Self-Reported Allergic Rhinitis and/or Allergic Conjunctivitis Associate with <b><i>IL13</i></b> rs20541 Polymorphism in Finnish Adult Asthma Patients

Abstract

Background: Our aim was to observe factors associated with IL13 rs20541 polymorphism and other factors with or without allergic comorbidities such as subject-reported allergic rhinitis (AR) and/or allergic conjunctivitis (AC) symptoms in adult asthmatics. Methods: A population-based sample of Finnish adult asthma patients (n = 1,156) and matched controls (n = 1,792) filled in a questionnaire. Asthma was diagnosed based on a typical history of asthma symptoms and lung function tests. Skin prick tests with 17 aeroallergens and blood tests including analysis of interleukin 13 (IL13) rs20541 (G/A) genotypes were performed for a subsample (n = 193). Results: The proportion of asthmatics reporting AR was 61.9% and reporting AC was 40.7%. After adjustments, the presence of the IL13 rs20541A- allele (OR 3.06, 95% CI 1.42-6.58, p = 0.004) or multisensitization (adjusted OR 4.59, 95% CI 1.48-14.26, p = 0.008) was associated with AR/AC asthma. Nasal polyps and acetylsalicylic acid-exacerbated respiratory disease was also associated with AR/AC asthma. Conclusions: Adult AR/AC asthma could putatively be a phenotype, characterized by the presence of atopic and/or eosinophilic factors and a high prevalence of the IL13 rs20541A- allele. Studies on the mechanisms behind this and in other populations are needed.

Risk of adult‐onset asthma increases with the number of allergic multimorbidities and decreases with age

“…24 In addition, we have previously detected in a smaller adult population that allergic rhinitis and/or allergic conjunctivitis (AR/AC) and polysensitization co-associate with adult asthma. 11 We found that the association between adult-onset asthma and allergic multimorbidity decreased with age. These findings of a stronger increase in asthma risk associated with allergic multimorbidity in the youngest group are in line with results from a Swedish study, showing that the prevalence of allergic asthma has increased during the past two decades, while the prevalence of nonallergic asthma has remained on a stable prevalence level.…”

“…These observations were recently extending by considering conjunctivitis in addition to rhinitis and asthma; the study showed that increase in allergic multimorbidity, irrespective of the disease (rhinitis, conjunctivitis, and asthma) was associated with a significant increase in the number of IgE reactivities to respiratory allergens . In addition, we have previously detected in a smaller adult population that allergic rhinitis and/or allergic conjunctivitis (AR/AC) and polysensitization co‐associate with adult asthma …”

“…It has been shown that the prevalence of allergic asthma has increased from 1996 to 2006 and further to 2016, while the prevalence of nonallergic asthma has remained stable. 9 We have found that polysensitization was associated with asthma in adults, 10,11 and polysensitization and its asthma risk increase in adults who were born after 1930 proposing a cohort and/or age affect between polysensitization and asthma in adults. 12 asthma [95% CI] associated with 1, 2, and 3 allergic diseases was 1.95 [1.52-2.49], 2.87 [2.19-3.77], and 4.26 [3.07-5.90], respectively.…”

Higher mortality of adults with asthma: A 15‐year follow‐up of a population‐based cohort

“…We have previously demonstrated that polysensitization and allergic rhinitis and/or allergic conjunctivitis (AR/AC) co‐associate with adult asthma population . Polysensitization is associated with higher morbidity among asthmatic children .…”

“…Polysensitization is associated with higher morbidity among asthmatic children . Despite the fact that AR causes significant work impairment, studies suggest that AR/AC would putatively not be associated with adult asthma morbidity . Yet, limited evidence exists on the effect of AR/AC or other risk factors for mortality among adult asthmatic patients …”