Cross-sectional study reveals reduced odds of allergies in people with hidradenitis suppurativa
نویسندگان
چکیده
To the Editor: Hidradenitis suppurativa is a complex inflammatory skin disorder of pilosebaceous unit consisting follicular occlusion, rupture, and inflammation. There substantial overlap between immune cells cytokines present in hidradenitis lesions those involved allergic disease, with some patients exhibiting high serum immunoglobulin E titers itching at (Table I).1Vossen A.R.J.V. Schoenmakers A. van Straalen K.R. Prens E.P. der Zee H.H. Assessing pruritus suppurativa: cross-sectional study.Am J Clin Dermatol. 2017; 18: 687-695Crossref PubMed Scopus (39) Google Scholar, 2Barnes P.J. Pathophysiology inflammation.Immunol Rev. 2011; 242: 31-50Crossref (251) 3Pascual J.C. García-Martínez F.J. Martorell González I. Hispan P. Increased total IgE levels moderate-to-severe suppurativa.Br 2016; 175: 1101-1102Crossref (15) 4Frew J.W. Hawkes J.E. Krueger J.G. A systematic review critical evaluation cytokine associations suppurativa.F1000Res. 2018; 7: 1930Crossref (50) Scholar Therefore, we investigated relationship allergy.Table IImmune cell responses allergiesHidradenitis suppurativaAllergyCell types Dendritic cells, eosinophils, macrophages, mast neutrophils, plasma (B cells), T cellsBasophils, cellsCytokines High productionHigh associationIL-1β, -6, -8, -10, -12, -17; IFN-γ; TI-IFN; TNF-α IL-4, -5, -9, -13, -25, -33; TSLP Low productionSupporting cytokinesIL-4, -13 IL-1β, TNF-αAntibody response IgG, IgE?∗One preliminary study.IgE, IgGMacrophages, DCs, neutrophils: -17, TNF-α. cells: Th1 = Th2 -25; Th9 IL-9; Th17 IL-17; Tregs IL-10. B -10; TNF-α; antibodies. Mast basophils: -25. Keratinocytes, fibroblasts: TSLP.DC, cell; IFN, interferon; IgE, Immunoglobulin E; G; IL, interleukin; Th, helper; TNF, tumor necrosis factor.∗ One study. Open table new tab Macrophages, TSLP. DC, factor. We used MarketScan Commercial Claims database (Truven Health Analytics, Ann Arbor, MI) to perform study health claims submitted by approximately 100 payers representing greater than 150 million individuals United States. Institutional board approval was obtained. For inclusion, were aged 12 years or older on enrollment January 1, 2013, December 31, 2017, continuous thereafter. The group included equal 1 claim. Control without suppurativa, pilonidal cyst, acne conglobata, dissecting scalp cellulitis randomly selected 10:1 ratio after sex age matching. Odds ratios (ORs) 95% confidence intervals (CIs) calculated considered significant if P < .05. Logistic regression adjust for confounding variables: age, sex, use antibiotic, anti-inflammatory, biologic drugs. In total, 294,360 included: 26,760 267,600 controls. had decreased odds contact dermatitis versus control (OR 0.61 [95% CI 0.58-0.64]; adjusted OR 0.51 0.48-0.53]) II). Furthermore, significantly developing unspecified other eczema 0.62 0.59-0.65]) caused nonfood plants 0.25 0.21-0.30]) Having also associated an overall conjunctivitis 0.37 0.34-0.39]; 0.33 0.31-0.35]) subtypes including acute atopic 0.39 0.30-0.51]), vernal 0.44 0.22-0.89]), chronic 0.38 0.34-0.44]). Finally, rhinitis 0.50 0.48-0.52]; 0.40 0.38-0.41]), pollen, nonpollen seasonal allergies, food cat dog allergy Adjustment medications reduced further all categories. all, various allergies. These findings may be limited differences care 2 cohorts, potentially causing diagnosis. Limitations include potential misclassification biases within exclusion uninsured individuals.Table IIAllergy calculations itDiagnosisICD-9, ICD-10 codesHS (n 26,760), no. (%)Control 267,600), (%)Unadjusted (95% CI)P valueAdjusted CI)∗Adjusted antibiotic use, anti-inflammatory use.Allergic dermatitisL23333 (1.24)5351 (2)0.61 (0.58–0.64)<.00010.51 (0.48–0.53) Contact eczema, cause692, L25.92175 (8.13)32,939 (12.31)0.62 (0.59–0.65)<.0001 Allergic dermatitis—plant, not food692.6, L23.7146 (0.55)5591 (2.09)0.25 (0.21–0.30)<.0001All conjunctivitisH10.45145 (0.54)3001 (1.12)0.37 (0.34–0.39)<.00010.33 (0.31–0.35) Acute conjunctivitis372.0559 (0.22)1477 (0.55)0.39 (0.30–0.51)<.0001 Vernal conjunctivitis372.138 (0.03)179 (0.07)0.44 (0.22–0.89).03 Other conjunctivitis372.14234 (0.87)5944 (2.22)0.38 (0.34–0.44)<.0001All rhinitis4771980 (7.4)44,393 (16.59)0.50 (0.48–0.52)<.00010.40 (0.38–0.41) Vasomotor rhinitisJ302213 (8.27)39,576 (14.79)0.51 (0.49–0.53)<.0001 from pollenJ30.1724 (2.71)12,225 (4.57)0.57 (0.53–0.62)<.0001 seasonalJ30.2463 (1.73)8529 (3.19)0.52 (0.48–0.58)<.0001 food477.1, J30.526 (0.1)681 (0.25)0.46 (0.34–0.62)<.0001 cat/dog477.2, J30.81260 (0.97)4022 (1.5)0.63 (0.56–0.72)<.0001Personal history medicinal agentsV14, Z88634 (2.37)7479 (2.79)0.83 (0.76–0.90)<.00010.78 (0.72–0.85)CI, Confidence interval; HS, suppurativa; ICD-9, International Classification Diseases, Ninth Revision; ICD-10, Statistical Diseases Related Problems, 10th Revision.∗ Adjusted use. CI, Revision. observe allergies because interferon interleukin expression patients, which blunt helper type 2–driven I).2Barnes Scholar,4Frew Classically such as mediators 4 E, likely contribute inflammation independent triggers. Mechanisms underlying suppurativa–associated itch are unknown but potentiated family factor α–mediated hypersensitivity stimuli5Miao X. Huang Y. Liu T.T. et al.TNF-α/TNFR1 signaling required full mice via peripheral central mechanisms.Neurosci Bull. 34: 42-53Crossref (29) rather allergen-associated histamine release. Despite profile this highlights presence polarization protects against immunomediated pathophysiology these patients.
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ژورنال
عنوان ژورنال: Journal of The American Academy of Dermatology
سال: 2021
ISSN: ['1097-6787', '0190-9622']
DOI: https://doi.org/10.1016/j.jaad.2020.08.014