Subscribe to RSS
DOI: 10.1055/a-2018-3568
The Frequency of Atopic Diseases and Metabolic Conditions in Patients with Ankylosing Spondylitis: A Cross-Sectional Clinical Trial with a Review of Literature
Die Häufigkeit atopischer Erkrankungen sowie Stoffwechselerkrankungen bei Patienten mit ankylosierender Spondylitis: Eine klinische Querschnittsstudie mit LiteraturrechercheAbstract
Introduction The immunological paradigm Th1/Th2 predicts a negative association between autoimmune (Th1) and atopic (Th2) diseases. In contrast to the Th1/Th2 paradigm, some of the latest evidence suggests the probability of coexistence of autoimmune diseases with atopic disorders. Therefore, this trial aims to investigate the frequency of atopic disorders and metabolic conditions in patients with AS and compare them with those in control groups.
Materials and methods A total of 563 AS patients (group 1) were matched in a 1:1 ratio with patients suffering from chronic low back pain due to intervertebral disc prolapse (group 2) utilizing gender and age as paired variables. Atopic diseases such as atopic dermatitis (AD), allergic rhinitis (AR) and asthma were investigated in all groups. Also, metabolic conditions such as hypertension (HT), diabetes mellitus (DM), hyperlipidaemia (HPL) and hypothyroidism (HPT) were examined in all groups.
Results The mean age was 42.86±11.04 years in both study groups. In all groups, 47.1% were female and 52.9% were male. The mean duration of disease was 10.51±8.93 years in the AS group. HLA-B27 was positive in 70.2% of the patients in the AS group. The adjusted odds ratios for patients with AS compared to controls were 1.47 (1.20–1.80) for AD, 1.76 (1.60–1.95) for AR, and 1.79 (1.57–2.05) for asthma. The adjusted odds ratios for patients with AS compared to controls were 1.09 (95% CI 0.87–1.38) for HT, 1.03 (95% CI 0.76–1.39) for DM, 1.22 (95% CI 0.80–1.87) for HPL, and 1.62 (95% CI 1.04–2.54) for HPT. There was a statistically significant distinction between groups, and the frequency of AD, AR, asthma and HPT was higher in patients with AS compared with the control group (p<0.05).
Conclusion According to the findings of this study, which are compatible with the literature, patients with AS have an increased frequency of atopic diseases as well as hypothyroidism. The tissue injury resulting from chronic inflammation in AS patients could be related to atopic disorders and hypothyroidism. In other words, the pathogenic pathways causing chronic inflammation in these diseases may interfere with each other.
Schlüsselwörter
Spondylitis ankylosans - Stoffwechselbedingungen - Th1/Th2-Paradigma - atopische ErkrankungenPublication History
Article published online:
23 March 2023
© 2023. Thieme. All rights reserved.
Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart,
Germany
-
References
- 1 Bartůnková J, Kayserová J, Shoenfeld Y. Allergy and autoimmunity: parallels and dissimilarity: the yin and yang of immunopathology. Autoimmun Rev 2009; 8: 302-308
- 2 Rudwaleit M, Siegert S, Yin Z. et al. Low T cell production of TNFα and IFNγ in ankylosing spondylitis: its relation to HLA-B27 and influence of the TNF-308 gene polymorphism. Ann Rheum Dis 2001; 60: 36-42
- 3 Rudwaleit M, Andermann B, Alten R. et al. Atopic disorders in ankylosing spondylitis and rheumatoid arthritis. Ann Rheum Dis 2002; 61: 968-974
- 4 Cipriani F, Ricci G, Leoni MC. et al. Autoimmunity in atopic dermatitis: Biomarker or simply epiphenomenon?. J Dermatol 2014; 41: 569-576
- 5 Akdis CA. Does the epithelial barrier hypothesis explain the increase in allergy, autoimmunity and other chronic conditions?. Nat Rev Immunol 2021; 21: 739-751
- 6 Deodhar A. Axial spondyloarthritis criteria and modified NY criteria: issue and controversies. Clin Rheumatol 2014; 33: 741-747
- 7 Burney PG, Luczynska C, Chinn S. et al. The European Community Respiratory Health Survey. Eur Respir J 1994; 7: 954-960
- 8 Asher MI, Keil U, Anderson HR. et al. International study of asthma and allergies in childhood (ISAAC): rationale and methods. Eur Respir J 1995; 8: 483-491
- 9 Rottem M, Gershwin ME, Shoenfeld Y. Allergic Disease and Autoimmune Effectors Pathways. Dev Immunol 2002; 9: 161-167
- 10 Díaz-Campos RM, Bobolea I, Girón-Matute W. et al. Autoimmune Diseases and Asthma. J Investig Allergol Clin Immunol 2019; 29: 246-248
