsevierStyleItalic">GSTP1</span> rs1695 and <span class="elsevierStyleItalic">IL13</span> rs20541 SNPs&#44; with susceptibility to asthma&#44; in the population studied&#46; Different genotype profiles of <span class="elsevierStyleItalic">IL17A</span> and <span class="elsevierStyleItalic">IL13</span> genes seem to influence the clinical pattern of disease expression mainly confined to the upper airways&#44; as rhinitis&#44; or including the lower airways&#44; as asthma&#46;</p></span>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Gene&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SNP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Primer sequence<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TaqMan assay ID&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IL4R</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">rs1805015&#59; TCC&#62;CCC<br>missense &#40;p&#46;Ser503Pro&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F 5&#8242; ATGCCTTCTTCCACCTTC<br>R 5&#8242; CATCTCGGGTTCTACTTCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#95;&#95;8903092&#95;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IL13</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">rs20541&#59; CAG&#62;CGG<br>missense &#40;p&#46;Gln144Arg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F 5&#8242; CCGTGAGGACTGAATGAG<br>R 5&#8242; CACAGGCTGAGGTCTAAG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#95;&#95;2259921&#95;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IL17A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">rs2275913&#59; &#8722;197G&#62;A<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a><br>&#40;regulatory region&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F 5&#8242; ATGACACCAGAAGACCTAC<br>R 5&#8242; TGTGCCTGCTATGAGATG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#95;&#95;15879983&#95;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GSTP1</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">rs1695&#59;<br>ATC&#62;GTC<br>missense &#40;p&#46;Ile105Val&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F 5&#8242; TGTGGCAGTCTCTCATCC<br>R 5&#8242; GCAGGTTGTGTCTTGTCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#95;&#95;3237198&#95;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">NM&#95;002190&#46;2&#58;c&#8722;197G&#62;A&#46;</p>"
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">SNPs evaluated&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Rhinitis<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>83 &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Asthma<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>149 &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>192 &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;36&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;33&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92 &#40;47&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#46;005</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;63&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99 &#40;66&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#40;52&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Age &#40;years&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;50 &#40;15&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#46;32 &#40;14&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#46;06 &#40;19&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Smoking habits</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No smoking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;65&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104 &#40;71&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">121 &#40;64&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">NS</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;34&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 &#40;35&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Skin test positive</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;48&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">117 &#40;78&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Test with at least one positive result&#46;</p> <p class="elsevierStyleNotepara" id="npar0020">NA &#8211; not available&#46;</p> <p class="elsevierStyleNotepara" id="npar0025">SD &#8211; standard deviation&#46;</p> <p class="elsevierStyleNotepara" id="npar0030">NS &#8211; without statistical significance&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Rhinitis<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Asthma<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AdjOR<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a><br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">GSTP1 rs1695</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ile&#47;Ile &#40;AA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;33&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;42&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73 &#40;49&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;96 &#40;1&#46;18&#8211;3&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ile&#47;Val &#40;AG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;50&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;48&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;849&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;40&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;418&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Val&#47;Val &#40;GG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;15&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;9&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;202&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;418&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">IL13 rs20541</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arg&#47;Arg &#40;GG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">136 &#40;70&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60 &#40;73&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;686&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;62&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gln&#47;Arg &#40;AG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;27&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;24&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;694&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;34&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;908&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gln&#47;Gln &#40;AA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;948&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;908&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">IL17 rs2275913</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94 &#40;49&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;33&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;068&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;46&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;552&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>AG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81 &#40;42&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;49&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;532&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71 &#40;48&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;978&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>AA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;8&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;16&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;072&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;5&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;230&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">IL4R rs1805015</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ser&#47;Ser &#40;TT&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">140 &#40;73&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;78&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;374&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115 &#40;77&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;939&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ser&#47;Pro &#40;TC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;22&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;18&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;447&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;20&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;614&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pro&#47;Pro &#40;CC&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;707&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">IL17 rs2275913</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GG&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;46&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                    0 => array:2 [
                      "titulo" => "Discovering susceptibility genes for asthma and allergy"
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                          "autores" => array:1 [
                            0 => "D&#46; Vercelli"
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                      "doi" => "10.1038/nri2257"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Rev Immunol"
                        "fecha" => "2008"
                        "volumen" => "8"
                        "paginaInicial" => "169"
                        "paginaFinal" => "182"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18301422"
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Original article
Asthma and rhinitis have different genetic profiles for IL13, IL17A and GSTP1 polymorphisms
E.P. Resendea,
Corresponding author
eresende@fmed.uc.pt

Corresponding author.
