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Ziyab AH, Jones AD, Chen S, Anthony TM, Mukherjee N, Arshad SH, Karmaus W. Fucoxanthin levels in maternal serum at birth and eczema risk in offspring in early childhood: A birth cohort study. Pediatr Allergy Immunol 2023; 34:e13979. [PMID: 37366203 DOI: 10.1111/pai.13979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Fucoxanthin, a marine xanthophyll carotenoid, has been shown to exert beneficial health effects. Cell-based and animal-based experimental studies have shown that fucoxanthin has the potential to mitigate eczema symptoms. Hence, we sought to assess whether fucoxanthinol 3-arachidate, a fucoxanthin metabolite, measured in maternal serum at birth is associated with eczema development during early childhood. METHODS Data from the 1989/1990 Isle of Wight birth cohort were analyzed. We focused on data obtained from the 1, 2, and 4 years follow-ups. Fucoxanthinol 3-arachidate was measured in maternal serum at the child's birth as abundance relative to the reference lipids. Eczema was ascertained according to parent-reported clinical history and characteristic morphology and distribution. Log-binomial regression models were used to estimate adjusted risk ratios (aRR) and their 95% confidence intervals (CI). RESULTS A total of 592 subjects (49.2% males and 50.8% females) were included in the current analysis. Associations between fucoxanthinol 3-arachidate levels and eczema risk during the first 4 years of life (longitudinal analysis) were evaluated using four modeling approaches, which showed higher fucoxanthinol 3-arachidate levels were associated with reduced eczema risk: (i) aRRper 10 unit increase = 0.88, 95% CI: 0.76-1.03; (ii) aRR>0 vs. =0 = 0.67, 0.45-0.99; (iii) aRR≥2.3 vs. <2.3 = 0.66, 0.44-0.98; and (iv) aRRtertile 3 vs. tertile 1 = 0.65, 0.42-0.99. CONCLUSION Our findings suggest that increased fucoxanthinol 3-arachidate levels measured in maternal serum at the child's birth is associated with reduced eczema risk during the first 4 years of the offspring life.
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Affiliation(s)
- Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - A Daniel Jones
- Department of Biochemistry & Molecular Biology, Michigan State University, East Lansing, Michigan, USA
| | - Su Chen
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Thilani M Anthony
- Department of Biochemistry & Molecular Biology, Michigan State University, East Lansing, Michigan, USA
| | - Nandini Mukherjee
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Syed Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee, USA
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Moosbrugger-Martinz V, Leprince C, Méchin MC, Simon M, Blunder S, Gruber R, Dubrac S. Revisiting the Roles of Filaggrin in Atopic Dermatitis. Int J Mol Sci 2022; 23:5318. [PMID: 35628125 PMCID: PMC9140947 DOI: 10.3390/ijms23105318] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 12/31/2022] Open
Abstract
The discovery in 2006 that loss-of-function mutations in the filaggrin gene (FLG) cause ichthyosis vulgaris and can predispose to atopic dermatitis (AD) galvanized the dermatology research community and shed new light on a skin protein that was first identified in 1981. However, although outstanding work has uncovered several key functions of filaggrin in epidermal homeostasis, a comprehensive understanding of how filaggrin deficiency contributes to AD is still incomplete, including details of the upstream factors that lead to the reduced amounts of filaggrin, regardless of genotype. In this review, we re-evaluate data focusing on the roles of filaggrin in the epidermis, as well as in AD. Filaggrin is important for alignment of keratin intermediate filaments, control of keratinocyte shape, and maintenance of epidermal texture via production of water-retaining molecules. Moreover, filaggrin deficiency leads to cellular abnormalities in keratinocytes and induces subtle epidermal barrier impairment that is sufficient enough to facilitate the ingress of certain exogenous molecules into the epidermis. However, although FLG null mutations regulate skin moisture in non-lesional AD skin, filaggrin deficiency per se does not lead to the neutralization of skin surface pH or to excessive transepidermal water loss in atopic skin. Separating facts from chaff regarding the functions of filaggrin in the epidermis is necessary for the design efficacious therapies to treat dry and atopic skin.
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Affiliation(s)
- Verena Moosbrugger-Martinz
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; (V.M.-M.); (S.B.); (R.G.)
| | - Corinne Leprince
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, Inserm UMR1291, UPS, 31059 Toulouse, France; (C.L.); (M.-C.M.); (M.S.)
| | - Marie-Claire Méchin
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, Inserm UMR1291, UPS, 31059 Toulouse, France; (C.L.); (M.-C.M.); (M.S.)
| | - Michel Simon
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, Inserm UMR1291, UPS, 31059 Toulouse, France; (C.L.); (M.-C.M.); (M.S.)
| | - Stefan Blunder
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; (V.M.-M.); (S.B.); (R.G.)
| | - Robert Gruber
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; (V.M.-M.); (S.B.); (R.G.)
| | - Sandrine Dubrac
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; (V.M.-M.); (S.B.); (R.G.)
