In June 2013, I graduated from medical school at Karolinska Institutet, and I recently earned my PhD (April 2015) with a thesis named "Early life origins of asthma - genetic and environmental factors in twin and kin". Parallel to continue doing research, I will now pursue my clinical career and work as a junior doctor at Visby Lasarett, Gotland.
- MD, Karolinska Institutet, 2013
- PhD, Karolinska Institutet, 2015
During the last decades there has been an upsurge of studies investigating how early life events or exposures may affect subsequent health outcomes of the child, such as childhood asthma. Much focus has been put into the idea of how our future may be programmed already in utero or during our first months in life.
By combining data from national health registers such as the National Patient Register, the Prescribed Drug Register and the Medical Birth Register, prospectively collected clinical material and questionnaire data, with twin- and family based designs, the studies included in my thesis aimed to disentangle familial genetic and environmental confounding from causal mechanisms leading to asthma. I have focused on the role of fetal growth and exposure to antibiotics, and the risk of developing asthma.
1. Fetal growth and asthma
We have previously investigated if birth weight, as a proxy for fetal growth in twins, affects the development of asthma in a cohort of 9-12 year old Swedish twins in CATSS. We found a significant association which was thought to be explained by unique individual factors and not due to confounding by familial factors shared by the twins.
We are currently investigating if fetal growth affects childhood lung function in a cohort of 9-14 year old twins clinically examined at several sites around Sweden in the STOPPA study.
2. Exposure and treatment of antibiotics and asthma
We have recently investigated the suggested association between exposure to antibioitcs in fetal life and in early childhood and asthma. Previous studies may have been confounded by shared genetic and environmental familial factors, by indication or reverse causation due to respiratory infections. By investigating this association in a family-based setting, comparing affected siblings with non-affected siblings, we aimed to further assess causality. We found that there was no association between antibiotic exposure in fetal or early life and childhood asthma. In summary, our study suggests that the association between antibiotics and asthma is caused by confounding factors shared within families, in addition to confounding by indication or reverse causation because of respiratory infections. The study was recently published in the BMJ and can be found here http://www.bmj.com/content/349/bmj.g6979.
3. Validation of asthma in national registers
A precise and accurate definition of asthma for register- and population-based studies has been lacking. We have previously collected medical records corresponding to prescription dates of asthma medications or to discharge dates with accompanying asthma diagnoses, identified from drug- and patient registers, from health care units all over Sweden. The information in the medical records was evaluated against pre-defined criteria of asthma and we found a high positive predictive value for asthma medication as a proxy for asthma/obstructive bronchitis. Moreover, the quality of asthma diagnoses for children in the patient register was considered to be high.
Academic honors, awards and prizes
- Nominated and awarded by the Swedish Nobel Foundation to represent medical students from Karolinska Institutet at the 61th Meeting of Nobel Laureates, dedicated to Physiology/Medicine, Lindau, Germany 2011
- Scholar ship from Kerstin Hejdenbergs minnesfond, Swedish Asthma and Allergy Association, for dedication in the project "Swedish Twin study On Perinatal characteristics to Prevent Asthma (STOPPA)", December 2012
- Travel grant by the Swedish INterdisciplinary Graduate School in Register-Based Research (SINGS) to participate in the European Respiratory Society’s yearly conference in Barcelona, Spain, September 2013
- Travel grant by the Swedish Heart and Lung foundation to participate in the Pediatric Allergy and Asthma Meeting in Athens, Greece, organized by the European Academy of Allergy and Clinical Immunology, October 2013
- Nominated to the "colleague of the year 2014" at the Dept. Medical Epidemiology and Biostatistics.