A BRIEF REVIEW ON - PARACETAMOL USE IN INFANCY IS LINKED TO INCREASED RISK OF ASTHMA IN TEENAGERS

Dr. S. Naga Subrahmanyam*, Dr. D. Tagoore Vijaya Lakshmi, Dr. G. V. Pavan Kumar and Dr. G. V.Naga Raju

ABSTRACT

Paracetamol, also known as acetaminophen or APAP, is a medicine used to treat pain and fever. It is typically used for mild to moderate pain relief. Evidence for its use to relieve fever in children is mixed. It is often sold in combination with other medications, such as in many cold medications. Paracetamol is available as tablets or capsules,liquid – usually for children soluble tablets (tablets that dissolve in water to make a drink),suppositories (capsules inserted into the back passage),an injection given into a vein – normally only used in hospital. The children had been recruited to the study before they were born because they were considered to be potentially at high risk of developing an allergy-related disease. They had at least one family member (mother, father or sibling) with a self-reported allergic disease (asthma, eczema, hay fever or a severe food allergy).After their birth, a research nurse rang the family every four weeks for the first 15 months, and then at 18 months and at two years old to ask how many days in the previous weeks had the child taken paracetamol. When the children were 18 years old, they gave a blood or saliva sample, which was tested for variants of the GST genes: GSTT1, GSTM1 and GSTP1. They were also assessed for asthma, and a spirometry test was performed to measure the amount of air inhaled and exhaled when breathing through a mouthpiece.One variant of the GSTP1 gene, GSTP1 Ile/Ile (in which the amino acid Isoleucine (Ile) is inherited from both parents), was associated with a higher risk of developing asthma."We found that children with the GSTP1 Ile/Ile variant had 1.8 times higher risk of developing asthma by the age of 18 years for each doubling of the days of paracetamol exposure when compared to children who were less exposed," said Ms Dai. "In contrast, increasing paracetamol exposure in children who had other types of GSTP1 did not alter the risk of asthma. Our findings provide more evidence that paracetamol use in infancy may have an adverse effect on respiratory health for children with particular genetic profiles and could be a possible cause of asthma. However, these findings would need to be confirmed by other studies and the degree of adverse effect better understood before this evidence could be used to influence practice and before guidelines on paracetamol use are altered.

Keywords: Paracetamol, acetaminophen, spirometry.