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Clinical & Experimental Allergy

Allergic sensitization and filaggrin variants predispose to the comorbidity of eczema, asthma, and rhinitis: results from the Isle of Wight birth cohort

Authors

  • A. H. Ziyab,

    1. Department of Epidemiology and Biostatistics, Norman J. Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
    2. Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
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  • W. Karmaus,

    Corresponding author
    1. Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
    • Correspondence:

      Wilfried Karmaus, Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, 301 Robison Hall, Memphis, TN 38152, USA.

      E-mail: karmaus1@memphis.edu

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  • H. Zhang,

    1. Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
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  • J. W. Holloway,

    1. Academic Units of Clinical and Experimental Medicine, University of Southampton, Southampton, UK
    2. Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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  • S. E. Steck,

    1. Department of Epidemiology and Biostatistics, Norman J. Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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  • S. Ewart,

    1. College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
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  • S. H. Arshad

    1. Academic Units of Clinical and Experimental Medicine, University of Southampton, Southampton, UK
    2. David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
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Summary

Background

Allergic sensitization and filaggrin gene (FLG) variants are important risk factors for allergic disorders; however, knowledge on their individual and interactive effects on the coexistence of eczema, asthma, and rhinitis is lacking.

Objective

This study aimed at investigating the single and combined effects of allergic sensitization and FLG variants on the development of single and multiple allergic disorders.

Methods

The Isle of Wight birth cohort (n = 1456) has been examined at 1, 2, 4, 10, and 18 years of age. Repeated measurements of eczema, asthma, rhinitis, and skin prick tests were available for all follow-ups. FLG variants were genotyped in 1150 participants. Associations of allergic sensitization and FLG variants with single and multiple allergic disorders were tested in log-binomial regression analysis.

Results

The prevalence of eczema-, asthma-, and rhinitis-only ranged from 5.6% to 8.5%, 4.9% to 10.2%, and 2.5% to 20.4%, respectively, during the first 18 years of life. The coexistence of allergic disorders is common, with approximately 2% of the population reporting the comorbidity of ‘eczema, asthma, and rhinitis’ during the study period. In repeated measurement analyses, allergic sensitization and FLG variants, when analysed separately, were associated with having single and multiple allergic disorders. Of particular significance, their combined effect increased the risk of ‘eczema and asthma’ (RR = 13.67, 95% CI: 7.35–25.42), ‘asthma and rhinitis’ (RR = 7.46, 95% CI: 5.07–10.98), and ‘eczema, asthma, and rhinitis’ (RR = 23.44, 95% CI: 12.27–44.78).

Conclusions and Clinical Relevance

The coexistence of allergic disorders is frequent, and allergic sensitization and FLG variants jointly increased risk of allergic comorbidities, which may represent more severe and complex clinical phenotypes. The interactive effect and the elevated proportion of allergic comorbidities associated with allergic sensitization and FLG variants emphasize their joint importance in the pathogenesis of allergic disorders.

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