Transgenerational occurrence of allergic disease and autoimmunity: general practice-based epidemiological research.
BACKGROUND
Corresponding with the T helper cell type 1/T helper cell type 2 hypothesis, autoimmune and allergic diseases are considered pathologically distinct and mutually exclusive conditions. Co-occurrence of autoimmune disorders and allergy within patients, however, has been reported. Transgenerational co-occurrence of autoimmune and allergic disease has been less often described and may differ from the intra-patient results.


OBJECTIVE
To test the hypothesis that autoimmune disorders in parents are a risk factor for the development of an allergic disease in their offspring.


METHODS
Prospectively registered (by academic general practitioners) International Classifications of Primary Care (ICPC) for diagnoses of autoimmune disorders and allergy within families were evaluated (n=5,604 families) by performing multiple logistic regression analyses.


RESULTS
The presence of any ICPC-encoded autoimmune disorder in fathers appeared to be associated with an increased risk in their eldest children of developing an allergy (odds ratio (OR) 1.4, 95% CI 1.042 to 1.794). Psoriasis in fathers was particularly shown to be of influence (OR 1.5, 95% CI 1.061 to 2.117) and, although any ICPC-encoded autoimmune disease in mothers was found not to be of significance, the combined international code for registering rheumatoid arthritis/ankylosing spondylitis in mothers was OR 1.7 (95% CI 1.031 to 2.852).


CONCLUSIONS
The occurrence of ICPC-encoded autoimmune disorders in parents, especially psoriasis and rheumatoid arthritis/ankylosing spondylitis, significantly increases the occurrence of allergic disease in their children. After validation in follow-up research in a larger sample, these results may lead to the inclusion of 'parental autoimmune condition' as a risk factor in the general practitioner's diagnostics of allergic disease.
Department of General Practice, Maastricht University, CAPHRI, Maastricht, The Netherlands.
Tanja
T
Maas
Chris
C
Nieuwhof
Valeria Lima
VL
Passos
Caroline
C
Robertson
Annelies
A
Boonen
Robert B
RB
Landewé
J Willem
JW
Voncken
J André
JA
Knottnerus
Jan G
JG
Damoiseaux
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000235:genetics*; D002648:Child; D005260:Female; D058006:General Practice; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult