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Transgenerational occurrence of allergic disease and autoimmunity: general practice-based epidemiological research.

Maas T, Nieuwhof C, Passos VL, Robertson C, Boonen A, Landewé RB, Voncken JW, Knottnerus JA, Damoiseaux JG.

Prim Care Respir J. 2014 Mar;23(1):14-21.

Department of General Practice, Maastricht University, CAPHRI, Maastricht, The Netherlands.

Abstract

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..

AIMS:

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-upresearch in a larger sample, these results may lead to the inclusion of ‘parental autoimmune condition’ as a risk factor in the generalpractitioner’s diagnostics of allergic disease.

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