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3
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Ziyab AH, Mukherjee N, Zhang H, Arshad SH, Karmaus W. Sex-specific developmental trajectories of eczema from infancy to age 26 years: A birth cohort study. Clin Exp Allergy 2022; 52:416-425. [PMID: 34854146 PMCID: PMC8866217 DOI: 10.1111/cea.14068] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/08/2021] [Accepted: 11/29/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Eczema is a common inflammatory skin disease with varying developmental trajectories/patterns that are influenced by different risk factors. The aim of this study was to investigate eczema development from infancy to early adulthood by identifying distinct developmental trajectories that describe disease patterns over time and evaluate the role of prenatal and early-life risk factors. METHODS The Isle of Wight Birth Cohort (n = 1456) was prospectively assessed at birth, 1, 2, 4, 10, 18 and 26 years. In all assessments, eczema was defined as chronic or chronically relapsing itchy dermatitis lasting >6 weeks with characteristic morphology and distribution in the past 12 months. Developmental trajectories of eczema between 1 or 2 and 26 years were identified separately for males and females by applying semiparametric mixture models. Associations were assessed by applying a modified Poisson regression to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI). RESULTS In both males and females, the following eczema developmental trajectories were identified: unaffected/transient (males: 77.7% vs. females: 73.0%), mid-onset late-resolving (males: 7.8% vs. females: 4.4%), late-onset (males: 5.2% vs. females: 9.5%) and early-onset persistent (males: 9.3% vs. females: 5.4%). In females, an additional trajectory was identified as follows: early-onset early-resolving (7.7%). Among males, filaggrin gene (FLG) variants (aRR = 2.45, 95% CI: 1.34-4.46) and paternal eczema (2.66, 1.39-5.08) were associated with the early-onset persistent trajectory. Among females, maternal eczema (2.84, 1.42-5.70) and high birthweight (2.25, 1.08-4.69) were associated with the early-onset persistent trajectory. CONCLUSIONS Four and five trajectories represented eczema development among males and females, respectively, with different predisposing risk factors. Our results indicate that males and females may experience a different course of eczema.
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Affiliation(s)
- Ali H. Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait
| | - Nandini Mukherjee
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - S. Hasan Arshad
- David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Isle of Wight, UK,Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, UK
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
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Hon KL, Chu S, Leung AKC, Wong A. Atopic Dermatitis: Conventional and Integrative Medicine. Curr Pediatr Rev 2022; 18:84-96. [PMID: 34279204 DOI: 10.2174/1573396317666210716152325] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/24/2021] [Accepted: 02/25/2021] [Indexed: 11/22/2022]
Abstract
Although Western medicine and ideas about atopic dermatitis (AD) have become popular in many Asian countries, local beliefs about the disease and its treatment often prevail. The multi- racial background of these countries as well as the influence of the diverse religions (such as Taoism and Ramadan) in these regions often lead to diverse belief systems about the causes of AD (such as the Chi concept, also known as the balance of yin and yang) and the types of treatment (e.g. herbal remedies, topical versus concoctions, and decoctions). In addition, many of the cultural practices are preserved among the Southeast Asian minorities residing in the United Kingdom and North America. Eastern treatments typically take a holistic approach to AD and emphasize the psychosomatic component of the disorder. This overview provides a summary of the difference between conventional, complementary, alternative, and integrative medicine in terms of epidemiology, aetiology, therapy, and prognosis in children with AD. There are a number of similarities in genetic and environmental factors in epidemiology and aetiology; however, differences exist in terms of the concept of management. Complementary and alternative medicine, traditional Chinese medicine, and integrative medicine usage are not only prevalent among the Asian population but are also becoming more popular and accepted in Western societies.
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Affiliation(s)
- Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Shenzhou, Hong Kong.,Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Kowloon, Hong Kong
| | - Samantha Chu
- Faculty of Medicine, The Chinese University of Hong Kong, Shenzhou, Hong Kong
| | - Alexander K C Leung
- Department of Paediatrics, The University of Calgary, and The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Alex Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
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5
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Current insights into the genetics of food allergy. J Allergy Clin Immunol 2021; 147:15-28. [PMID: 33436162 DOI: 10.1016/j.jaci.2020.10.039] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/02/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022]
Abstract
Food allergy (FA), a growing public health burden in the United States, and familial aggregation studies support strong roles for both genes and environment in FA risk. Deepening our understanding of the molecular and cellular mechanisms driving FAs is paramount to improving its prevention, diagnosis, and clinical management. In this review, we document lessons learned from the genetics of FA that have aided our understanding of these mechanisms. Although current genetic association studies suffer from low power, heterogeneity in definition of FA, and difficulty in our ability to truly disentangle FA from food sensitization (FS) and general atopy genetics, they reveal a set of genetic loci, genes, and variants that continue to implicate the importance of barrier and immune function genes across the atopic march, and FA in particular. The largest reported effects on FA are from MALT1 (odds ratio, 10.99), FLG (average odds ratio, ∼2.9), and HLA (average odds ratio, ∼2.03). The biggest challenge in the field of FA genetics is to elucidate the specific mechanism of action on FA risk and pathogenesis for these loci, and integrative approaches including genetics/genomics with transcriptomics, proteomics, and metabolomics will be critical next steps to translating these genetic insights into practice.
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6
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Different Measures of Diet Diversity During Infancy and the Association with Childhood Food Allergy in a UK Birth Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:2017-2026. [PMID: 32004745 DOI: 10.1016/j.jaip.2020.01.029] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/27/2019] [Accepted: 01/14/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Diet diversity (DD) during infancy may prevent food allergies (FA), possibly by exposing the gastrointestinal microbiota to diverse foods and nutrients. OBJECTIVE To investigate the association between 4 different measures of DD during infancy and development of FA over the first decade of life. METHODS A birth cohort born between 2001 and 2002 were followed prospectively, providing information on sociodemographic, environmental, and dietary exposures. Information on age of introduction of a range of foods and food allergens was collected during infancy. Children were assessed for FA at 1, 2, 3, and 10 years. DD was defined using 4 measures in the first year of life: the World Health Organization definition of minimum DD at 6 months, as food diversity (FD) and fruit and vegetable diversity (FVD) at 3, 6, and 9 months, and as food allergen diversity (FAD) at 3, 6, 9, and 12 months. RESULTS A total of 969 pregnant women were recruited at 12-week gestation. A total of 900, 858, 891, and 827 offspring were assessed at 1, 2, 3, and 10 years. Univariate analysis showed that World Health Organization DD (P = .0047), FD (P = .0009), FAD (P = .0048), and FVD (P = .0174) at 6 months and FD (P = .0392), FAD (P = .0233), and FVD (.0163) at 9 months significantly reduced the odds of FA over the first decade of life. DD measures at 3 months were not associated with FA, but only 33% of the cohort had solid foods introduced by this age. CONCLUSION Increased infant DD, as measured by 4 different methods, decreased the likelihood of developing FA.
