STOPPA - Swedish Twin study On Perinatal characteristics to Prevent Asthma

STOPPA stands for "Swedish Twin study On Perinatal characteristics to Prevent Asthma". The aim of the STOPPA study (Swedish Twin study On Prediction and Prevention of Asthma) is to identify environmental and genetic factors as determinants for asthmatic disease.

Asthma is a common childhood disease and several risk factors have been identified; however, the impact of genes and environment is not fully understood. Based on the Child and Adolescent Twin Study in Sweden (CATSS), which is part of the Swedish Twin Registry, parental interview at 9 or 12 years and an asthma and/or wheezing algorithm, we identified monozygotic (MZ) and dizygotic (DZ) same-sexed twin pairs. The twin pairs were classified as asthma concordant (ACC), asthma discordant (ADC) and healthy concordant (HCC). A sample of 9- to 14-year-old twins and their parents were invited to participate in a clinical examination.

Background characteristics were collected in questionnaires and obtained from the National Health Registers. A clinical examination was performed to test lung function and capacity (spirometry with reversibility test and exhaled nitric oxide) and collect blood (serology, genomics, epigenomics, transcriptomics and proteomics), urine (metabolites), feces (microbiota), and saliva (cortisol).

The data-collection is now completed and in total, 376 twin pairs (752 individual twins) contributed to the study, with a response rate of 52%. All participating twins answered the questionnaire and >90% participated in lung function testing, blood-, and saliva sampling. We have a number of ongoing and planned analyses in STOPPA and contribute towards consortia such as the Pregnancy And Childhood Epigenetics (PACE) and the Genomic Agregation Project in Sweden (GAPS). Another collaborative project is the Systems pharmacology approach to difficult-to-treat pediatric asthma (SysPharmPediA).

We welcome fellow researchers to novel and innovative collaborations on research questions using data derived from the STOPPA cohort.


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Catarina Almqvist Malmros

Professor/Senior Physician
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Anna Hedman

Senior Research Specialist;Lecturer


Cohort Profile: Swedish Twin Study on Prediction and Prevention of Asthma (STOPPA).
Almqvist C, Örtqvist AK, Ullemar V, Lundholm C, Lichtenstein P, Magnusson PK
Twin Res Hum Genet 2015 Jun;18(3):273-80

Fetal Growth and Childhood Lung Function in the Swedish Twin Study on Prediction and Prevention of Asthma.
Örtqvist AK, Ullemar V, Lundholm C, Kuja-Halkola R, Magnusson PKE, Lichtenstein P, et al
Ann Am Thorac Soc 2017 Jul;14(7):1147-1153

The STOPPA Twin Study Explains the Exhaled Nitric Oxide and Asthma Link by Genetics and Sensitization.
Nordlund B, Lundholm C, Ullemar V, van Hage M, Örtqvist AK, Almqvist C
Twin Res Hum Genet 2017 08;20(4):330-337

Associations Between Asthma and Sensitization to Pet or Pollen Allergens in Young Swedish Twins - The STOPPA Study.
Lindemalm C, Nordlund B, Örtqvist AK, Lundholm C, van Hage M, Gong T, et al
Twin Res Hum Genet 2017 10;20(5):380-388

Education in Twins and Their Parents Across Birth Cohorts Over 100 years: An Individual-Level Pooled Analysis of 42-Twin Cohorts.
Silventoinen K, Jelenkovic A, Latvala A, Sund R, Yokoyama Y, Ullemar V, et al
Twin Res Hum Genet 2017 10;20(5):395-405

Shared genetic origin of asthma, hay fever and eczema elucidates allergic disease biology.
Ferreira MA, Vonk JM, Baurecht H, Marenholz I, Tian C, Hoffman JD, et al
Nat. Genet. 2017 Dec;49(12):1752-1757

Cohort Profile: Pregnancy And Childhood Epigenetics (PACE) Consortium.
Felix JF, Joubert BR, Baccarelli AA, Sharp GC, Almqvist C, Annesi-Maesano I, et al
Int J Epidemiol 2018 02;47(1):22-23u

Eleven loci with new reproducible genetic associations with allergic disease risk.
Ferreira MAR, Vonk JM, Baurecht H, Marenholz I, Tian C, Hoffman JD, et al
J. Allergy Clin. Immunol. 2019 02;143(2):691-699