, A. Todo-Bomb,d, C. Loureirob, A. Mota Pintoc,d, B. Oliveirose, L. Mesquitaa, H.C. Silvaa,d
a Genetics Institute, Faculty of Medicine, University of Coimbra, Portugal
b Immunoallergology Department, Coimbra University Hospital, Portugal
c Laboratory of General Pathology, Faculty of Medicine, University of Coimbra, Portugal
d CIMAGO – Centre of Investigation of Environment, Genetics and Oncobiology, Coimbra, Portugal
e Laboratory for Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Asthma and asthma-related disorders&#44; such as sinusitis and rhinitis&#44; are complex diseases with strong genetic and environmental components&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">1</span></a> Over the last decades their prevalence has been increasing worldwide&#44; with a significant economic impact on health services&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Asthma is a common chronic inflammatory disease of the lower airways&#44; characterized by reversible airflow obstruction&#44; inflammation&#44; persistent hyper-reactivity and airway remodeling&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">2</span></a> Rhinitis is an upper airways inflammatory disease&#44; often associated with asthma<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">3</span></a> and have been recognized as a risk factor for its development and severity&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Genetic contribution to these phenotypes may account for 50&#8211;60&#37;&#44;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">5&#44;6</span></a> so dissecting genetic susceptible profiles may provide insight into the pathogenesis&#44; allowing us to identify different sub-phenotypes and also contribute to finding new targeted therapies&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">An increasing number of asthma susceptibility loci are continuously being identified&#44; either by candidate gene studies or&#44; more recently&#44; by microarray-based whole genome approach&#44; the genome-wide association &#40;GWA&#41; studies&#46; Results are hampered by difficulties common to other complex diseases&#58; inconsistent replication of results&#44; functional association between identified loci and phenotype is not obvious&#44; and most of all&#44; allele penetrance is low and phenotype variance largely remains to be explained&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">7&#8211;10</span></a> Most marker SNPs &#40;single nucleotide polymorphisms&#41; are localized in or near-by genes encoding proteins directly or indirectly involved in immunologic response&#46; Recently&#44; GWAs have revealed that different allergic diseases with common immunological physiopathology&#44; also share susceptibility loci&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Interleukin-4 &#40;IL4&#41; mediates important pro-inflammatory functions in allergic phenotypes and has principle responsibility for the IgE isotype switch by B lymphocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">11</span></a> IL4 is also involved in T helper type 2 &#40;TH2&#41; lymphocytes activation&#44; induction of endothelium modifications&#44; hypersecretion of mucus and with lung remodeling in chronic asthma&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">11</span></a> IL4 action is mediated through activation of its receptor IL4R&#44; a cell-surface heterodimeric complex&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Interleukin-13 &#40;IL13&#41; is one of the cytokines released by IL4 mediated Th2 induced cells and shares most of IL4 functions&#46; IL13 production in the airway promotes the survival and migration of eosinophils&#44; activation of macrophages&#44; increased permeability and mucus production by airway epithelial cells and stimulates airways hyperresponsiveness&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">12</span></a> Huang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">13</span></a> found that asthmatic and rhinitis patients submitted to allergen-challenge had a significant enhancement of <span class="elsevierStyleItalic">IL13</span> gene expression at mRNA and protein levels in bronchoalveolar lavage samples compared with the saline-challenged control sites&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Interleukin-17A &#40;IL17A&#41; is the best studied member of IL17 family of cytokines&#46; It is mainly produced by activated T cells&#46; Signaling through activation NF-kappaB and mitogen-activated protein kinases&#44; IL17A regulates local tissue inflammation inducing the expression of pro-inflammatory cytokines&#44; neutrophil-recruiting chemokines&#44; cyclooxygenase-2 &#40;COX2&#41; and nitric oxide &#40;NO&#41;&#46; IL17A may also modulate the activation and proliferation of B cells&#44; thus enhancing IgE production and has been associated with airway hyperresponsiveness and remodeling&#46;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">SNPs from <span class="elsevierStyleItalic">IL4</span>&#44; <span class="elsevierStyleItalic">IL4R</span> and <span class="elsevierStyleItalic">IL13</span> genes are among the polymorphisms most frequently implicated in susceptibility to asthma&#44; rhinitis and allergic phenotypes in general&#44;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">16</span></a> with some of these SNPs being associated with increased serum IgE levels&#46;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">17&#44;18</span></a> Up to now few studies are available on the association with genetic polymorphisms of IL17A family members&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">19&#8211;21</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Reactive oxygen and nitrogen species&#44; originated from air pollutants or released by inflammatory cells and stressed bronchial epithelia&#44; are major contributors to asthma and asthma related phenotypes&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">22</span></a> Glutathione-S-transferases &#40;GSTs&#41; are enzymes involved in the cellular detoxification of free radicals&#46; A missense SNP in Glutathione S-transferase P1 &#40;<span class="elsevierStyleItalic">GSTP1</span>&#41;&#44; rs1695 &#40;p&#46;Ile105Val&#41;&#44; has been associated with differences in enzyme activity and susceptibility to environmental-induced diseases&#44; including asthma&#44; but results remain controversial&#46;<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">23&#44;24</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Frequencies of DNA polymorphisms vary between populations of diverse ethnical origins&#44; as their contributions to complex diseases&#44; therefore&#44; it is important to study different populations&#46; In this study we evaluate the role of <span class="elsevierStyleItalic">IL4R</span> rs1805015&#44; <span class="elsevierStyleItalic">IL13</span> rs20541&#44; <span class="elsevierStyleItalic">IL17A</span> rs2275913 and <span class="elsevierStyleItalic">GSTP1</span> rs1695 in the susceptibility to asthma and rhinitis in an adult population of Portuguese ancestry&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Clinical samples</span><p id="par0055" class="elsevierStylePara elsevierViewall">This case&#8211;control study comprises 424 non related Caucasian Portuguese individuals&#44; including 232 patients and 192 controls&#44; randomly selected from a larger sample that answered a home inquiry about symptoms of asthma&#44; rhinitis and sinusitis&#46; Individuals willing to participate were than observed at the Immunoallergology Department of Coimbra University Hospitals&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The patient population was subdivided into two groups&#44; according to the clinical diagnosis&#44; using ARIA &#40;Allergic Rhinitis and Its Impact On Asthma&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">4</span></a> GINA &#40;Global Initiative for Asthma&#41;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">2</span></a> and EP3OS &#40;European Position Paper on Rhinosinusitis and Nasal Polyps 2007&#41;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">25</span></a> criteria&#58; one group including patients with rhinitis but no asthma and another group including patients with persistent asthma&#44; which could also have rhinitis&#46; As explained in &#8220;Results&#8221; section&#44; patients with both rhinitis and asthma were grouped with those who only had asthma&#46; Controls had no symptoms related to respiratory system and no history of any allergic disease&#46; Other known inflammatory or chronic conditions&#44; including cancer&#44; were exclusion criteria for both patients and controls&#46; A skin prick test for 17 different inhalant allergens&#44; selected according to the recommendations of the GA2LEN &#40;Global Asthma and Allergy European Network&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">26</span></a> was performed on all patients and those who had at least one positive result were considered allergic&#46; The test was considered positive when wheal diameter was &#8805;3<span class="elsevierStyleHsp" style=""></span>mm and controls showed sufficient reaction&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">26</span></a> Participants were considered allergic only in the presence of both symptoms and a positive skin prick test&#46; The local ethics committee approved the study and patients provided informed consent&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Genotyping</span><p id="par0065" class="elsevierStylePara elsevierViewall">DNA was extracted from 5<span class="elsevierStyleHsp" style=""></span>ml of frozen peripheral blood by standard methods&#46; Characterization of the four SNPs was achieved by real time polymerase chain reaction &#40;PCR&#41; using the TaqMan assays &#40;Applied Biosystems&#41;&#44; iQTM Supermix &#40;Bio-Rad Laboratories&#41; and 10&#8211;30<span class="elsevierStyleHsp" style=""></span>ng of DNA&#44; in a 7500 Fast Real-Time PCR System &#40;Applied Biosystems&#41;&#46; As positive controls&#44; we used samples previously genotyped by automatic sequencing in an AbiPrism 3130 Genetic Analyser using BD v1&#46;1 &#40;Applied Biosystems&#41; and Sequencing Analysis Software v5&#46;2&#46; The description of the four SNPs&#44; the primers used in sequencing and TaqMan assay references are depicted in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Statistical analysis</span><p id="par0070" class="elsevierStylePara elsevierViewall">Statistical analysis was developed using the IBM<span class="elsevierStyleSup">&#174;</span> program SPSS<span class="elsevierStyleSup">&#174;</span> &#40;Statistical Package for Social Sciences&#41; version 20&#46; Fisher exact-test&#44; <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> was applied to analyze the difference between the three groups&#46; Logistic regression models were used to control for potential confounders and to evaluate the associations between the risk of disease and genetic polymorphisms&#46; All odds ratios &#40;ORs&#41; with 95&#37; confidence intervals &#40;CI&#41; were adjusted for age&#44; sex and smoking habits and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was considered statistically significant&#46; When comparing rhinitis and asthma patients&#44; ORs were also adjusted for atopy&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Results</span><p id="par0075" class="elsevierStylePara elsevierViewall">A preliminary analysis revealed that for distribution of SNP variants&#44; smoking habits and atopy &#40;positive skin prick test results&#41;&#44; there were no statistically significant differences between patients associating asthma and rhinitis and patients only with asthma &#40;Supplementary Table 1&#41;&#46; For this reason&#44; and because asthma is considered a more aggressive phenotype&#44; the two groups were joined together&#44; so patients were further on classified as having rhinitis or asthma&#44; as described in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The cohort of 83 patients with rhinitis had a mean age of 48&#46;50 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#46;17&#41; and 63&#46;9&#37; females&#46; The group of 149 asthmatic patients was younger&#44; with a mean age of 39&#46;32 