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7
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Mukherjee N, Sutter TR, Arshad SH, Holloway JW, Zhang H, Karmaus W. Breastfeeding duration modifies the effect of smoking during pregnancy on eczema from early childhood to adolescence. Clin Exp Allergy 2019; 48:1688-1697. [PMID: 30311981 DOI: 10.1111/cea.13294] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/26/2018] [Accepted: 10/05/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cigarette smoke contains compounds similar to coal tar, an ancient remedy of eczema. Some studies have reported protective effects of maternal gestational smoking on offspring eczema; however, others have shown no or increased risks. Similarly, studies linking breastfeeding duration and eczema have demonstrated contradictory findings. No study has yet investigated combined effects of these two factors on eczema. OBJECTIVE Since tobacco compounds can pass to offspring via breast milk, we investigated their combined effects on eczema development from childhood to adolescence. METHODS We obtained information regarding gestational smoking, exclusive breastfeeding duration, and eczema at ages 1-or-2, 4, 10, and 18 years from the Isle of Wight (IOW) birth cohort, UK. Using generalized estimating equations, we assessed the interaction of gestational smoking and residual exclusive breastfeeding duration (Resid-BF-duration, obtained by regressing the latter on maternal smoking) on eczema over time adjusting for confounders. For the three transition periods of 1-or-2 to 4 years, 4-10, and 10-18 years, we estimated risks of persistent, incident, and remitting eczema associated with the interaction using repeated measurements. RESULTS If the mother smoked during gestation, longer Resid-BF-duration was associated with a lower risk of eczema, compared to if she did not smoke. The risk ratios (95% CI) if the mother smoked during gestation and exclusively breastfed for at least 3, 9, 15, 21 weeks are 0.7 (0.6, 1.7), 0.6 (0. 4, 0.9), 0.5 (0.3, 0.8), and 0.4 (0.2, 0. 8), respectively. Additionally, in all three transition periods, the risk of persistent eczema was lower with longer Resid-BF-duration if the mother smoked during gestation. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest a protective effect of gestational smoking combined with longer duration of exclusive breastfeeding on early-onset persistent eczema. Future studies should examine underlying biological mechanisms. Prolonged breastfeeding should be encouraged even if the mother smoked during gestation.
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Affiliation(s)
- Nandini Mukherjee
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee
| | - Thomas R Sutter
- Department of Biological Sciences, University of Memphis, Memphis, Tennessee
| | - Syed Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,NIHR Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton, UK
| | - John W Holloway
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee
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8
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Chan A, Terry W, Zhang H, Karmaus W, Ewart S, Holloway JW, Roberts G, Kurukulaaratchy R, Arshad SH. Filaggrin mutations increase allergic airway disease in childhood and adolescence through interactions with eczema and aeroallergen sensitization. Clin Exp Allergy 2019; 48:147-155. [PMID: 29266469 DOI: 10.1111/cea.13077] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/02/2017] [Accepted: 12/01/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Filaggrin loss-of-function (FLG-LOF) mutations are an established genetic cause of eczema. These mutations have subsequently been reported to increase the risk of aeroallergen sensitization and allergic airway disease. However, it is unclear whether FLG variants require both eczema and aeroallergen sensitization to influence airway disease development long-term outcomes. OBJECTIVE To examine the effects of FLG-LOF mutations on allergic airway disease outcomes, with eczema and aeroallergen sensitization as intermediate variables, using the Isle of Wight birth cohort. METHODS Study participants were evaluated at ages 1, 2, 4, 10 and 18 years to ascertain the development of allergic diseases (eczema, asthma and allergic rhinitis) and aeroallergen sensitization (determined by skin prick tests). FLG-LOF mutations were genotyped in 1150 subjects. To understand the complex associations between FLG mutations, intermediate variables (eczema and aeroallergen sensitization) and airway disease, path analysis was performed. RESULTS There were significant total effects of FLG-LOF mutations on both asthma and allergic rhinitis at all ages as well as on aeroallergen sensitization up till 10 years old. In the filaggrin-asthma analysis, a direct effect of FLG-LOF mutations was observed on early childhood eczema (age 1 and 2 years) (relative risk (RR) 2.01, 95% CI: 1.74-2.31, P < .001), and all significant indirect pathways on asthma outcomes passed through eczema at these ages. In contrast, for the filaggrin-rhinitis model, FLG-LOF mutations exerted significant direct effects on early eczema as well as rhinitis at 10 years (RR 1.99; 95% CI: 1.72-2.29, P = .002). CONCLUSION FLG-LOF mutations are a significant risk factor for later childhood asthma and rhinitis. However, the pathway to asthma is only through early childhood eczema while a direct effect was observed for childhood rhinitis.
