Liu H H, Jiang X, Deng G H, Ma Y H, Tan G L
Otorhinolaryngology Head and Neck Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Aug 7;59(8):820-827. doi: 10.3760/cma.j.cn115330-20240206-00079.
To explore the causal relationship between asthma, allergic rhinitis (AR), and chronic sinusitis (CRS), using two sample Mendelian randomization (MR) analysis, thereby providing foundational evidences for the pathogenesis and treatment of CRS. The genetic variations in AR and asthma were used as instrumental variables, with genetic data from the Integrated Epidemiology Unit (IEU) Open database. A total of 14 283 asthma and 18 934 AR cases were included, with 98 300 and 64 595 corresponding normal control cases, respectively. For CRS, there were 3 236 CRSwNP and 8 524 CRSsNP, respectively, with 167 849 and 167 849 corresponding normal control cases, respectively. The genetic data were analyzed using the inverse variance weighting method (IVW), MR Egger method, weighted median method, and Cochran's Q-test. The IVW analysis showed that asthma increased the risk of both CRSwNP (=482.8, 95%: 57.18-4 077.78, <0.001) and CRSsNP (=25.73, 95%: 9.79-67.56, <0.001); AR significantly increased the risk of CRSsNP (=5.40, 95%: 1.68-17.26, =0.004), but not CRSwNP (=7.38, 95%: 0.80-67.73, =0.077). Conversely, neither CRSwNP nor CRSsNP increased the risk of asthma or AR. According to Mendelian genetic laws, asthma is a risk factor for CRSwNP and CRSsNP, while AR is a risk factor for CRSsNP.
采用两样本孟德尔随机化（MR）分析方法，探讨哮喘、变应性鼻炎（AR）和慢性鼻窦炎（CRS）之间的因果关系，从而为CRS的发病机制和治疗提供基础证据。以AR和哮喘的基因变异作为工具变量，使用综合流行病学单位（IEU）开放数据库中的基因数据。共纳入14283例哮喘病例和18934例AR病例，分别有98300例和64595例相应的正常对照病例。对于CRS，分别有3236例慢性鼻窦炎伴鼻息肉（CRSwNP）和8524例不伴鼻息肉的慢性鼻窦炎（CRSsNP），分别有167849例相应的正常对照病例。采用逆方差加权法（IVW）、MR Egger法、加权中位数法和Cochran's Q检验对基因数据进行分析。IVW分析显示，哮喘增加了CRSwNP（比值比=482.8，95%置信区间：57.18 - 4077.78，P<0.001）和CRSsNP（比值比=25.73，95%置信区间：9.79 - 67.56，P<0.001）的发病风险；AR显著增加了CRSsNP的发病风险（比值比=5.40，95%置信区间：1.68 - 17.26，P=0.004），但未增加CRSwNP的发病风险（比值比=7.38，95%置信区间：0.80 - 67.73，P=0.077）。相反，CRSwNP和CRSsNP均未增加哮喘或AR的发病风险。根据孟德尔遗传定律，哮喘是CRSwNP和CRSsNP的危险因素，而AR是CRSsNP的危险因素。
