Department of Dermatology, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, People's Republic of China.
Arch Dermatol Res. 2024 May 18;316(5):181. doi: 10.1007/s00403-024-02978-2.
Background An increasing body of observational studies has indicated a potential link between allergic diseases, namely atopic dermatitis (AD), allergic rhinitis (AR), allergic asthma (AA), and psoriasis (PSO) as well as psoriatic arthritis (PSA). However, the presence and causal direction of this association remain uncertain. Methods We conducted two-sample Mendelian randomization (TSMR) analyses utilizing summary statistics derived from genome-wide association studies (GWAS) consortia. The summary statistics were obtained from a substantial participant cohort, consisting of 116,000 individuals (21,000 AD cases and 95,000 controls), 462,933 individuals (26,107 AR cases and 436,826 controls), and 140,308 individuals (4859 AA cases and 135,449 controls). The summary statistics for PSO (9267 cases and 360,471 controls) and PSA (3186 cases and 240,862 controls) were sourced from the FinnGen database. The primary analytical approach employed inverse variance weighting (IVW) as the main method within TSMR. We validated our findings through a series of sensitivity analyses. Furthermore, we performed reverse TSMR analyses to evaluate the potential presence of reverse causality. Results Our investigation revealed a potential protective effect of AD against both PSO (OR = 0.922, 95% CI = 0.863-0.984, p = 0.015)and PSA(OR = 0.915, 95% CI = 0.843-0.993, p = 0.033). Moreover, employing inverse MR analysis, we obtained compelling evidence supporting the protective role of PSO in preventing AD (OR = 0.891, 95% CI = 0.829-0.958, p = 0.002), as well as AR (OR = 0.998, 95% CI = 0.996-0.999, p = 0.008), these associations remained statistically significant even after Bonferroni correction was applied to account for multiple comparisons. Furthermore, our findings did not reveal any substantial causal relationship between AA and either PSO or PSA. Conclusion Our study provides compelling evidence that PSO significantly confers protection against both AD and AR, while AD is likely to act as a protective factor for both PSO and PSA. Despite previous studies suggesting an association between allergic diseases and the incidence of PSO and PSA, our findings do not support this claim. To obtain more accurate and reliable conclusions regarding the causal mechanisms involved, larger sample sizes in randomized controlled trials or MR studies are warranted.
越来越多的观察性研究表明,特应性皮炎(AD)、过敏性鼻炎(AR)、过敏性哮喘(AA)和银屑病(PSO)以及银屑病关节炎(PSA)等过敏性疾病之间存在潜在联系。然而,这种关联的存在和因果方向仍不确定。
我们利用来自全基因组关联研究(GWAS)联盟的汇总统计数据进行了两样本孟德尔随机化(TSMR)分析。汇总统计数据来自一个由 116000 人组成的大量参与者队列(21000 例 AD 病例和 95000 例对照)、462933 人(26107 例 AR 病例和 436826 例对照)和 140308 人(4859 例 AA 病例和 135449 例对照)。PSO(9267 例病例和 360471 例对照)和 PSA(3186 例病例和 240862 例对照)的汇总统计数据来自 FinnGen 数据库。我们主要采用 TSMR 中的逆方差加权(IVW)作为主要分析方法。我们通过一系列敏感性分析验证了我们的发现。此外,我们还进行了反向 TSMR 分析,以评估潜在的反向因果关系。
我们的研究表明,AD 可能对 PSO(OR=0.922,95%CI=0.863-0.984,p=0.015)和 PSA(OR=0.915,95%CI=0.843-0.993,p=0.033)具有保护作用。此外,采用逆 MR 分析,我们获得了有力的证据支持 PSO 在预防 AD(OR=0.891,95%CI=0.829-0.958,p=0.002)和 AR(OR=0.998,95%CI=0.996-0.999,p=0.008)方面的保护作用,即使在进行了 Bonferroni 校正以考虑多次比较后,这些关联仍然具有统计学意义。此外,我们的研究结果表明 AA 与 PSO 或 PSA 之间没有明显的因果关系。
我们的研究提供了有力的证据表明 PSO 显著预防 AD 和 AR,而 AD 可能对 PSO 和 PSA 具有保护作用。尽管先前的研究表明过敏疾病与 PSO 和 PSA 的发病之间存在关联,但我们的研究结果不支持这一观点。为了获得更准确和可靠的结论,需要在随机对照试验或 MR 研究中增加样本量。