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Affiliation(s)
- Adrian Chan
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore City, Singapore
| | - William Terry
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Colorado, SC, USA
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Susan Ewart
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,Respiratory Biomedical Research Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Ramesh Kurukulaaratchy
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK.,Respiratory Biomedical Research Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Syed Hasan Arshad
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
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Arshad SH, Holloway JW, Karmaus W, Zhang H, Ewart S, Mansfield L, Matthews S, Hodgekiss C, Roberts G, Kurukulaaratchy R. Cohort Profile: The Isle Of Wight Whole Population Birth Cohort (IOWBC). Int J Epidemiol 2019; 47:1043-1044i. [PMID: 29547889 DOI: 10.1093/ije/dyy023] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Hasan Arshad
- The David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK.,Clinical and Experimental Sciences, University of Southampton, Southampton, UK.,NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - John W Holloway
- Human Development and Health, University of Southampton, Southampton, UK
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN, USA
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN, USA
| | - Susan Ewart
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
| | - Linda Mansfield
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA
| | - Sharon Matthews
- The David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK
| | - Claire Hodgekiss
- The David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK
| | - Graham Roberts
- The David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK.,Clinical and Experimental Sciences, University of Southampton, Southampton, UK.,NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Human Development and Health, University of Southampton, Southampton, UK
| | - Ramesh Kurukulaaratchy
- The David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK.,Clinical and Experimental Sciences, University of Southampton, Southampton, UK.,NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
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Bonamonte D, Filoni A, Vestita M, Romita P, Foti C, Angelini G. The Role of the Environmental Risk Factors in the Pathogenesis and Clinical Outcome of Atopic Dermatitis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2450605. [PMID: 31119157 PMCID: PMC6500695 DOI: 10.1155/2019/2450605] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/10/2019] [Indexed: 12/17/2022]
Abstract
Atopic dermatitis (AD) prevalence is rising worldwide. Literature data suggest the incidence of AD in developing countries is gradually getting close to that of developed ones, in which AD affects 20% of the paediatric population. Such an increment, associated with significant variations in prevalence among the various countries, underlines the importance of environmental factors in the disease onset. Among these, great importance is given to hygiene, intestinal microbiota, exposure to bacterial endotoxins, outdoor living with contact to animals, atmospheric pollution, weather, and diet. Genetic (alteration of the skin barrier function) as well as immunologic factors concur with the environmental ones. Only the systematical study of all these elements can best elucidate AD epidemiology.
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Affiliation(s)
- Domenico Bonamonte
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, 11 Piazza Giulio Cesare, Bari 70124, Italy
| | - Angela Filoni
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, 11 Piazza Giulio Cesare, Bari 70124, Italy
- San Gallicano Dermatologic Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Michelangelo Vestita
- Section of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11 Piazza Giulio Cesare, Bari 70124, Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, 11 Piazza Giulio Cesare, Bari 70124, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, 11 Piazza Giulio Cesare, Bari 70124, Italy
| | - Gianni Angelini
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, 11 Piazza Giulio Cesare, Bari 70124, Italy
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11
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Ziyab AH, Hankinson J, Ewart S, Schauberger E, Kopec-Harding K, Zhang H, Custovic A, Arshad H, Simpson A, Karmaus WJ. Epistasis between FLG and IL4R Genes on the Risk of Allergic Sensitization: Results from Two Population-Based Birth Cohort Studies. Sci Rep 2018; 8:3221. [PMID: 29459738 PMCID: PMC5818621 DOI: 10.1038/s41598-018-21459-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 02/05/2018] [Indexed: 11/12/2022] Open
Abstract
Immune-specific genes as well as genes responsible for the formation and integrity of the epidermal barrier have been implicated in the pathogeneses of allergic sensitization. This study sought to determine whether an epistatic effect (gene-gene interaction) between genetic variants within interleukin 4 receptor (IL4R) and filaggrin (FLG) genes predispose to the development of allergic sensitization. Data from two birth cohort studies were analyzed, namely the Isle of Wight (IOW; n = 1,456) and the Manchester Asthma and Allergy Study (MAAS; n = 1,058). In the IOW study, one interaction term (IL4R rs3024676 × FLG variants) showed statistical significance (interaction term: P = 0.003). To illustrate the observed epistasis, stratified analyses were performed, which showed that FLG variants were associated with allergic sensitization only among IL4R rs3024676 homozygotes (OR, 1.97; 95% CI, 1.27–3.05; P = 0.003). In contrast, FLG variants effect was masked among IL4R rs3024676 heterozygotes (OR, 0.53; 95% CI, 0.22–1.32; P = 0.175). Similar results were demonstrated in the MAAS study. Epistasis between immune (IL4R) and skin (FLG) regulatory genes exist in the pathogenesis of allergic sensitization. Hence, genetic susceptibility towards defective epidermal barrier and deviated immune responses could work together in the development of allergic sensitization.