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#46;04&#41; and 66&#46;4&#37; were females&#46; The control group had a mean age of 56&#46;06 years &#40;SD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#46;48&#41; and 52&#46;1&#37; females&#46; According to results of skin prick test&#44; allergy was more frequent among asthmatic patients &#40;78&#46;5&#37;&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The Hardy&#8211;Weinberg equilibrium was verified for the four polymorphisms &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; The frequency of <span class="elsevierStyleItalic">GSTP1</span> rs1695 AA genotype was significantly higher in patients with asthma than in controls &#40;49&#46;0&#37; vs&#46; 33&#46;9&#37;&#59; OR &#8211; 1&#46;96&#44; 95&#37; CI &#8211; 1&#46;18 to 3&#46;25&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;010&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; When only considering patients with allergic asthma &#40;data not shown&#41; results were similar &#40;OR &#8211; 2&#46;17&#44; 95&#37; CI &#8211; 1&#46;23 to 3&#46;80&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#46; <span class="elsevierStyleItalic">IL13</span> rs20541 GG genotype was significantly less prevalent in asthma cases &#40;62&#46;6&#37;&#41; than in controls &#40;70&#46;8&#37;&#41; &#40;OR &#8211; 0&#46;55&#44; 95&#37; CI &#8211; 0&#46;33 to 0&#46;94&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;028&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Among patients&#44; <span class="elsevierStyleItalic">IL13</span> rs20541 GG genotype was less frequently associated with asthma than with rhinitis &#40;OR &#8211; 0&#46;48&#44; 95&#37; CI &#8211; 0&#46;25 to 0&#46;93&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;031&#41;&#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; The <span class="elsevierStyleItalic">IL17A</span> rs2275913 AA genotype was also significantly less frequent in asthmatic patients &#40;5&#46;4&#37;&#41; than in rhinitis patients &#40;16&#46;9&#37;&#41;&#40;OR &#8211; 0&#46;20&#44; 95&#37; CI &#8211; 0&#46;07 to 0&#46;56&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">For <span class="elsevierStyleItalic">IL4R</span> rs1805015&#44; there were no significant differences in the distribution of allelic and genotypic frequencies between patients and controls &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41; or between the two disease phenotypes &#40;data not shown&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">In this work we evaluate the role of polymorphisms of four genes&#44; <span class="elsevierStyleItalic">IL4R</span>&#44; <span class="elsevierStyleItalic">IL13</span>&#44; <span class="elsevierStyleItalic">IL17A</span>&#44; and <span class="elsevierStyleItalic">GSTP1</span> in the susceptibility to two related phenotypes&#44; asthma and rhinitis&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">As expected&#44;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">27</span></a> patients were mostly of female gender&#46; In agreement with previous studies&#44;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">28</span></a> our results suggest that most patients with asthma have allergen sensitization&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Comparing patients and controls&#44; <span class="elsevierStyleItalic">GSTP1</span> rs1695 AA genotype conferred about twofold risk for developing asthma and allergic asthma&#46; These results of a Portuguese population are in accordance with previous studies that have associated the A variant with a higher risk&#44;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">29</span></a> or the G &#40;Val&#41; variant with a lower risk<a class="elsevierStyleCrossRefs" href="#bib0410"><span class="elsevierStyleSup">30&#44;31</span></a> to develop asthma and allergic phenotypes&#46; Yet a meta-analysis<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">23</span></a> only suggested a possible&#44; weak protective effect of the G &#40;Val&#41; allele&#46; Like other authors&#44; we found no evidence of a correlation between <span class="elsevierStyleItalic">GSTP1</span> SNP and rhinitis&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">32</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">GSTs play important roles in airway antioxidant defenses<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">33</span></a> and <span class="elsevierStyleItalic">GSTP1</span> enzyme contributes to more than 90&#37; of GST-derived enzyme activity in human lung epithelium&#46;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">34</span></a> The rs1695 SNP has been associated with differences in GSTP1 substrate affinities&#46;<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">35</span></a> A recent study<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">36</span></a> showed that asthma patients who have homozygosity for A &#40;Ile&#41; allele are more likely to be affected by air pollutants&#46; These findings substantiate the functional relevance of the SNP&#44;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">37</span></a> and support our results&#46; Yet&#44; we are aware that this genetic effect can be affected by environment-induced epigenetic modifications that influence gene expression and ultimately&#44; the level of enzymatic activity&#46;<a class="elsevierStyleCrossRefs" href="#bib0450"><span class="elsevierStyleSup">38&#44;39</span></a> Epigenetic regulation is tissue-specific and may account for some of the differences in GSTP1 role between upper and lower airways&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">For <span class="elsevierStyleItalic">IL13</span> SNP&#44; our results suggest that homozygosity for G allele&#44; corresponding to arginine &#40;Arg&#41; variant&#44; may decrease susceptibility to asthma&#46; <span class="elsevierStyleItalic">IL13</span> polymorphisms have repeatedly being associated with increased IgE serum levels&#44; allergy and asthma&#46;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">16&#44;40</span></a> The association of rs20541 with allergic rhinitis was