Open Access Research article

A methodology to establish a database to study gene environment interactions for childhood asthma

Stephen W Turner1*, Jon G Ayres2, Tatiana V Macfarlane3, Anil Mehta4, Gita Mehta4, Colin N Palmer5, Steve Cunningham6, Tim Adams7, Krishnan Aniruddhan8, Claire Bell7, Donna Corrigan9, Jason Cunningham10, Andrew Duncan11, Gerard Hunt12, Richard Leece1, Una MacFadyen13, Jonathan McCormick14, Sally McLeish1, Andrew Mitra15, Deborah Miller6, Elizabeth Waxman16, Alan Webb17, Slawomir Wojcik18, Somnath Mukhopadhyay104 and Donald Macgregor19

Author Affiliations

1 Academic Child Health, University of Aberdeen, Aberdeen, UK

2 Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK

3 Division of Applied Medicine, University of Aberdeen, Aberdeen, UK

4 Maternal and Child Health Services, University of Dundee, Dundee, UK

5 Population Pharmacogenetics Group, Biomedical Research Institute, University of Dundee, Dundee, UK

6 Department of Respiratory, Sleep and General Medicine, Royal Hospital for Sick Children Edinburgh, Edinburgh, UK

7 Department of Paediatrics, Crosshouse Hospital, Kilmarnock, UK

8 Department of Paediatrics, Victoria Hospital, Kirkcaldy, UK

9 Department of Paediatrics, Wishaw General Hospital, Wishaw, UK

10 Academic Department of Paediatrics, Brighton and Sussex Medical School, Brighton, UK

11 Department of Paediatrics, Borders General Hospital, Melrose, UK

12 Department of Paediatrics, Royal Alexandra Hospital, Paisley, UK

13 Department of Paediatrics, Stirling Royal Infirmary, Stirling, UK

14 Women & Child Health, Tayside Children's Hospital, Ninewells Hospital, Dundee, UK

15 Department of Paediatrics, Dumfries Galloway Royal Infirmary, Dumfries, UK

16 Clinical Research Facility, Royal Hospital for Sick Children, Glasgow, UK

17 Department of Paediatrics, Raigmore Hospital, Inverness, UK

18 Department of Paediatrics, Dr Grey's Hospital, Elgin, UK

19 Department of Paediatrics, Perth Royal Infirmary, Perth UK

For all author emails, please log on.

BMC Medical Research Methodology 2010, 10:107  doi:10.1186/1471-2288-10-107

Published: 6 December 2010



Gene-environment interactions are likely to explain some of the heterogeneity in childhood asthma. Here, we describe the methodology and experiences in establishing a database for childhood asthma designed to study gene-environment interactions (PAGES - Paediatric Asthma Gene Environment Study).


Children with asthma and under the care of a respiratory paediatrician are being recruited from 15 hospitals between 2008 and 2011. An asthma questionnaire is completed and returned by post. At a routine clinic visit saliva is collected for DNA extraction. Detailed phenotyping in a proportion of children includes spirometry, bronchodilator response (BDR), skin prick reactivity, exhaled nitric oxide and salivary cotinine. Dietary and quality of life questionnaires are completed. Data are entered onto a purpose-built database.


To date 1045 children have been invited to participate and data collected in 501 (48%). The mean age (SD) of participants is 8.6 (3.9) years, 57% male. DNA has been collected in 436 children. Spirometry has been obtained in 172 children, mean % predicted (SD) FEV1 97% (15) and median (IQR) BDR is 5% (2, 9). There were differences in age, socioeconomic status, severity and %FEV1 between the different centres (p≤0.024). Reasons for non-participation included parents not having time to take part, children not attending clinics and, in a small proportion, refusal to take part.


It is feasible to establish a national database to study gene-environment interactions within an asthmatic paediatric population; there are barriers to participation and some different characteristics in individuals recruited from different centres. Recruitment to our study continues and is anticipated to extend current understanding of asthma heterogeneity.