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Affiliation(s)
- Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
| | - Jenny Hankinson
- Division of Infection, Immunity and Respiratory Medicine, Manchester Academic Health Science Centre, The University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| | - Susan Ewart
- College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Eric Schauberger
- Division of Allergy and Immunology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Kamilla Kopec-Harding
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Adnan Custovic
- Department of Paediatrics, Imperial College London, London, UK
| | - Hasan Arshad
- David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK.,Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, Manchester Academic Health Science Centre, The University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| | - Wilfried J Karmaus
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
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Tanjung C, Rzehak P, Mansyur M, Munasir Z, Sudoyo H, Immanuel S, Irawan R, Reischl E, Demmelmair H, Koletzko B, Hadinegoro SR, Sjarif DR. Study protocol to investigate the environmental and genetic aetiology of atopic dermatitis: the Indonesian Prospective Study of Atopic Dermatitis in Infants (ISADI). BMJ Open 2017; 7:e012475. [PMID: 28259851 PMCID: PMC5353254 DOI: 10.1136/bmjopen-2016-012475] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 01/26/2017] [Accepted: 02/08/2017] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Atopic dermatitis (AD) is the most common skin disorder in young children worldwide, with a high impact on morbidity and quality of life. To date, no prospective study has been published on the incidence and potential predictors of AD in South East Asian populations. The Indonesian Prospective Study of Atopic Dermatitis in Infants (ISADI) will address the genetic, metabolic and dietary characteristics of mothers and their offspring, as well as potential determinants of AD within the first year of infant life. METHODS AND ANALYSIS This prospective study will be undertaken in about 400 infants to investigate the direct and indirect effects of filaggrin (FLG) gene mutations, the genetic variants of FADS1, FADS2 and FADS3 and the role of long-chain polyunsaturated fatty acids (LCPUFA) on the development of AD. We will use standardised protocols for subject recruitment, umbilical artery plasma analysis, buccal cell sampling for genotyping, fatty acid analysis, physical exams, 3-day food-intake recall of mothers and children, as well as comprehensive questionnaires on environmental, socioeconomic and AD-related factors, including family history. Monthly monitoring by telephone and physical exams every 3 months will be carried out to assess participants' anthropometry, medical history and incidence of AD diagnosis during the first year of life. Hypotheses-driven analyses of quality-controlled dietary, genetic and metabolic data will be performed with state-of-the-art statistical methods (eg, AD-event history, haplotype, dietary or metabolic factor analysis). Direct and indirect effects of genetics and LCPUFA in buccal cell and cord plasma glycerophospholipids as potential mediators of inflammation on AD development will be evaluated by path analysis. ETHICS AND DISSEMINATION The Permanent Medical Research Ethics Committee in Medicine and Health/Faculty of Medicine Universitas Indonesia/Dr Cipto Mangunkusumo Hospital (No. 47/H2.F1/ETIK/2014) approved the study protocol (extended by the letter no. 148/UN2.F1/ETIK/2015). We aim to disseminate our findings via publication in an international journal with high impact factor.
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Affiliation(s)
- Conny Tanjung
- Postgraduate Program, Faculty of Medicine, Universitas Indonesia,Jakarta, Indonesia
- Pantai Indah Kapuk Hospital, Jakarta, Indonesia
| | - Peter Rzehak
- Division of Metabolic and Nutritional Medicine, Ludwig-Maximilians-Universität München, Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | | | - Zakiudin Munasir
- Department of Paediatrics, Faculty of Medicine,Universitas Indonesia, Dr Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Herawati Sudoyo
- Faculty of Medicine, Sydney University, Sydney,Australia
- Department of Medical Biology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Suzanna Immanuel
- Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Dr Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Roedi Irawan
- Department of Paediatrics, Faculty of Medicine, Universitas Airlangga, Dr Sutomo General Hospital, Surabaya, Indonesia
| | - Eva Reischl
- Research Unit of Molecular Epidemiology, Institute of Epidemiology II, Helmholtz Zentrum Muenchen, Munich, Germany
| | - Hans Demmelmair
- Division of Metabolic and Nutritional Medicine, Ludwig-Maximilians-Universität München, Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Ludwig-Maximilians-Universität München, Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Sri Rezeki Hadinegoro
- Department of Paediatrics, Faculty of Medicine,Universitas Indonesia, Dr Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Damayanti Rusli Sjarif
- Department of Paediatrics, Faculty of Medicine,Universitas Indonesia, Dr Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
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Ziyab AH, Mukherjee N, Ewart S, Arshad SH, Karmaus W, Turati F, Bertuccio P, Galeone C, Pelucchi C, Naldi L, Bach JF, Vecchia CL, Chatenoud L. Filaggrin gene loss-of-function variants modify the effect of breast-feeding on eczema risk in early childhood. Allergy 2016; 71:1371-3. [PMID: 27492891 DOI: 10.1111/all.12940] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- A. H. Ziyab
- Department of Community Medicine and Behavioral Sciences; Faculty of Medicine; Kuwait University; Kuwait Kuwait
| | - N. Mukherjee
- Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health; University of Memphis; Memphis TN USA
| | - S. Ewart
- Department of Large Animal Clinical Sciences; Michigan State University; East Lansing MI USA
| | - S. H. Arshad
- Clinical and Experimental Sciences; Faculty of Medicine; University of Southampton; Southampton UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton; Southampton UK
- The David Hide Asthma and Allergy Research Centre; Isle of Wight UK
| | - W. Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health; University of Memphis; Memphis TN USA
| | - F. Turati
- Department of Epidemiology - IRCCS Istituto di Ricerche Farmacologiche ‘Mario Negri’; Milan Italy
| | - P. Bertuccio