reported in a recent meta-analysis of an Asian population&#46;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">41</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">IL13</span> rs20541 &#40;C<span class="elsevierStyleBold">A</span>G&#62;C<span class="elsevierStyleBold">G</span>G&#41; results in the non-conservative replacement of a neutral glutamine &#40;Gln&#41; for a positively charged arginine &#40;Arg&#41; in the IL13 &#945; helix of D domain&#44; the region that is thought to interact with IL4R&#945;&#47;IL13R&#945;1 heterodimers&#46;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">42</span></a> The A allele has been associated with increased IL13 expression<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">43</span></a> and a lower affinity for the IL13 receptor &#945;2 chain &#40;IL13R&#945;2&#41;&#44; which is a decoy receptor that antagonizes inflammation and tissue remodeling&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">44</span></a> These observations point to a lower inflammatory activity of arginine variant &#40;G allele&#41; comparing with glutamine &#40;A allele&#41;&#44; supporting the association with a decreased susceptibility to asthma&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">In contrast to other studiess&#44;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">17&#44;41</span></a> we could not confirm the same correlations for rhinitis&#46; The difference in results may be explained by the fact that upper airways patency is largely influenced by vascular tone&#44; whereas in the lower airways&#44; smooth muscle function is determinant&#46;<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">45</span></a> IL13 was shown to directly interfere with airway smooth muscle cell responsiveness by enhancing agonist-induced contractility and calcium signals&#44; a mechanism that may be mediated by stromal interaction molecule-1 &#40;STIM1&#41;&#44; a sarcoplasmic reticulum protein involved in the regulation of intracellular Ca<span class="elsevierStyleSup">2&#43;</span> concentrations&#46;<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">46</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Comparing both groups of patients&#44; <span class="elsevierStyleItalic">IL17A</span> rs2275913 AA genotype was less frequently associated with asthma than with rhinitis&#44; reinforcing the difference between the genetic profiles of these phenotypes&#46; This SNP is located in 5&#8242; regulatory region&#44; within a binding motif for the nuclear factor of activated T cells &#40;NFAT&#41;&#44; which is a critical regulator of the <span class="elsevierStyleItalic">IL17A</span> promoter&#46; Peripheral blood level determination and gene reporter assays showed that the A variant was associated with increased levels of IL17A expression and displayed a higher affinity for NFAT&#46;<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">47</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">For rhinitis&#44; our data concur with the functional relevance of A variant&#46; IL17A is known to be a proinflammatory&#44; leukocyte-derived cytokine that targets epithelial cells<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">48</span></a> and that seems to play a central role in rhinitis&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">14</span></a> IL17A expression in the nasal mucosa was associated with the pathophysiology of allergic rhinitis&#44; including disease severity and local eosinophilia&#46;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">49</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">In asthma&#44; increased expression of IL17A has been described mainly in severe and non-allergic forms&#46;<a class="elsevierStyleCrossRefs" href="#bib0510"><span class="elsevierStyleSup">50&#44;51</span></a> The majority of patients included in our study had moderate asthma&#44; which may account for the negative association observed with the higher inflammatory activity A allele&#46; Reinforcing our results&#44; Lei et al&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">52</span></a> describe similar serum levels of IL-17A between asthmatic and normal controls&#46; Globally&#44; controversial results have been published&#44; with studies suggesting that different polymorphisms of <span class="elsevierStyleItalic">IL17A</span> and <span class="elsevierStyleItalic">IL17F</span> may contribute both to susceptibility or resistance to asthma or allergic rhinitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">19&#8211;21</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">No significant association was observed between <span class="elsevierStyleItalic">IL4R</span> rs1805015 polymorphism with rhinitis or asthma&#46; Although this association was confirmed in recent GWA studies&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">9</span></a> contradictory reports exist and results frequently differ between populations&#46;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">16&#44;18</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">The difference in results between our data and some previous reports is a common issue in complex disease research&#46; Differences in population genetic backgrounds&#44; in sample size and selection&#44; phenotype classification&#44; in environmental exposure and epigenetic mechanisms&#44; contribute to the results divergence&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">To overcome limitations of this study&#44; in future work it will be important to enlarge the population samples to be analyzed and to define more specific and homogeneous phenotypes&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclusions</span><p id="par0160" class="elsevierStylePara elsevierViewall">We describe the existence of a significant association between <span class="elsevierStyleItalic">GSTP1 rs1695</span> and <span class="elsevierStyleItalic">IL13</span> rs20541 polymorphisms&#44; respectively with higher and reduced susceptibility to asthma&#46; For patients that develop reactive inflammatory respiratory diseases&#44; <span class="elsevierStyleItalic">IL17A</span> rs2275913 and <span class="elsevierStyleItalic">IL13</span> rs20541 polymorphisms influence the predominant upper airways &#40;rhinitis&#41; or lower airways &#40;asthma&#41; clinical pattern&#46; These results also support the hypothesis that the genetic susceptibility profiles of asthma and isolate chronic rhinitis are not equivalent&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Ethical disclosures</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Protection of human and animal subjects</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Confidentiality of data</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Right to privacy and informed consent</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">None of the authors have any conflicts of interest to declare&#46;</p></span></span>"
