Coincidence of immune-mediated diseases driven by Th1 and Th2 subsets suggests a common aetiology

a population-based study using computerized General Practice data

Colin Simpson, W. J. A. Anderson, Peter Joseph Benedict Helms, Michael William Taylor, Lorna Watson, Gordon James Prescott, David John Godden, Robert Norman Barker

Research output: Contribution to journalArticle

137 Citations (Scopus)

Abstract

Background The recent rise in the prevalence of immune-mediated diseases has been attributed to environmental factors such as a lack of microbial challenge, or dietary change, that deviate the overall balance between mutually antagonistic subsets of T helper (Th) cells.

Objective An alternative proposal is that recent environmental changes have resulted in an immune system that is more likely to produce both Th1 and Th 2 responses against benign antigens. The prediction of this hypothesis, that Th1 and Th 2-mediated diseases are not mutually exclusive, and may be positively associated, is tested here in a whole population.

Methods Data from General Practices participating in the Scottish Continuous Morbidity Recording (CMR) project were used to determine the coincidence of the major Th 2-mediated atopic diseases; asthma, eczema and allergic rhinitis, with the Th1-mediated autoimmune conditions; type I diabetes, rheumatoid arthritis and psoriasis. We also identified the prescription rates of inhaled therapy for asthma in patients with Th1-mediated disease.

Results There was a significant increase in the risk of presenting with a Th1-mediated autoimmune condition in patients with a history of allergic disease (standardized prevalence ratio (95% confidence interval) 1.28 (1.18-1.37)). Likewise, the standardized prevalence ratios of presenting with either eczema (1.67 (1.48-1.87)) or allergic rhinitis (1.22 (1.02-1.44)) were significantly increased in subjects with a history of Th1-mediated disease. There was a particularly strong association between current psoriasis and current eczema (standardized prevalence ratio of psoriasis in subjects with eczema 2.88, 95% confidence interval (CI) 2.38-3.45). There was also a significant increase in prescriptions for inhaled asthma therapy in patients with Th1 disease.

Conclusion It is concluded that Th1- and Th2-mediated diseases are significantly associated in a large General Practice population. This finding supports the proposal that autoimmune and atopic diseases share risk factors that increase the propensity of the immune system to generate both Th1- and Th 2-mediated inappropriate responses to non-pathological antigens.

Original languageEnglish
Pages (from-to)37-42
Number of pages6
JournalClinical & experimental allergy
Volume32
Issue number1
DOIs
Publication statusPublished - Jan 2002

Keywords

  • T helper cell
  • asthma
  • eczema
  • allergic rhinitis
  • diabetes
  • psoriasis
  • rheumatoid arthritis
  • T-CELLS
  • DIABETES-MELLITUS
  • RISING INCIDENCE
  • FATTY-ACIDS
  • CHILDHOOD
  • PSORIASIS
  • PREVALENCE
  • ASTHMA
  • CHILDREN
  • PATTERNS
  • T helper cell
  • asthma
  • allergic rhinitis

Cite this

Coincidence of immune-mediated diseases driven by Th1 and Th2 subsets suggests a common aetiology : a population-based study using computerized General Practice data. / Simpson, Colin; Anderson, W. J. A.; Helms, Peter Joseph Benedict; Taylor, Michael William; Watson, Lorna; Prescott, Gordon James; Godden, David John; Barker, Robert Norman.

In: Clinical & experimental allergy, Vol. 32, No. 1, 01.2002, p. 37-42.