- Department of Epidemiology - IRCCS Istituto di Ricerche Farmacologiche ‘Mario Negri’; Milan Italy
| | - C. Galeone
- Department of Epidemiology - IRCCS Istituto di Ricerche Farmacologiche ‘Mario Negri’; Milan Italy
| | - C. Pelucchi
- Department of Epidemiology - IRCCS Istituto di Ricerche Farmacologiche ‘Mario Negri’; Milan Italy
| | - L. Naldi
- Department of Dermatology; Azienda Ospedaliera Papa Giovanni XXIII; Centro Studi GISED; Bergamo Italy
| | - J-F. Bach
- Université Paris Descartes; Paris France
- INSERM; Paris France
| | - C. L. Vecchia
- Department of Clinical Sciences and Community Health; Università degli Studi di Milano; Milan Italy
| | - L. Chatenoud
- Department of Epidemiology - IRCCS Istituto di Ricerche Farmacologiche ‘Mario Negri’; Milan Italy
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Perkin MR, Logan K, Marrs T, Radulovic S, Craven J, Flohr C, Lack G. Enquiring About Tolerance (EAT) study: Feasibility of an early allergenic food introduction regimen. J Allergy Clin Immunol 2016; 137:1477-1486.e8. [PMID: 26896232 PMCID: PMC4852987 DOI: 10.1016/j.jaci.2015.12.1322] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 11/27/2015] [Accepted: 12/29/2015] [Indexed: 12/20/2022]
Abstract
Background The influence of early exposure to allergenic foods on the subsequent development of food allergy remains uncertain. Objective We sought to determine the feasibility of the early introduction of multiple allergenic foods to exclusively breast-fed infants from 3 months of age and the effect on breastfeeding performance. Methods We performed a randomized controlled trial. The early introduction group (EIG) continued breastfeeding with sequential introduction of 6 allergenic foods: cow's milk, peanut, hard-boiled hen's egg, sesame, whitefish (cod), and wheat; the standard introduction group followed the UK infant feeding recommendations of exclusive breastfeeding for around 6 months with no introduction of allergenic foods before 6 months of age. Results One thousand three hundred three infants were enrolled. By 5 months of age, the median frequency of consumption of all 6 foods was 2 to 3 times per week for every food in the EIG and no consumption for every food in the standard introduction group (P < .001 for every comparison). By 6 months of age, nonintroduction of the allergenic foods in the EIG was less than 5% for each of the 6 foods. Achievement of the stringent per-protocol consumption target for the EIG proved more difficult (42% of evaluable EIG participants). Breastfeeding rates in both groups significantly exceeded UK government data for equivalent mothers (P < .001 at 6 and at 9 months of age). Conclusion Early introduction, before 6 months of age, of at least some amount of multiple allergenic foods appears achievable and did not affect breastfeeding. This has important implications for the evaluation of food allergy prevention strategies.
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Affiliation(s)
- Michael R Perkin
- Population Health Research Institute, St George's, University of London, London, United Kingdom; Department Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - Kirsty Logan
- Department Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - Tom Marrs
- Department Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - Suzana Radulovic
- Department Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - Joanna Craven
- Department Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - Carsten Flohr
- Department Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom; St John's Institute of Dermatology, Guy' and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Gideon Lack
- Department Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom.
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15
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Ziyab AH, Karmaus W, Zhang H, Holloway JW, Steck SE, Ewart S, Arshad SH. Allergic sensitization and filaggrin variants predispose to the comorbidity of eczema, asthma, and rhinitis: results from the Isle of Wight birth cohort. Clin Exp Allergy 2015; 44:1170-8. [PMID: 24708301 DOI: 10.1111/cea.12321] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 02/25/2014] [Accepted: 03/26/2014] [Indexed: 02/05/2023]
Abstract
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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Affiliation(s)
- A H Ziyab
- Department of Epidemiology and Biostatistics, Norman J. Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
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16
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Venkataraman D, Soto-Ramírez N, Kurukulaaratchy RJ, Holloway JW, Karmaus W, Ewart SL, Arshad SH, Erlewyn-Lajeunesse M. Filaggrin loss-of-function mutations are associated with food allergy in childhood and adolescence. J Allergy Clin Immunol 2014; 134:876-882.e4. [PMID: 25174864 PMCID: PMC4186905 DOI: 10.1016/j.jaci.2014.07.033] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 07/21/2014] [Accepted: 07/22/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Filaggrin is an epidermal protein that has a role in skin barrier function. Filaggrin loss-of-function (FLG-LOF) mutations are a significant risk factor for eczema and atopy, but their association with food allergy (FA) is less clear. OBJECTIVE We explored the longitudinal relationship between 3 common FLG-LOF mutations and FA using the Isle of Wight birth cohort. METHODS FA diagnosis was based on recognized allergic reactions within 4 hours after exposure to known food allergens. Food allergen sensitization (FAS) was identified by using skin prick tests conducted between 1 and 18 years of age to a range of food allergens. Three FLG mutations were genotyped in 1150 (79%) of 1456 children. The temporal relationships between FA, FAS, and eczema in children with FLG mutations were explored by using path analysis with total, direct, and indirect effect models. RESULTS There was a significant total effect of FLG-LOF mutations on the risk of FA in later childhood at the ages of 10 (odds ratio, 31.46; 95% CI, 2.86 to >100) and 18 (odds ratio, 4.25; 95% CI, 1.55-11.61) years. Path analysis showed that there was no direct effect of FLG-LOF mutations on FA at any age; however, an indirect effect was found on FA at all ages through eczema and FAS in the earlier years. CONCLUSION FLG-LOF mutations are associated with FA in older children through eczema and FAS during early childhood. Our results highlight a biologically plausible pathway, which suggests that skin barrier function is important in the development and persistence of FA.
