Asthma is a common, serious and difficult-to-manage chronic health condition. In the U.S., , and that number is rising.
Over the years, researchers have identified a mix of individual and environmental factors that play a role in asthma. For instance, increase a person’s risk for asthma. And more .
In that mix of research, a new pattern has emerged pointing to by a current or former romantic partner. As surprising as that might sound, these links are important because intimate partner abuse is common in the U.S. An estimated 47% of women and 44% of men are at some point in their lives.
As a and an , we have teamed up to learn more about asthma and intimate partner abuse.
And what we’re seeing has important implications for treatment.
The role of inflammation
To understand how factors such as obesity or extreme weather can result in asthma, researchers have . Inflammation plays a key role in keeping humans and other animals healthy.
When pathogens such as viruses attack the body, or the body suffers an injury, the . This immediate, short-term response helps the body minimize damage to cells and fight infection. It’s also what causes the red hotness that surrounds a skin injury or bothersome symptoms when fighting a cold.
While short-term inflammation is critical to good health, the inflammation system can go awry. Chronic inflammation contributes to many kinds of diseases, .
Uncontrolled inflammation drives . Over the years, a better understanding of different types of inflammation that can worsen asthma has led to the and important advances in care.
Because of this inflammation-asthma connection, most drug treatments for asthma today .
Looking for other explanations
Despite significant advances in drug treatments for asthma, a majority of , which means more flare-ups and an increased chance of dying from the disease.
As researchers and medical providers have figured out that , they’ve turned to more personalized approaches to understanding asthma predictors.
That more personalized approach led one of us, Dr. Wang, to wonder whether intimate partner abuse might play a role in asthma for some of her patients. After all, intimate partner abuse is linked with a and .
Using a large database that was representative of the U.S. population, one of us (Dr. Wang) led a team in 2021 that discovered intimate partner abuse was associated with . That study included over 2,600 adults and found that having asthma along with a history of intimate partner abuse meant significantly greater odds of asthma attacks, more frequent symptoms and greater impact of symptoms on daily life.
This pattern was true even for adults who were out of the abusive relationships for a year or more, suggesting a persistent effect of intimate partner abuse on asthma.
Over time, other research teams also found links between of for adults.
In addition, research showed that intimate partner abuse also affects the next generation. Multiple studies have shown increased rates of asthma in children of .
A new view of inflammation
So, does this mean that intimate partner abuse leads to chronic overinflammation, which in turn causes asthma? Not necessarily, according to another study we did.
We worked with a team of researchers to recruit 60 adults with uncontrolled asthma into our study and examined many different markers of inflammation in the blood. Importantly, about half of those adults told us they had been abused by an intimate partner at some time in their lives. And about half said they had not.
First, we looked at the traditional types of inflammation studied in prior asthma research, including those targeted by currently available treatments. On measure after measure, our team found that patients with than those without histories of abuse, despite having uncontrolled asthma.
Surprised by this finding, we tested whether other factors that have been linked with asthma could better explain what we found. However, the pattern was still there – even when we took into account factors such as gender, obesity, anxiety and depression.
Next, we looked closely at the histories of abuse that patients reported. Most were out of the abusive relationship for more than a year. Therefore, these new findings offer additional evidence that intimate partner abuse can affect people’s health long after the trauma has ended.
Ultimately, these findings have important implications for public health and the treatment of asthma. Current asthma treatments target specific types of overinflammation. However, survivors of intimate partner abuse had lower levels of the types of inflammation that medications target. That could be key to understanding why survivors are more likely than other patients to have uncontrolled asthma even with treatment.
Our recent findings suggest that intimate partner abuse may be linked to asthma through other biological mechanisms, such as alternative or nontraditional types of inflammation. More research is needed to identify what drives asthma among survivors so more effective treatments can be developed.
, Professor of Psychology, and , Associate Professor of Allergy and Immunology,
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