Ji Dongshuo, Liu Ying, Han Xing, Hu Shouduo, Zhao Yanyong
Plastic surgery Department, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, 100038, China.
Ear Reconstruction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100144, China.
Eur J Dermatol. 2025 Jun 1;35(3):167-173. doi: 10.1684/ejd.2025.4888.
Autoimmune diseases have been linked to keloids in observational studies. Yet, the causality underlying this association remains ambiguous. To investigate the causal effects of selected autoimmune diseases, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), type 1 diabetes (T1D), inflammatory bowel disease (IBD), Crohn's disease (CD), and ulcerative colitis (UC), on keloids. We conducted a bidirectional two-sample Mendelian randomization (MR) analysis utilizing publicly released genome-wide association studies summary statistics. The inverse-variance weighted (IVW) method served as the primary analysis tool, supplemented by other methods such as weighted median, weighted mode, and MR Egger regression. Outliers, heterogeneity, and pleiotropy were assessed using the MR-PRESSO outlier test, Cochran's Q test, and MR-Egger regression, respectively. The IVW analysis revealed that genetically determined autoimmune diseases do not causally effect keloids (RA: OR=0.95, 95% CI: 0.89-1.00, p=0.07; SLE: OR=0.98, 95% CI: 0.93-1.02, p=0.34; IBD: OR=1.01, 95% CI: 0.90-1.03, p=0.27; CD: OR=1.02, 95% CI: 0.96-1.09, p=0.56; UC: OR=0.97, 95% CI: 0.90-1.04, p=0.34; T1D: OR=0.98, 95% CI: 0.95-1.01, p=0.27). Reverse IVW MR analysis showed no significant causal effect of keloids on autoimmune diseases. The results from MR-Egger regression, weighted median, and weighted mode methods were consistent with those obtained from the IVW method, and sensitivity analysis suggested that horizontal pleiotropy was unlikely to distort the causal estimates. Our MR analysis does not provide strong evidence supporting causal associations between autoimmune diseases and keloids in the European population.
在观察性研究中,自身免疫性疾病已被发现与瘢痕疙瘩有关。然而,这种关联背后的因果关系仍不明确。为了研究包括类风湿性关节炎(RA)、系统性红斑狼疮(SLE)、1型糖尿病(T1D)、炎症性肠病(IBD)、克罗恩病(CD)和溃疡性结肠炎(UC)在内的特定自身免疫性疾病对瘢痕疙瘩的因果影响。我们利用公开发布的全基因组关联研究汇总统计数据进行了双向两样本孟德尔随机化(MR)分析。逆方差加权(IVW)方法作为主要分析工具,并辅以加权中位数、加权众数和MR Egger回归等其他方法。分别使用MR - PRESSO异常值检验、 Cochr an's Q检验和MR - Egger回归评估异常值、异质性和多效性。IVW分析显示,基因决定的自身免疫性疾病对瘢痕疙瘩没有因果影响(RA:OR = 0.95,95% CI:0.89 - 1.00,p = 0.07;SLE:OR = 0.98,95% CI:0.93 - 1.02,p = 0.34;IBD:OR = 1.01,95% CI:0.90 - 1.03,p = 0.27;CD:OR = 1.02,95% CI:0.96 - 1.09,p = 0.56;UC:OR = 0.97,95% CI:0.90 - 1.04,p = 0.34;T1D:OR = 0.98,95% CI:0.95 - 1.01,p = 0.27)。反向IVW MR分析显示瘢痕疙瘩对自身免疫性疾病没有显著的因果影响。MR Egger回归、加权中位数和加权众数方法的结果与IVW方法的结果一致,敏感性分析表明水平多效性不太可能扭曲因果估计。我们的MR分析没有提供有力证据支持欧洲人群中自身免疫性疾病与瘢痕疙瘩之间的因果关联。
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