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Affiliation(s)
- Devasmitha Venkataraman
- University of Southampton, Faculty of Medicine, Southampton, United Kingdom; James Cook University Hospital, Middlesbrough, United Kingdom
| | - Nelís Soto-Ramírez
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tenn
| | - Ramesh J Kurukulaaratchy
- David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom; University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - John W Holloway
- Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom; Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tenn
| | - Susan L Ewart
- College of Veterinary Medicine, Michigan State University, East Lansing, Mich
| | - S Hasan Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom; University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom; Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom.
| | - Mich Erlewyn-Lajeunesse
- University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom; Clinical and Experimental Sciences, University of Southampton, Southampton, United Kingdom
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Ziyab AH, Karmaus W, Zhang H, Holloway JW, Steck SE, Ewart S, Arshad SH. Association of filaggrin variants with asthma and rhinitis: is eczema or allergic sensitization status an effect modifier? Int Arch Allergy Immunol 2014; 164:308-18. [PMID: 25277085 DOI: 10.1159/000365990] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 07/16/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Associations of variants of the filaggrin gene, i.e. FLG with asthma and rhinitis have been shown to be modulated by eczema status. However, it is unknown whether allergic sensitization status modifies this association. The aim of this study was to determine whether FLG variants need eczema and/or allergic sensitization as a necessary component to execute adverse effects on coexisting and subsequent asthma and rhinitis. METHODS In the Isle of Wight birth cohort, repeated measurements of asthma, rhinitis, eczema and allergic sensitization (documented by skin-prick tests) were taken in 1,456 children at the ages of 1, 2, 4, 10 and 18 years. Filaggrin haploinsufficiency was defined as having at least the minor allele of R501X, 2282del4 or S3247X variants. log-binomial regression models were used to test associations and statistical interactions. RESULTS FLG variants increased the risk of asthma [risk ratio (RR) 1.39, 95% confidence interval (CI) 1.06-1.80] and rhinitis (RR 1.37, 95% CI 1.16-1.63). In the delayed-effects models, 'FLG variants plus allergic sensitization' and 'FLG variants plus eczema' increased the risk of subsequent asthma by 4.93-fold (95% CI 3.61-6.71) and 3.33-fold (95% CI 2.45-4.51), respectively, during the first 18 years of life. In contrast, neither eczema nor allergic sensitization in combination with FLG variants increased the risk of later rhinitis. CONCLUSIONS Allergic sensitization and eczema modulated the association between FLG variants and asthma but not rhinitis. Our results imply that the mechanisms and pathways through which FLG variants predispose to an increased risk of asthma and rhinitis may be different.
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Affiliation(s)
- Ali H Ziyab
- Department of Epidemiology and Biostatistics, Norman J. Arnold School of Public Health, University of South Carolina, Columbia, S.C., USA
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Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy 2014; 69:3-16. [PMID: 24417229 DOI: 10.1111/all.12270] [Citation(s) in RCA: 303] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2013] [Indexed: 12/31/2022]
Abstract
There is a growing desire to explain the worldwide rise in the prevalence of atopic dermatitis (AD). Trend data on the burden of AD suggest that the picture in the developing world may soon resemble that of wealthier nations, where AD affects over 20% of children. This, combined with significant variations in prevalence within countries, emphasizes the importance of environmental factors. Many hypotheses have been explored, from the modulation of immune priming by hygiene, gut microbiota diversity, and exposure to endotoxins through farm animals to the effects of pollution, climate, and diet. The discovery of the filaggrin skin barrier gene and its importance in AD development and severity has brought the focus on gene-environment interactions and the identification of environmental factors that impact on skin barrier function. This article reviews our current understanding of the epidemiology of AD, with an emphasis on the findings reported in the international literature over the last 5 years.
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Affiliation(s)
- C. Flohr
- Departments of Paediatric Dermatology & Children's Allergies; St John's Institute of Dermatology; Guy's and St Thomas’ Hospitals NHS Foundation Trust and King's College; London UK
| | - J. Mann
- Department of Dermatology; Medway NHS Foundation Trust; Medway Maritime Hospital; Gillingham Kent UK
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Ballardini N, Kull I, Söderhäll C, Lilja G, Wickman M, Wahlgren CF. Eczema severity in preadolescent children and its relation to sex, filaggrin mutations, asthma, rhinitis, aggravating factors and topical treatment: a report from the BAMSE birth cohort. Br J Dermatol 2013; 168:588-94. [PMID: 23445315 DOI: 10.1111/bjd.12196] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Filaggrin (FLG) mutations are major genetic determinants for eczema, but their role in eczema severity needs further investigation. Children with eczema are at higher risk of having asthma and rhinitis but it is not known if this risk is associated with the severity of eczema. OBJECTIVES To investigate eczema severity in relation to sex, FLG mutations, asthma, rhinitis and topical treatment among preadolescent children in a population-based cohort. METHODS Parental questionnaires were used to obtain data on symptoms of eczema, asthma, and rhinitis among 3301 preadolescent children. Eczema severity was evaluated based on sleep disturbance, extent of disease and total time with eczema the previous year. Genotyping was performed in 1854 individuals for three common FLG mutations (R501X, R2447X and 2282del4). Results Eczema was more prevalent among girls (14·5%) than boys (9·4%). FLG mutations were detected in 13·1% of children with mild eczema and 12·5% with moderate-to-severe eczema. Of children with moderate-to-severe eczema, 45·1% had rhinitis and 22·0% had asthma compared with 32·7% and 13·8% of children with mild eczema, respectively. Children with moderate-to-severe eczema used moisturizers and topical glucocorticoids more frequently than children with mild eczema. Boys used moisturizers less frequently than girls. CONCLUSIONS More preadolescent girls than boys had eczema. FLG mutations did not influence eczema severity in our population-based cohort. Prevalence of rhinitis and asthma was associated with eczema severity, with the highest prevalence among boys with moderate-to-severe eczema.
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Affiliation(s)
- N Ballardini
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm SE-171 77, Sweden.
