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 language | English |
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Pages (from-to) | 37-42 |
Number of pages | 6 |
Journal | Clinical & experimental allergy |
Volume | 32 |
Issue number | 1 |
DOIs | |
Publication status | Published - 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