title: Associations between allergic conditions and pediatric brain tumors in Neurofibromatosis type 1.
abstract: Individuals with Neurofibromatosis type 1 (NF1) are at increased risk for pediatric brain tumors (PBTs), especially optic gliomas; however, factors influencing their development are largely unknown. Extensive research suggests that allergic conditions protect against brain tumors, particularly gliomas in individuals without NF1. In this large cross-sectional study, we employed two different data sources to evaluate evidence for the hypothesis that allergic conditions (allergies, asthma, and eczema) may protect against PBT development in individuals with NF1. We used self- and parent/legal guardian reported questionnaire data from participants in the NF1 Patient Registry Initiative (NPRI, n = 1660) born from 1933 to 2014 to ascertain allergic condition and PBT diagnosis histories. Medical records (MRs) of 629 NF1 patients at a large medical center born from 1930 to 2012 were also reviewed for PBT and allergic condition diagnoses to evaluate additional evidence for our hypothesis. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between allergic condition diagnoses and PBTs. Both data sources provided limited to no support for a protective effect of allergies or eczema on PBT development. Non-significant inverse associations between asthma and PBTs were observed (NPRI: OR = 0.80, 95% CI 0.55-1.17; MR: OR = 0.71, 95% CI 0.40-1.28) with stronger associations for optic gliomas specifically. Additionally, a significant inverse association was observed in an NPRI subgroup analysis where the reported asthma diagnosis age was younger than the reported PBT diagnosis age (OR = 0.57; 95% CI 0.36-0.89). Our study supports the hypothesis that asthma protects against PBT development in NF1.
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
authors.forename: Bree
authors.initials: B
authors.lastname: Porcelli
authors.affiliation: Brown School, Washington University in St. Louis, One Brookings Drive, 237 Goldfarb Hall, Campus Box 1196, St. Louis, MO, 63130, USA.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Zoellner
authors.affiliation: Brown School, Washington University in St. Louis, One Brookings Drive, 237 Goldfarb Hall, Campus Box 1196, St. Louis, MO, 63130, USA.
authors.forename: Salmafatima S
authors.initials: SS
authors.lastname: Abadin
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Gutmann
authors.affiliation: Brown School, Washington University in St. Louis, One Brookings Drive, 237 Goldfarb Hall, Campus Box 1196, St. Louis, MO, 63130, USA. kijohnson@wustl.edu.
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Johnson
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000209:etiology; D001932:Brain Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004485:Eczema / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008499:Medical Records; D009456:Neurofibromatosis 1 / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D020339:Optic Nerve Glioma / Q000209:etiology / Q000276:immunology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
keywords: Allergies; Asthma; Brain tumors; Neurofibromatosis type 1; Optic pathway gliomas