Research output: Contribution to journalArticle

Simpson, Colin ; Anderson, W. J. A. ; Helms, Peter Joseph Benedict ; Taylor, Michael William ; Watson, Lorna ; Prescott, Gordon James ; Godden, David John ; Barker, Robert Norman. / Coincidence of immune-mediated diseases driven by Th1 and Th2 subsets suggests a common aetiology : a population-based study using computerized General Practice data. In: Clinical & experimental allergy. 2002 ; Vol. 32, No. 1. pp. 37-42.
@article{7d86e9bfb5fe4767b7f22741f674a59c,
title = "Coincidence of immune-mediated diseases driven by Th1 and Th2 subsets suggests a common aetiology: a population-based study using computerized General Practice data",
abstract = "Background The recent rise in the prevalence of immune-mediated diseases has been attributed to environmental factors such as a lack of microbial challenge, or dietary change, that deviate the overall balance between mutually antagonistic subsets of T helper (Th) cells.Objective An alternative proposal is that recent environmental changes have resulted in an immune system that is more likely to produce both Th1 and Th 2 responses against benign antigens. The prediction of this hypothesis, that Th1 and Th 2-mediated diseases are not mutually exclusive, and may be positively associated, is tested here in a whole population.Methods Data from General Practices participating in the Scottish Continuous Morbidity Recording (CMR) project were used to determine the coincidence of the major Th 2-mediated atopic diseases; asthma, eczema and allergic rhinitis, with the Th1-mediated autoimmune conditions; type I diabetes, rheumatoid arthritis and psoriasis. We also identified the prescription rates of inhaled therapy for asthma in patients with Th1-mediated disease.Results There was a significant increase in the risk of presenting with a Th1-mediated autoimmune condition in patients with a history of allergic disease (standardized prevalence ratio (95{\%} confidence interval) 1.28 (1.18-1.37)). Likewise, the standardized prevalence ratios of presenting with either eczema (1.67 (1.48-1.87)) or allergic rhinitis (1.22 (1.02-1.44)) were significantly increased in subjects with a history of Th1-mediated disease. There was a particularly strong association between current psoriasis and current eczema (standardized prevalence ratio of psoriasis in subjects with eczema 2.88, 95{\%} confidence interval (CI) 2.38-3.45). There was also a significant increase in prescriptions for inhaled asthma therapy in patients with Th1 disease.Conclusion It is concluded that Th1- and Th2-mediated diseases are significantly associated in a large General Practice population. This finding supports the proposal that autoimmune and atopic diseases share risk factors that increase the propensity of the immune system to generate both Th1- and Th 2-mediated inappropriate responses to non-pathological antigens.",
keywords = "T helper cell, asthma, eczema, allergic rhinitis, diabetes, psoriasis, rheumatoid arthritis, T-CELLS, DIABETES-MELLITUS, RISING INCIDENCE, FATTY-ACIDS, CHILDHOOD, PSORIASIS, PREVALENCE, ASTHMA, CHILDREN, PATTERNS, T helper cell , asthma , allergic rhinitis",
author = "Colin Simpson and Anderson, {W. J. A.} and Helms, {Peter Joseph Benedict} and Taylor, {Michael William} and Lorna Watson and Prescott, {Gordon James} and Godden, {David John} and Barker, {Robert Norman}",
year = "2002",
month = "1",
doi = "10.1046/j.0022-0477.2001.01250.x",
language = "English",
volume = "32",
pages = "37--42",
journal = "Clinical & experimental allergy",
issn = "0954-7894",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Coincidence of immune-mediated diseases driven by Th1 and Th2 subsets suggests a common aetiology

T2 - a population-based study using computerized General Practice data

AU - Simpson, Colin

AU - Anderson, W. J. A.