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          "titulo" => "Introduction"
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          "titulo" => "Materials and methods"
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          "titulo" => "Ethical disclosures"
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              "identificador" => "sec0050"
              "titulo" => "Protection of human and animal subjects"
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              "identificador" => "sec0055"
              "titulo" => "Confidentiality of data"
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              "identificador" => "sec0060"
              "titulo" => "Right to privacy and informed consent"
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    "fechaRecibido" => "2016-03-29"
    "fechaAceptado" => "2016-06-27"
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          "clase" => "keyword"
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          "palabras" => array:9 [
            0 => "Asthma"
            1 => "Rhinitis"
            2 => "Allergy"
            3 => "IL4R"
            4 => "IL13"
            5 => "IL17A"
            6 => "GSTP1"
            7 => "Genetic polymorphism"
            8 => "Genetic profile"
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    "resumen" => array:1 [
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Asthma and rhinitis have a complex etiology&#44; depending on multiple genetic and environmental risk factors&#46; An increasing number of susceptibility genes are currently being identified&#44; but the majority of reported associations have not been consistently replicated across populations of different genetic backgrounds&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Purpose</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To evaluate whether polymorphisms of <span class="elsevierStyleItalic">IL4R</span> &#40;rs1805015&#41;&#44; <span class="elsevierStyleItalic">IL13</span> &#40;rs20541&#41;&#44; <span class="elsevierStyleItalic">IL17A</span> &#40;rs2275913&#41; and <span class="elsevierStyleItalic">GSTP1</span> &#40;rs1695&#41; genes are associated with rhinitis and&#47;or asthma in adults of Portuguese ancestry&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">192 unrelated healthy individuals and 232 patients&#44; 83 with rhinitis and 149 with asthma&#44; were studied&#46; All polymorphisms were detected by real time polymerase chain reaction &#40;PCR&#41; using TaqMan assays&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Comparing to controls&#44; significant association with asthma was observed for <span class="elsevierStyleItalic">GSTP1</span> rs1695 AA genotype &#40;odds ratio &#40;OR&#41; &#8211; 1&#46;96&#59; 95&#37; CI &#8211; 1&#46;18 to 3&#46;25&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;010&#41;&#46; The association sustains for allergic asthma &#40;OR &#8211; 2&#46;17&#59; 95&#37; CI &#8211; 1&#46;23 to 3&#46;80&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#46; <span class="elsevierStyleItalic">IL13</span> rs20541 GG genotype was associated with less susceptibility to asthma &#40;OR &#8211; 0&#46;55&#44; 95&#37; CI &#8211; 0&#46;33 to 0&#46;94&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;028&#41;&#46; Among patients&#44; <span class="elsevierStyleItalic">IL17A</span> rs2275913 AA genotype was less associated with asthma than with rhinitis &#40;OR &#8211; 0&#46;20&#59; 95&#37; CI of 0&#46;07 to 0&#46;56&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#46; A similar association was found for <span class="elsevierStyleItalic">IL13</span> rs20541 GG genotype &#40;OR &#8211; 0&#46;48&#59; 95&#37; CI of 0&#46;25 to 0&#46;93&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;031&#41;&#46; There were no significant differences in the distribution of allelic and genotypic frequencies between patients and controls for the <span class="elsevierStyleItalic">IL4R</span> polymorphism&#8217; analyzed&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">These results support the existence of a significant association between <span class="elsevierStyleItalic">GSTP1</span> rs1695 and <span class="elsevierStyleItalic">IL13</span> rs20541 SNPs&#44; with susceptibility to asthma&#44; in the population studied&#46; Different genotype profiles of <span class="elsevierStyleItalic">IL17A</span> and <span class="elsevierStyleItalic">IL13</span> genes seem to influence the clinical pattern of disease expression mainly confined to the upper airways&#44; as rhinitis&#44; or including the lower airways&#44; as asthma&#46;</p></span>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Gene&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SNP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Primer sequence<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TaqMan assay ID&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IL4R</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">rs1805015&#59; TCC&#62;CCC<br>missense &#40;p&#46;Ser503Pro&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F 5&#8242; ATGCCTTCTTCCACCTTC<br>R 5&#8242; CATCTCGGGTTCTACTTCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#95;&#95;8903092&#95;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IL13</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">rs20541&#59; CAG&#62;CGG<br>missense &#40;p&#46;Gln144Arg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F 5&#8242; CCGTGAGGACTGAATGAG<br>R 5&#8242; CACAGGCTGAGGTCTAAG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#95;&#95;2259921&#95;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IL17A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">rs2275913&#59; &#8722;197G&#62;A<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a><br>&#40;regulatory region&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F 5&#8242; ATGACACCAGAAGACCTAC<br>R 5&#8242; TGTGCCTGCTATGAGATG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#95;&#95;15879983&#95;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GSTP1</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">rs1695&#59;<br>ATC&#62;GTC<br>missense &#40;p&#46;Ile105Val&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F 5&#8242; TGTGGCAGTCTCTCATCC<br>R 5&#8242; GCAGGTTGTGTCTTGTCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#95;&#95;3237198&#95;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Primers used in genotyping by sequencing&#46;</p>"
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              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">NM&#95;002190&#46;2&#58;c&#8722;197G&#62;A&#46;</p>"
            ]
          ]
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">SNPs evaluated&#46;</p>"
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        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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            "identificador" => "at2"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Rhinitis<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>83 &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Asthma<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>149 &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>192 &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;36&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;33&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92 &#40;47&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#46;005</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;63&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99 &#40;66&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#40;52&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Age &#40;years&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;50 &#40;15&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#46;32 &#40;14&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#46;06 &#40;19&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Smoking habits</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No smoking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;65&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104 &#40;71&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">121 &#40;64&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">NS</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;34&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 &#40;35&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Skin test positive</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;48&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">117 &#40;78&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "identificador" => "tblfn0015"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Test with at least one positive result&#46;</p> <p class="elsevierStyleNotepara" id="npar0020">NA &#8211; not available&#46;</p> <p class="elsevierStyleNotepara" id="npar0025">SD &#8211; standard deviation&#46;</p> <p class="elsevierStyleNotepara" id="npar0030">NS &#8211; without statistical significance&#46;</p>"
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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Characteristics of patients and controls&#46;</p>"
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        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Rhinitis<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Asthma<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AdjOR<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a><br>&#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">GSTP1 rs1695</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ile&#47;Ile &#40;AA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;33&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;42&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73 &#40;49&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;96 &#40;1&#46;18&#8211;3&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ile&#47;Val &#40;AG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;50&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;48&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;849&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;40&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;418&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Val&#47;Val &#40;GG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;15&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;9&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;202&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;418&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">IL13 rs20541</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arg&#47;Arg &#40;GG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">136 &#40;70&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60 &#40;73&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;686&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;62&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;55 &#40;0&#46;33&#8211;0&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gln&#47;Arg &#40;AG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;27&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;24&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;694&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;34&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;908&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gln&#47;Gln &#40;AA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;948&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;908&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">IL17 rs2275913</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94 &#40;49&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;33&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;068&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;46&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>AG&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;49&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;532&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>AA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;8&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;16&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;072&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;5&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;230&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">IL4R rs1805015</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ser&#47;Ser &#40;TT&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">140 &#40;73&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;78&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;374&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115 &#40;77&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;939&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ser&#47;Pro &#40;TC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;22&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;18&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;447&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;20&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;614&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;707&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;199&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">IL13 rs20541</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arg&#47;Arg &#40;GG&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;34&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;797&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">IL17 rs2275913</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>GG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;33&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;46&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>AG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;49&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71 &#40;48&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;5&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;20 &#40;0&#46;07&#8211;0&#46;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Comparative study of <span class="elsevierStyleItalic">IL17A</span> and <span class="elsevierStyleItalic">IL13</span> polymorphisms genotypic frequencies between the two patient groups&#46;</p>"
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      "titulo" => "References"
      "seccion" => array:1 [
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          "identificador" => "bibs0005"
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            0 => array:3 [
              "identificador" => "bib0265"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Discovering susceptibility genes for asthma and allergy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Vercelli"
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                    0 => array:2 [
                      "doi" => "10.1038/nri2257"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Rev Immunol"
                        "fecha" => "2008"
                        "volumen" => "8"
                        "paginaInicial" => "169"
                        "paginaFinal" => "182"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18301422"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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              "identificador" => "bib0270"
              "etiqueta" => "2"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Global strategy for asthma management and prevention&#58; GINA executive summary"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;D&#46; Bateman"
                            1 => "S&#46;S&#46; Hurd"
                            2 => "P&#46;J&#46; Barnes"
                            3 => "J&#46; Bousquet"
                            4 => "J&#46;M&#46; Drazen"
                            5 => "M&#46; FitzGerald"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00138707"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2008"
                        "volumen" => "31"
                        "paginaInicial" => "143"
                        "paginaFinal" => "178"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18166595"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0275"
              "etiqueta" => "3"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rhinitis phenotypes correlate with different symptom presentation and risk factor patterns of asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Eriksson"
                            1 => "A&#46; Bjerg"
                            2 => "J&#46; Lotvall"
                            3 => "G&#46; Wennergren"
                            4 => "E&#46; Ronmark"
                            5 => "K&#46; Toren"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2011.06.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2011"
                        "volumen" => "105"
                        "paginaInicial" => "1611"
                        "paginaFinal" => "1621"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21764573"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0280"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Allergic Rhinitis and its Impact on Asthma &#40;ARIA&#41; 2008 update &#40;in collaboration with the World Health Organization&#44; GA&#40;2&#41;LEN and AllerGen&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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Original language: English
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