Epigenome-wide meta-analysis of DNA methylation and childhood asthma.
Reese SE, Xu CJ, den Dekker HT, Lee MK, Sikdar S, Ruiz-Arenas C, et al
J. Allergy Clin. Immunol. 2019 Jun;143(6):2062-2074

Genetic Architectures of Childhood- and Adult-Onset Asthma Are Partly Distinct.
Ferreira MAR, Mathur R, Vonk JM, Szwajda A, Brumpton B, Granell R, et al
Am. J. Hum. Genet. 2019 04;104(4):665-684

Meta-analysis of epigenome-wide association studies in neonates reveals widespread differential DNA methylation associated with birthweight.
Küpers LK, Monnereau C, Sharp GC, Yousefi P, Salas LA, Ghantous A, et al
Nat Commun 2019 04;10(1):1893

A modern approach to identifying and characterizing child asthma and wheeze phenotypes based on clinical data.
Brew BK, Chiesa F, Lundholm C, Örtqvist A, Almqvist C
PLoS One 2019 ;14(12):e0227091

Age-of-onset information helps identify 76 genetic variants associated with allergic disease.
Ferreira MAR, Vonk JM, Baurecht H, Marenholz I, Tian C, Hoffman JD, Helmer Q, Tillander A, Ullemar V, Lu Y, Grosche S, Rüschendorf F, Granell R, Brumpton BM, Fritsche LG, Bhatta L, Gabrielsen ME, Nielsen JB, Zhou W, Hveem K, Langhammer A, Holmen OL, Løset M, Abecasis GR, Willer CJ, Emami NC, Cavazos TB, Witte JS, Szwajda A, , , Hinds DA, Hübner N, Weidinger S, Magnusson PK, Jorgenson E, Karlsson R, Paternoster L, Boomsma DI, Almqvist C, Lee YA, Koppelman GH
PLoS Genet 2020 06;16(6):e1008725

Effects of inhaled corticosteroids on DNA methylation in peripheral blood cells in children with asthma.
Kere M, Gruzieva O, Ullemar V, Söderhäll C, Greco D, Kull I, Bergström A, Pershagen G, Almqvist C, Melén E
Allergy 2020 03;75(3):688-691

DNA methylation and body mass index from birth to adolescence: meta-analyses of epigenome-wide association studies.
Vehmeijer FOL, Küpers LK, Sharp GC, Salas LA, Lent S, Jima DD, Tindula G, Reese S, Qi C, Gruzieva O, Page C, Rezwan FI, Melton PE, Nohr E, Escaramís G, Rzehak P, Heiskala A, Gong T, Tuominen ST, Gao L, Ross JP, Starling AP, Holloway JW, Yousefi P, Aasvang GM, Beilin LJ, Bergström A, Binder E, Chatzi L, Corpeleijn E, Czamara D, Eskenazi B, Ewart S, Ferre N, Grote V, Gruszfeld D, Håberg SE, Hoyo C, Huen K, Karlsson R, Kull I, Langhendries JP, Lepeule J, Magnus MC, Maguire RL, Molloy PL, Monnereau C, Mori TA, Oken E, Räikkönen K, Rifas-Shiman S, Ruiz-Arenas C, Sebert S, Ullemar V, Verduci E, Vonk JM, Xu CJ, Yang IV, Zhang H, Zhang W, Karmaus W, Dabelea D, Muhlhausler BS, Breton CV, Lahti J, Almqvist C, Jarvelin MR, Koletzko B, Vrijheid M, Sørensen TIA, Huang RC, Arshad SH, Nystad W, Melén E, Koppelman GH, London SJ, Holland N, Bustamante M, Murphy SK, Hivert MF, Baccarelli A, Relton CL, Snieder H, Jaddoe VWV, Felix JF
Genome Med 2020 11;12(1):105

Genetic effects of allergen-specific IgE levels on exhaled nitric oxide in schoolchildren with asthma: The STOPPA twin study.
Hedman AM, Kuja-Halkola R, Örtqvist AK, van Hage M, Almqvist C, Nordlund B
Pediatr Allergy Immunol 2021 May;32(4):709-719

Preterm birth reduces the risk of IgE sensitization up to early adulthood: A population-based birth cohort study.
Mitselou N, Andersson N, Bergström A, Kull I, Georgelis A, van Hage M, Hedman AM, Almqvist C, Ludvigsson JF, Melén E
Allergy 2022 May;77(5):1570-1582

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