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丝聚合蛋白功能丧失突变作为波兰儿童人群特应性皮炎、过敏致敏和湿疹相关性哮喘的预测指标。

Filaggrin loss-of-function mutations as a predictor for atopic eczema, allergic sensitization and eczema-associated asthma in Polish children population.

作者信息

Dębińska Anna, Danielewicz Hanna, Drabik-Chamerska Anna, Kalita Danuta, Boznański Andrzej

机构信息

1st Department and Clinic of Pediatrics, Allergology and Cardiology, Wroclaw Medical University, Poland.

出版信息

Adv Clin Exp Med. 2017 Sep;26(6):991-998. doi: 10.17219/acem/61430.

Abstract

BACKGROUND

Loss-of-function mutations in the filaggrin (FLG) gene were identified as a major risk factor for atopic eczema.

OBJECTIVES

The aim of the study was to investigate the importance of 4 common FLG null mutations in the susceptibility to atopic eczema and other allergic phenotypes in Polish children population.

MATERIAL AND METHODS

The FLG mutations were determined in 158 children younger than 2 years of age. All subjects were selected using a detailed questionnaire and blood samples for total and specific IgE measurements were obtained. Cases of atopic eczema were diagnosed according to the criteria of Hanifin and Rajka and skin examination. All FLG mutations were genotyped by real-time PCR assays with a subsequent melting curve analysis using a SimpleProbe® probes.

RESULTS

The combined genotype of all 4 mutations (carriage of ≥ 1 FLG mutation) was significantly associated with atopic eczema (p = 0.016). The odds ratio (OR) for individuals carrying 1 of these 4 null mutations was 5.52 (95% CI; 1.11 ÷ 37.12). The significant association between either the combined FLG genotype or 2282del14 deletion and eczema was seen only in the allergic group. The association with asthma was restricted to asthma occurring in the context of eczema (OR, 6.27; 95% CI, 0.89 ÷ 53.56; p = 0.042).

CONCLUSIONS

Our study confirms the previous findings that FLG mutations are strongly associated with atopic eczema and confer a significant risk of allergic sensitization and asthma in the context of eczema. These results underline the role of the epidermal barrier and filaggrin insufficiency in the pathogenesis of atopic eczema and eczema-associated asthma.

摘要

背景

丝聚合蛋白(FLG)基因功能缺失突变被确定为特应性皮炎的主要危险因素。

目的

本研究旨在调查波兰儿童人群中4种常见的FLG无效突变在特应性皮炎易感性及其他过敏表型中的重要性。

材料与方法

对158名2岁以下儿童进行FLG突变检测。所有受试者均通过详细问卷筛选,并采集血样用于总IgE和特异性IgE检测。特应性皮炎病例根据Hanifin和Rajka标准及皮肤检查进行诊断。所有FLG突变均通过实时PCR检测进行基因分型,随后使用SimpleProbe®探针进行熔解曲线分析。

结果

所有4种突变的联合基因型(携带≥1种FLG突变)与特应性皮炎显著相关(p = 0.016)。携带这4种无效突变之一的个体的优势比(OR)为5.52(95%可信区间;1.11÷37.12)。仅在过敏组中观察到联合FLG基因型或2282del14缺失与湿疹之间的显著关联。与哮喘的关联仅限于在湿疹背景下发生的哮喘(OR,6.27;95%可信区间,0.89÷53.56;p = 0.042)。

结论

我们的研究证实了先前的发现,即FLG突变与特应性皮炎密切相关,并在湿疹背景下赋予过敏致敏和哮喘的显著风险。这些结果强调了表皮屏障和丝聚合蛋白不足在特应性皮炎和湿疹相关性哮喘发病机制中的作用。

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