New JACI Study Asks: Does Asthma Increase Risks of Getting Shingles?

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Experts believe asthma is an unrecognized risk factor for zoster in children and adults

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“As asthma is an unrecognized risk factor for zoster in adults, consideration should be given to immunizing adults aged 50 years and older with asthma or atopic dermatitis as a target group for zoster vaccination,” Juhn concluded.

Shingles (also known as herpes zoster or zoster) will occur in one third of the U.S. population by the age of 80 years. Despite its prevalence, particularly between the ages of 50-59, it is still unclear why some individuals will develop zoster (shingles) and others will not. Could other, less than perfect innate and adaptive immune functions - like asthma - be unrecognized risk factors?

A population-based study, published today in The Journal of Allergy and Clinical Immunology (JACI), builds on the work that Mayo Clinic Rochester first explored in 2013, which connected asthma in childhood with an increased risk of zoster.

“Asthma represents one of the five most burdensome chronic diseases in the United States, affecting up to 17% of the population. And the effect of asthma on the risk of infection or immune dysfunction might very well go beyond the airways,” corresponding author Young J. Juhn, MD, MPH, FAAAAI, Academic General Pediatrician and asthma researcher at the Mayo Clinic Children’s Research Center, explained.

Charts for all potential patients with zoster were reviewed in Olmsted County, Minnesota, where 371 cases with zoster, aged 67 on average, were identified during the study period and compared against 742 control subjects. Of the 371 zoster cases, 23% (87 individuals) had asthma compared with 15% (114of 742) from the control group.

Also noteworthy, with asthma and other atopic conditions accounted for, both asthma and atopic dermatitis were found to be independently associated with a higher risk of zoster. Zoster occurred at a rate of 12% in patients with atopic dermatitis (45 of 371 zoster cases) versus 8% (58 of 742) of the control subjects.

The underlying mechanisms are not clear but impairment in innate immune functions in both the skin and airways is well documented in patients with asthma or atopic dermatitis. Researchers believe that because asthma plays a role in suppressing adaptive immunity, it may increase the risk of varicella zoster virus reactivation.

It is important to remember that neither inhaled corticosteroids nor vaccinations were associated with a higher risk of zoster. In fact, zoster vaccination was associated with a lower risk of zoster.

“As asthma is an unrecognized risk factor for zoster in adults, consideration should be given to immunizing adults aged 50 years and older with asthma or atopic dermatitis as a target group for zoster vaccination,” Juhn concluded.

More information about asthma can be found on the AAAAI website.

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 6,800 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

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Megan Brown, Senior Media & Member Communications Manager