支气管哮喘和外周嗜酸性粒细胞计数与过敏或自身免疫性疾病相关性的孟德尔随机化研究  

Correlation of bronchial asthma and peripheral eosinophil counts with allergic or autoimmune diseases:a mendelian randomization study

作　　者：李晓芳[1] 张英民[1] LI Xiao-fang;ZHANG Ying-min(Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)

机构地区：[1]河南科技大学第一附属医院呼吸与危重症医学科,河南洛阳471000

出　　处：《环境与健康杂志》2024年第12期1076-1081,共6页Journal of Environment and Health

基　　金：洛阳市科技发展项目(1920002A)。

摘　　要：目的探讨支气管哮喘及外周嗜酸性粒细胞计数对8种常见过敏性及自身免疫性疾病的风险影响。方法通过人类全基因组关联分析(GWAS)数据,提取与支气管哮喘及外周嗜酸性粒细胞计数相关的工具变量,并确保满足孟德尔随机化的相关性、独立性和排他性假设。应用逆方差加权法(IVW)、加权中位数法、MR-Egger和MR-PRESSO等四种两样本孟德尔随机化(MR)方法,分析支气管哮喘和外周嗜酸性粒细胞计数对过敏性结膜炎、过敏性鼻炎、荨麻疹、湿疹、银屑病、类风湿关节炎、弥漫性甲状腺肿及溃疡性结肠炎的发病风险影响。此外,采用多变量MR方法评估支气管哮喘与外周嗜酸性粒细胞计数的相互作用。结果支气管哮喘明显增加过敏性结膜炎、过敏性鼻炎、荨麻疹及湿疹的发病风险(分别为OR=72.488,95%CI:36.955~142.187,P<0.001;OR=280.674,95%CI:123.711~636.793,P<0.001;OR=5.224,95%CI:2.654~10.281,P<0.001;OR=12.960,95%CI:6.601~25.443,P<0.001)。外周嗜酸性粒细胞计数升高与过敏性结膜炎、过敏性鼻炎、湿疹及类风湿关节炎的风险增加明显相关(分别为OR=1.324,95%CI:1.232~1.423,P<0.001;OR=1.491,95%CI:1.357~1.638,P<0.001;OR=1.195,95%CI:1.127~1.268,P<0.001;OR=1.253,95%CI:1.116~1.408,P<0.001),与荨麻疹和银屑病风险增加也存在相关性(分别为OR=1.100,95%CI:1.015~1.193,P=0.021;OR=1.126,95%CI:1.004~1.264,P=0.043)。在调整外周嗜酸性粒细胞计数后,支气管哮喘对过敏性结膜炎、过敏性鼻炎及湿疹的影响仍明显(分别为OR=67.446,95%CI:34.918~130.278,P<0.001;OR=394.808,95%CI:174.661~892.434,P<0.001;OR=12.277,95%CI:6.900~21.844,P<0.001);调整支气管哮喘后,外周嗜酸性粒细胞计数对上述疾病的影响则不再明显。结论支气管哮喘和外周嗜酸性粒细胞计数升高均可能增加过敏性结膜炎、过敏性鼻炎、荨麻疹及湿疹的发病风险,且支气管哮喘对这些疾病的影响独立于外周嗜酸性粒细胞计数。�Objective To understand the effect of bronchial asthma and peripheral eosinophil count on the risk of eight common allergic and autoimmune diseases.Methods The instrumental variables associated with bronchial asthma and peripheral eosinophil counts were extracted from human genome-wide association analysis(GWAS)data and ensured to satisfy the assumptions of relevance,independence and exclusivity of Mendelian randomization.In this study,four two-sample Mendelian randomization(MR)methods,including inverse variance weighting(IVW),weighted median,MR-Egger,and MR-PRESSO,were applied to analyze the effects of bronchial asthma and peripheral eosinophil count on the risk of developing allergic conjunctivitis,allergic rhinitis,urticaria,eczema,psoriasis,rheumatoid arthritis,diffuse goiter,and ulcerative colitis.In addition,a multifactorial MR approach was used to assess the interaction between bronchial asthma and peripheral eosinophil count.Results Bronchial asthma significantly increased the risk of allergic conjunctivitis,allergic rhinitis,urticaria and eczema(OR=72.488,95%CI:36.955-142.187,P<0.001;OR=280.674,95%CI:123.711-636.793,P<0.001;OR=5.224,95%CI:2.654-10.281,P<0.001;OR=12.960,95%CI:6.601-25.443,P<0.001).Increased peripheral eosinophil counts were significantly(P<0.001)associated with increased risk of allergic conjunctivitis,allergic rhinitis,eczema,and rheumatoid arthritis(OR=1.324,95%CI:1.232-1.423,P<0.001;OR=1.491,95%CI:1.357-1.638,P<0.001;OR=1.195,95%CI:1.127-1.268,P<0.001;OR=1.253,95%CI:1.116-1.408,P<0.001),and also correlated with an increased risk of urticaria and psoriasis(OR=1.100,95%CI:1.015-1.193,P=0.021;OR=1.126,95%CI:1.004-1.264,P=0.043).The effect of bronchial asthma on allergic conjunctivitis,allergic rhinitis,and eczema remained significant(P<0.001)after adjusting for peripheral eosinophil counts(OR=67.446,95%CI:34.918-130.278,P<0.001;OR=394.808,95%CI:174.661-892.434,P<0.001;OR=12.277,95%CI:6.900-21.844,P<0.001);conversely,after adjusting for bronchial asthma,the effect of peripheral eosinophil

关 键 词：支气管哮喘 嗜酸性粒细胞 过敏性疾病 自身免疫性疾病 

分 类 号：R181.3[医药卫生—流行病学]