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Ziyab AH, Davies GA, Ewart S, Hopkin JM, Schauberger EM, Wills-Karp M, Holloway JW, Arshad SH, Zhang H, Karmaus W. Interactive effect of STAT6 and IL13 gene polymorphisms on eczema status: results from a longitudinal and a cross-sectional study. BMC MEDICAL GENETICS 2013; 14:67. [PMID: 23815671 PMCID: PMC3700873 DOI: 10.1186/1471-2350-14-67] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 06/27/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Eczema is a prevalent skin disease that is mainly characterized by systemic deviation of immune response and defective epidermal barrier. Th2 cytokines, such as IL-13 and transcription factor STAT6 are key elements in the inflammatory response that characterize allergic disorders, including eczema. Previous genetic association studies showed inconsistent results for the association of single nucleotide polymorphisms (SNPs) with eczema. Our aim was to investigate whether SNPs in IL13 and STAT6 genes, which share a biological pathway, have an interactive effect on eczema risk. METHODS Data from two independent population-based studies were analyzed, namely the Isle of Wight birth cohort study (IOW; n = 1,456) and for the purpose of replication the Swansea PAPA (Poblogaeth Asthma Prifysgol Abertawe; n = 1,445) cross-sectional study. Log-binomial regressions were applied to (i) account for the interaction between IL13 (rs20541) and STAT6 (rs1059513) polymorphisms and (ii) estimate the combined effect, in terms of risk ratios (RRs), of both risk factors on the risk of eczema. RESULTS Under a dominant genetic model, the interaction term [IL13 (rs20541) × STAT6 (rs1059513)] was statistically significant in both studies (IOW: adjusted P(interaction) = 0.046; PAPA: P(interaction) = 0.037). The assessment of the combined effect associated with having risk genotypes in both SNPs yielded a 1.52-fold increased risk of eczema in the IOW study (95% confidence interval (CI): 1.05 - 2.20; P = 0.028) and a 2.01-fold higher risk of eczema (95% CI: 1.29 - 3.12; P = 0.002) in the PAPA study population. CONCLUSIONS Our study adds to the current knowledge of genetic susceptibility by demonstrating for the first time an interactive effect between SNPs in IL13 (rs20541) and STAT6 (rs1059513) on the occurrence of eczema in two independent samples. Findings of this report further support the emerging evidence that points toward the existence of genetic effects that occur via complex networks involving gene-gene interactions (epistasis).
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Affiliation(s)
- Ali H Ziyab
- Department of Epidemiology and Biostatistics, Norman J. Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Barbarot S. [What's new in pediatric dermatology?]. Ann Dermatol Venereol 2013; 139 Suppl 5:S202-16. [PMID: 23522707 DOI: 10.1016/s0151-9638(12)70135-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This paper is based on a review of the literature focused on pediatric dermatology, from October 2011 to september 2012. Our objective was to highlight the main advances in fields such as atopic dermatitis, infantile hemangiomas, infectious diseases, inflammatory disorders, and genodermatoses.
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Affiliation(s)
- S Barbarot
- Clinique dermatologique, Hôtel Dieu, CHU Nantes, Place Alexis Ricordeau, 44000 Nantes, France.
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[Which was first: the chicken or the egg? : an update on sensitization risks and pathways: is sensitization secondary to eczema or vice-versa?]. Hautarzt 2012; 63:903-4. [PMID: 23070423 DOI: 10.1007/s00105-012-2473-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ziyab AH, Karmaus W, Holloway JW, Zhang H, Ewart S, Arshad SH. DNA methylation of the filaggrin gene adds to the risk of eczema associated with loss-of-function variants. J Eur Acad Dermatol Venereol 2012; 27:e420-3. [PMID: 23003573 DOI: 10.1111/jdv.12000] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Loss-of-function variants within the filaggrin gene (FLG) are associated with a dysfunctional skin barrier that contributes to the development of eczema. Epigenetic modifications, such as DNA methylation, are genetic regulatory mechanisms that modulate gene expression without changing the DNA sequence. OBJECTIVES To investigate whether genetic variants and adjacent differential DNA methylation within the FLG gene synergistically act on the development of eczema. METHODS A subsample (n = 245, only females aged 18 years) of the Isle of Wight birth cohort participants (n = 1456) had available information for FLG variants R501X, 2282del4 and S3247X and DNA methylation levels for 10 CpG sites within the FLG gene. Log-binomial regression was used to estimate the risk ratios (RRs) of eczema associated with FLG variants at different methylation levels. RESULTS The period prevalence of eczema was 15.2% at age 18 years and 9.0% of participants were carriers (heterozygous) of FLG variants. Of the 10 CpG sites spanning the genomic region of FLG, methylation levels of CpG site 'cg07548383' showed a significant interaction with FLG sequence variants on the risk for eczema. At 86% methylation level, filaggrin haploinsufficient individuals had a 5.48-fold increased risk of eczema when compared to those with wild type FLG genotype (P-value = 0.0008). CONCLUSIONS Our novel results indicated that the association between FLG loss-of-function variants and eczema is modulated by DNA methylation. Simultaneously assessing the joint effect of genetic and epigenetic factors within the FLG gene further highlights the importance of this genomic region for eczema manifestation.
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Affiliation(s)
- A H Ziyab
- Department of Epidemiology and Biostatistics, Norman J. Arnold School of Public Health, University of South Carolina, Columbia, SC, USA Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait Academic Unit of Clinical and Experimental Medicine, Faculty of Medicine, University of Southampton, Southampton, UK College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA Academic Unit of Human Genetics, Faculty of Medicine, University of Southampton, Southampton, UK David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
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