Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany,
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel,
Dermatology. 2021;237(6):921-928. doi: 10.1159/000512917. Epub 2021 Feb 26.
Bullous pemphigoid (BP) and asthma both share a pathogenic role of eosinophils and immunoglobulin E (IgE) and favorable response for corticosteroids and omalizumab. However, the association between these conditions is yet to be investigated. We sought to estimate the risk of having BP among patients previously diagnosed with asthma and to characterize patients with coexistent BP and asthma.
Utilizing the dataset of Clalit Health Services, a population-based case-control study was conducted comparing BP patients (n = 3,924) with age-, sex-, and ethnicity-matched control subjects (n = 19,280) regarding the presence of asthma. Logistic regression models were utilized for univariate and multivariate analyses.
The prevalence of preceding asthma was higher in patients with BP than in control subjects (11.1 vs. 7.9%, respectively; p < 0.001). A history of asthma was associated with a 50% increase in the risk of BP (OR 1.45; 95% CI 1.30-1.62). The association was not altered greatly after adjusting for demographics (adjusted OR 1.43; 95% CI 1.28-1.61) as well as for demographics and comorbidities (adjusted OR 1.40; 95% CI 1.25-1.57). The average (SD) latency between the diagnosis of asthma and the development of BP was 12.5 (14.7) years. When compared with other patients with BP, those with a dual diagnosis of BP and asthma were older, had higher BMI, and were more frequently managed by corticosteroids and immunosuppressive and immunomodulatory adjuvants.
Asthma confers a predisposition to the development of BP. Awareness of this association may be of help for physicians managing patients with BP and asthma. Further research is required to elucidate the mechanism underlying this observation.
天疱疮（BP）和哮喘都具有嗜酸性粒细胞和免疫球蛋白 E（IgE）的致病作用，并且对皮质类固醇和奥马珠单抗有良好的反应。然而，这些疾病之间的关联尚未得到研究。我们试图估计先前被诊断患有哮喘的患者中发生 BP 的风险，并描述同时患有 BP 和哮喘的患者的特征。
利用 Clalit 健康服务数据集，进行了一项基于人群的病例对照研究，比较了 3924 名 BP 患者（n=BP 患者）和年龄、性别和种族匹配的对照组患者（n=19280 名）中哮喘的存在情况。使用逻辑回归模型进行单变量和多变量分析。
BP 患者中既往哮喘的患病率高于对照组（分别为 11.1%和 7.9%；p<0.001）。哮喘病史与 BP 风险增加 50%相关（OR 1.45；95%CI 1.30-1.62）。调整人口统计学因素（调整后的 OR 1.43；95%CI 1.28-1.61）以及人口统计学因素和合并症（调整后的 OR 1.40；95%CI 1.25-1.57）后，该关联并未发生很大变化。哮喘诊断和 BP 发病之间的平均（SD）潜伏期为 12.5（14.7）年。与其他 BP 患者相比，同时患有 BP 和哮喘的患者年龄更大，BMI 更高，并且更常接受皮质类固醇和免疫抑制及免疫调节佐剂治疗。
哮喘使发生 BP 的风险增加。了解这种关联可能有助于管理 BP 和哮喘的医生。需要进一步研究阐明这种观察结果的机制。
