Ziyab A H, Karmaus W, Zhang H, Holloway J W, Steck S E, Ewart S, Arshad S H
Department of Epidemiology and Biostatistics, Norman J. Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Clin Exp Allergy. 2014 Sep;44(9):1170-8. doi: 10.1111/cea.12321.
Allergic sensitization and filaggrin gene (FLG) variants are important risk factors for allergic disorders; however, knowledge on their individual and interactive effects on the coexistence of eczema, asthma, and rhinitis is lacking.
This study aimed at investigating the single and combined effects of allergic sensitization and FLG variants on the development of single and multiple allergic disorders.
The Isle of Wight birth cohort (n = 1456) has been examined at 1, 2, 4, 10, and 18 years of age. Repeated measurements of eczema, asthma, rhinitis, and skin prick tests were available for all follow-ups. FLG variants were genotyped in 1150 participants. Associations of allergic sensitization and FLG variants with single and multiple allergic disorders were tested in log-binomial regression analysis.
The prevalence of eczema-, asthma-, and rhinitis-only ranged from 5.6% to 8.5%, 4.9% to 10.2%, and 2.5% to 20.4%, respectively, during the first 18 years of life. The coexistence of allergic disorders is common, with approximately 2% of the population reporting the comorbidity of 'eczema, asthma, and rhinitis' during the study period. In repeated measurement analyses, allergic sensitization and FLG variants, when analysed separately, were associated with having single and multiple allergic disorders. Of particular significance, their combined effect increased the risk of 'eczema and asthma' (RR = 13.67, 95% CI: 7.35-25.42), 'asthma and rhinitis' (RR = 7.46, 95% CI: 5.07-10.98), and 'eczema, asthma, and rhinitis' (RR = 23.44, 95% CI: 12.27-44.78).
The coexistence of allergic disorders is frequent, and allergic sensitization and FLG variants jointly increased risk of allergic comorbidities, which may represent more severe and complex clinical phenotypes. The interactive effect and the elevated proportion of allergic comorbidities associated with allergic sensitization and FLG variants emphasize their joint importance in the pathogenesis of allergic disorders.
过敏致敏和丝聚蛋白基因（FLG）变异是过敏性疾病的重要危险因素；然而，关于它们对湿疹、哮喘和鼻炎共存的个体及交互作用的了解尚缺。
本研究旨在调查过敏致敏和FLG变异对单一和多种过敏性疾病发生发展的单一及联合作用。
怀特岛出生队列（n = 1456）在1、2、4、10和18岁时接受了检查。所有随访均有对湿疹、哮喘、鼻炎和皮肤点刺试验的重复测量数据。对1150名参与者进行了FLG变异的基因分型。在对数二项回归分析中测试了过敏致敏和FLG变异与单一和多种过敏性疾病的关联。
在生命的前18年中，仅患湿疹、仅患哮喘和仅患鼻炎的患病率分别为5.6%至8.5%、4.9%至10.2%和2.5%至20.4%。过敏性疾病共存很常见，在研究期间约2%的人群报告有“湿疹、哮喘和鼻炎”的合并症。在重复测量分析中，过敏致敏和FLG变异单独分析时，均与单一和多种过敏性疾病相关。特别值得注意的是，它们的联合作用增加了“湿疹和哮喘”（RR = 13.67，95% CI：7.35 - 25.42）、“哮喘和鼻炎”（RR = 7.46，95% CI：5.07 - 10.98）以及“湿疹、哮喘和鼻炎”（RR = 23.44，95% CI：12.27 - 44.78）的风险。
过敏性疾病共存很常见，过敏致敏和FLG变异共同增加了过敏性合并症的风险，这可能代表更严重和复杂的临床表型。过敏致敏和FLG变异相关的交互作用及过敏性合并症比例的升高强调了它们在过敏性疾病发病机制中的共同重要性。