- 11 Matheiu S, Soubrier M. Cardiovascular events in ankylosing spondylitis: a 2018 meta-analysis. Ann Rheum Dis 2019; 78: e57
- 12 Liew JW, Ward MM, Reveille JD. et al. Nonsteroidal Anti-inflammatory Drug use is Associated with Incident Hypertension in Ankylosing Spondylitis. Arthritis Care Hes (Hoboken) 2020; 72: 1645-1652
- 13 Toussirot E. The Risk of Cardiovascular Diseases in Axial Spondyloarthritis. Current Insights. Front Med (Lausanne) 2021; 8: 782150
- 14 Shuster MV, Gendelman O, Tiosano S. et al. Ischemic heart disease and ankylosing spondylitis-assessing the role of inflammation. Clin Rheumatol 2018; 37: 1053-1058
- 15 Liao KF, Kuo YH, Lai SW. Diabetes mellitus in ankylosing spondylitis. Ann Rheum Dis 2019; annrheumdis- 2019-216221
- 16 Lee YH, Song GG. Diabetes mellitus in ankylosing spondylitis. Ann Rheum Dis 2021; 80: e142
- 17 Atzeni F, Nucera V, Galloway J. et al. Cardiovascular risk in ankylosing spondylitis and the effect of anti-TNF drugs: a narrative review. Expert Opin Biol Ther 2020; 20: 517-524
- 18 Degirmenci PB, Kirmaz C, Oz D. et al. Allergic rhinitis and its relationship with autoimmune thyroid diseases. Am J Rhinol Allergy 2015; 29: 257-261
- 19 Peluso R, Lupoli GA, Del Puente A. et al. Prevalence of thyroid autoimmunity in patients with spondyloarthropathies. J Rheumatol 2011; 38: 1371-1377
- 20 Pérez-Fernández OM, Mantilla RD, Cruz-Tapias P. et al. Spondyloarthropathies in autoimmune diseases and vice versa. Autoimmune Dis 2012; 2012: 736384
- 21 Tarhan F, Orük G, Niflioğlu O. et al. Thyroid involvement in ankylosing spondylitis and relationship of thyroid dysfunction with anti-TNF α treatment. Rheumatol Int 2013; 33: 853-857
- 22 Emmungil H, Erdogan M, Kalfa M. et al. Autoimmune thyroid disease in ankylosing spondylitis. Clin Rheumatol 2014; 33: 955-961
- 23 Zochling J, Bohl-Bühler MH, Baraliakos X. et al. The high prevalence of infections and allergic symptoms in patients with ankylosing spondylitis is associated with clinical symptoms. Clin Rheumatol 2006; 25: 648-658
- 24 Kamanli A, Ardicoglu O, Godekmerdan A. HLA-b27 subtypes in patients with spondyloarthropathies, IgE levels against some allergens and their relationship to the disease parameters. Bratisl Lek Listy 2009; 110: 480-485
- 25 Karatay S, Yildirim K, Ugur M. et al. Prevalence of atopic disorders in rheumatic diseases. Mod Rheumatol 2013; 23: 351-356
- 26 Shen TC, Lin CL, Wei CC. et al. The Risk of Asthma in Patients with Ankylosing Spondylitis: A Population-Based Cohort Study. PLoS One 2015; 10: e0116608
- 27 Turgan A, Ural A, Işık AÜ. et al. A preliminary report on the prevalence and clinical features of allergic rhinitis in ankylosing spondylitis patients. ENT Updates 2015; 5: 35-40
- 28 Chang WP, Kuo CN, Kuo LN. et al. Increase risk of allergic diseases in patients with ankylosing spondylitis. A 10-year follow-up population-based study in Taiwan. Medicine (Baltimore) 2016; 95: e5172
- 29 Rottem M, Shoenfeld Y. Asthma as a paradigm for autoimmune disease. Int Arch Allergy Immunol 2003; 132: 210-214
- 30 Badloe FMS, De Vriese S, Coolens K. et al. IgE autoantibodies and autoreactive T cells and their role in children and adults with atopic dermatitis. Clin Transl Allergy 2020; 10: 34
- 31 Pellefigues C. IgE Autoreactivity in Atopic Dermatitis: Paving the Road for Autoimmune Diseases?. Antibodies (Basel) 2020; 9: 47
- 32 Tedeschi A, Asero R. Asthma and autoimmunity: a complex but intriguing relation. Expert Rev Clin Immunol 2008; 4: 767-776
- 33 Maurer M, Altrichter S, Schmetzer O. et al. Immunoglobulin E-Mediated Autoimmunity. Front Immunol 2018; 9: 689
- 34 Mukherjee M, Nair P. Autoimmune Responses in Severe Asthma. Allergy Asthma Immunol Res 2018; 10: 428-447
- 35 Ziade NR, Mallak I, Merheb G. et al. Added Value of Anti-CD74 Autoantibodies in Axial SpondyloArthritis in a Population With Low HLA-B27 Prevalence. Front Immunol 2019; 10: 574
- 36 Hu CJ, Li MT, Li X. et al. CD74 auto-antibodies display little clinical value in Chinese Han population with axial spondyloarthritis. Medicine (Baltimore) 2020; 99: e23433
- 37 Do L, Granåsen G, Hellman U. et al. Anti-CD74 IgA autoantibodies in radiographic axial spondyloarthritis: a longitudinal Swedish study. Rheumatology (Oxford) 2021; 60: 4085-4093
- 38 McGonagle D, Aydin SZ, Gül A. et al. ‘MHC-I-opathy’-unified concept for spondyloarthritis and Behçet disease. Nat Rev Rheumatol 2015; 11: 731-740