Allergic diseases and long-term risk of autoimmune disorders: longitudinal cohort study and cluster analysis

被引:78
作者
Krishna, Mamidipudi Thirumala [1 ,2 ]
Subramanian, Anuradhaa [3 ]
Adderley, Nicola J. [3 ]
Zemedikun, Dawit T. [3 ]
Gkoutos, Georgios V. [4 ,5 ]
Nirantharakumar, Krishnarajah [3 ,5 ]
机构
[1] Univ Hosp Birmingham NHS Fdn Trust, Dept Allergy & Immunol, Birmingham, W Midlands, England
[2] Univ Birmingham, Inst Immunol & Immunotherapy, Birmingham, W Midlands, England
[3] Univ Birmingham, Inst Appl Hlth Res, Birmingham, W Midlands, England
[4] Univ Birmingham, Inst Canc & Genom, Birmingham, W Midlands, England
[5] Midlands Hlth Data Res UK, Birmingham, W Midlands, England
基金
欧盟地平线“2020”;
关键词
SYSTEMIC-LUPUS-ERYTHEMATOSUS; ASTHMA; PREVALENCE; MECHANISMS; ECZEMA; HEALTH; LOCI;
D O I
10.1183/13993003.00476-2019
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Introduction: The association between allergic diseases and autoimmune disorders is not well established. Our objective was to determine incidence rates of autoimmune disorders in allergic rhinitis/conjunctivitis (ARC), atopic eczema and asthma, and to investigate for co-occurring patterns. Methods: This was a retrospective cohort study (1990-2018) employing data extracted from The Health Improvement Network (UK primary care database). The exposure group comprised ARC, atopic eczema and asthma (all ages). For each exposed patient, up to two randomly selected age- and sex-matched controls with no documented allergic disease were used. Adjusted incidence rate ratios (aIRRs) were calculated using Poisson regression. A cross-sectional study was also conducted employing Association Rule Mining (ARM) to investigate disease clusters. Results: 782 320, 1 393570 and 1 049 868 patients with ARC, atopic eczema and asthma, respectively, were included. aIRRs of systemic lupus erythematosus (SLE), Sjogren's syndrome, vitiligo, rheumatoid arthritis, psoriasis, pernicious anaemia, inflammatory bowel disease, coeliac disease and autoimmune thyroiditis were uniformly higher in the three allergic diseases compared with controls. Specifically, aIRRs of SLE (1.45) and Sjogren's syndrome (1.88) were higher in ARC; aIRRs of SLE (1.44), Sjogren's syndrome (1.61) and myasthenia (1.56) were higher in asthma; and aIRRs of SLE (1.86), Sjogren's syndrome (1.48), vitiligo (1.54) and psoriasis (2.41) were higher in atopic eczema. There was no significant effect of the three allergic diseases on multiple sclerosis or of ARC and atopic eczema on myasthenia. Using ARM, allergic diseases clustered with multiple autoimmune disorders. Three age- and sex-related clusters were identified, with a relatively complex pattern in females >= 55 years old. Conclusions: The long-term risks of autoimmune disorders are significantly higher in patients with allergic diseases. Allergic diseases and autoimmune disorders show age- and sex-related clustering patterns.
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页数:10
相关论文
共 37 条
[1]   How accurate are Townsend Deprivation Scores as predictors of self-reported health? A comparison with individual level data [J].
Adams, J ;
Ryan, V ;
White, M .
JOURNAL OF PUBLIC HEALTH, 2005, 27 (01) :101-106
[2]   Mechanisms of allergen-specific immunotherapy: Multiple suppressor factors at work in immune tolerance to allergens [J].
Akdis, Muebeccel ;
Akdis, Cezmi A. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2014, 133 (03) :621-631
[3]   Defining asthma and assessing asthma outcomes using electronic health record data: a systematic scoping review [J].
Al Sallakh, Mohammad A. ;
Vasileiou, Eleftheria ;
Rodgers, Sarah E. ;
Lyons, Ronan A. ;
Sheikh, Aziz ;
Davies, Gwyneth A. .
EUROPEAN RESPIRATORY JOURNAL, 2017, 49 (06)
[4]   Large population study shows that adolescents with celiac disease have an increased risk of multiple autoimmune and nonautoimmune comorbidities [J].
Assa, Amit ;
Frenkel-Nir, Yael ;
Tzur, Dorit ;
Katz, Lior H. ;
Shamir, Raanan .
ACTA PAEDIATRICA, 2017, 106 (06) :967-972
[5]   Mechanisms of disease: The effect of infections on susceptibility to autoimmune and allergic diseases [J].
Bach, JF .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (12) :911-920
[6]   Incidence and sociodemographic characteristics of eczema diagnosis in children: A cohort study [J].
Ban, Lu ;
Langan, Sinead M. ;
Abuabara, Katrina ;
Thomas, Kim S. ;
Sultan, Alyshah Abdul ;
Sach, Tracey ;
McManus, Emma ;
Santer, Miriam ;
Ratib, Sonia .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2018, 141 (05) :1927-+
[7]   Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema:: ISAAC [J].
Beasley, R ;
Keil, U ;
von Mutius, E ;
Pearce, N ;
Aït-Khaled, N ;
Anabwani, G ;
Anderson, HR ;
Asher, MI ;
Björkstéin, B ;
Burr, ML ;
Clayton, TO ;
Crane, J ;
Ellwood, P ;
Lai, CKW ;
Mallol, J ;
Martinez, FD ;
Mitchell, EA ;
Montefort, S ;
Robertson, CF ;
Shah, JR ;
Sibbald, B ;
Stewart, AW ;
Strachan, DP ;
Weiland, SK ;
Williams, HC .
LANCET, 1998, 351 (9111) :1225-1232
[8]   Underlying disease specificity of genetic loci in atopic dermatitis [J].
Becker, KG ;
Barnes, KC .
JOURNAL OF INVESTIGATIVE DERMATOLOGY, 2001, 117 (05) :1325-1327
[9]  
Blak Betina T, 2011, Inform Prim Care, V19, P251
[10]  
Booth N, 1994, Health Libr Rev, V11, P177