AU - Helms, Peter Joseph Benedict

AU - Taylor, Michael William

AU - Watson, Lorna

AU - Prescott, Gordon James

AU - Godden, David John

AU - Barker, Robert Norman

PY - 2002/1

Y1 - 2002/1

N2 - Background The recent rise in the prevalence of immune-mediated diseases has been attributed to environmental factors such as a lack of microbial challenge, or dietary change, that deviate the overall balance between mutually antagonistic subsets of T helper (Th) cells.Objective An alternative proposal is that recent environmental changes have resulted in an immune system that is more likely to produce both Th1 and Th 2 responses against benign antigens. The prediction of this hypothesis, that Th1 and Th 2-mediated diseases are not mutually exclusive, and may be positively associated, is tested here in a whole population.Methods Data from General Practices participating in the Scottish Continuous Morbidity Recording (CMR) project were used to determine the coincidence of the major Th 2-mediated atopic diseases; asthma, eczema and allergic rhinitis, with the Th1-mediated autoimmune conditions; type I diabetes, rheumatoid arthritis and psoriasis. We also identified the prescription rates of inhaled therapy for asthma in patients with Th1-mediated disease.Results There was a significant increase in the risk of presenting with a Th1-mediated autoimmune condition in patients with a history of allergic disease (standardized prevalence ratio (95% confidence interval) 1.28 (1.18-1.37)). Likewise, the standardized prevalence ratios of presenting with either eczema (1.67 (1.48-1.87)) or allergic rhinitis (1.22 (1.02-1.44)) were significantly increased in subjects with a history of Th1-mediated disease. There was a particularly strong association between current psoriasis and current eczema (standardized prevalence ratio of psoriasis in subjects with eczema 2.88, 95% confidence interval (CI) 2.38-3.45). There was also a significant increase in prescriptions for inhaled asthma therapy in patients with Th1 disease.Conclusion It is concluded that Th1- and Th2-mediated diseases are significantly associated in a large General Practice population. This finding supports the proposal that autoimmune and atopic diseases share risk factors that increase the propensity of the immune system to generate both Th1- and Th 2-mediated inappropriate responses to non-pathological antigens.

AB - Background The recent rise in the prevalence of immune-mediated diseases has been attributed to environmental factors such as a lack of microbial challenge, or dietary change, that deviate the overall balance between mutually antagonistic subsets of T helper (Th) cells.Objective An alternative proposal is that recent environmental changes have resulted in an immune system that is more likely to produce both Th1 and Th 2 responses against benign antigens. The prediction of this hypothesis, that Th1 and Th 2-mediated diseases are not mutually exclusive, and may be positively associated, is tested here in a whole population.Methods Data from General Practices participating in the Scottish Continuous Morbidity Recording (CMR) project were used to determine the coincidence of the major Th 2-mediated atopic diseases; asthma, eczema and allergic rhinitis, with the Th1-mediated autoimmune conditions; type I diabetes, rheumatoid arthritis and psoriasis. We also identified the prescription rates of inhaled therapy for asthma in patients with Th1-mediated disease.Results There was a significant increase in the risk of presenting with a Th1-mediated autoimmune condition in patients with a history of allergic disease (standardized prevalence ratio (95% confidence interval) 1.28 (1.18-1.37)). Likewise, the standardized prevalence ratios of presenting with either eczema (1.67 (1.48-1.87)) or allergic rhinitis (1.22 (1.02-1.44)) were significantly increased in subjects with a history of Th1-mediated disease. There was a particularly strong association between current psoriasis and current eczema (standardized prevalence ratio of psoriasis in subjects with eczema 2.88, 95% confidence interval (CI) 2.38-3.45). There was also a significant increase in prescriptions for inhaled asthma therapy in patients with Th1 disease.Conclusion It is concluded that Th1- and Th2-mediated diseases are significantly associated in a large General Practice population. This finding supports the proposal that autoimmune and atopic diseases share risk factors that increase the propensity of the immune system to generate both Th1- and Th 2-mediated inappropriate responses to non-pathological antigens.

KW - T helper cell

KW - asthma

KW - eczema

KW - allergic rhinitis

KW - diabetes

KW - psoriasis

KW - rheumatoid arthritis

KW - T-CELLS

KW - DIABETES-MELLITUS

KW - RISING INCIDENCE

KW - FATTY-ACIDS

KW - CHILDHOOD

KW - PSORIASIS

KW - PREVALENCE

KW - ASTHMA

KW - CHILDREN

KW - PATTERNS

KW - T helper cell

KW - asthma

KW - allergic rhinitis

U2 - 10.1046/j.0022-0477.2001.01250.x

DO - 10.1046/j.0022-0477.2001.01250.x

M3 - Article

VL - 32

SP - 37

EP - 42

JO - Clinical & experimental allergy

JF - Clinical & experimental allergy

SN - 0954-7894

IS - 1

ER -