Young J. Juhn, M.D.

Overview
Given the significant number of people affected by asthma or other allergic conditions, such as eczema or allergic rhinitis in the United States and worldwide, the impact of allergic conditions on risk of other diseases is poorly understood.

My lab (the Pediatric Asthma Epidemiology Research Unit) has studied the impact of asthma, allergic rhinitis or eczema on risk of emerging or re-emerging infectious diseases, as well as chronic diseases. As we discover important findings in this area of research, we focus our effort on identifying the mechanistic underpinnings for the influence of asthma or other atopic conditions on infection and other diseases. In investigating this association, my lab examines the role of socioeconomic status in health. Our goal is to understand how biomedical (e.g., immune system) and macro-environmental factors (e.g., socioeconomics) interact in a way promoting or compromising health and to improve overall health.

Specific Research Topics
Our clinical epidemiologic work focuses on the influence of asthma and other atopic conditions (allergic rhinitis or eczema) on the risks of microbial infections, as well as other chronic diseases. Our lab is concerned about the potential influences of the rising trend of asthma or other atopic conditions on susceptibility to emerging and re-emerging microbial infections at a population level.We have found that asthma and other atopic conditions increase the risk of serious pneumococcal disease, pertussis, ear infections, and throat infections.

We postulate that the epidemiology of asthma or other atopic conditions may influence the epidemiology of infectious diseases. Currently, we make an effort to identify therapeutic options and public health intervention to protect people with asthma or other atopic conditions from serious microbial infections.

We try to identify mechanisms for why asthmatics have increased risks of microbial infections. We have some evidence that the immunological underpinnings of asthma or other atopic conditions are related to the risk of infections. Specifically, our research team aims at determining the roles of T-helper 2 predominant cytokines and HLA class II genes in the relationship between asthma and microbial infections.

Also, our lab is extending our research efforts to the long-term relationship between asthma epidemiology and other chronic disease.

As social epidemiologic work, we recently developed and validated a housing-based socioeconomic measure (HOUSES index). We are applying this index to epidemiologic research to assess socioeconomic status (SES) and health outcomes.

SES is a known determinant of health and affects the type of environment where we live. However, socioeconomic measures are often unavailable in commonly used data sources, such as medical records, so that advancement of our understanding on the role of SES in health outcomes has been slowed. As a new socioeconomic index is successfully formulated, we will determine the influence of socioeconomic environment on health outcomes, such as asthma outcomes and underlying mechanisms. As we learn how SES operates its influence on health outcomes, we are conceptualizing and implementing SES-based individualized health care delivery or medicine to modify SES-driven health effects.