Allergy and autoimmune disease: a registry-based study.
BACKGROUND
Allergy and autoimmunity are two potential outcomes of a dysregulated immune system, but the relationship between them is unclear. It has been hypothesized that they could be inversely associated because of different T helper cell reactivity patterns. However, both positive and negative associations have been reported. Therefore, our aim was to perform a large epidemiological study with a defined allergic disease cohort.


METHODS
During the years 1990-2002, 68 770 subjects were tested for total serum IgE (Total-IgE) and 72 228 were tested with Phadiatop for diagnosing allergic disease at Karolinska University Hospital, Stockholm, Sweden. This cohort was then linked with the Swedish Inpatient Registry 1968-2004 for a follow-up with regard to recorded discharges for 28 autoimmune diseases. We then used Cox regression and logistic regression to estimate the risk of autoimmune diseases in general in the allergy-tested subjects.


RESULTS
Subjects with positive Phadiatop test were at a statistically decreased risk of subsequent autoimmune disease in comparison with subjects with negative test; hazard ratio (HR): 0.80 [95% (Confidence interval) CI: 0.68-0.94). Prior autoimmune disease was associated with a decreased risk of positive Phadiatop test [odds ratio: 0.83 (95% CI: 0.72-0.96)] in comparison with negative test. Subjects with highly elevated Total-IgE were at a statistically increased risk of a subsequent autoimmune disease in comparison with subjects with normal levels [HR: 1.36 (95% CI: 1.09-1.70)], but no association was found between prior autoimmune disease and different Total-IgE levels.


CONCLUSIONS
The study supports the hypothesis that allergy, defined as positive Phadiatop test, could be inversely related to autoimmune disease but this association is weak.
Lindelöf
B
B
Dermatology and Venereology, The Children's Hospital at Westmead, Sydney, Australia. bernt.lindelof@karolinska.se
Granath
F
F
Tengvall-Linder
M
M
Lindelöf
H
H
Ekbom
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
D007073:Immunoglobulin E