Atopic dermatitis and the risk for non-allergic inflammatory comorbidities

Published Online: August 4, 2015

Atopic dermatitis (AD) is among the most prevalent chronic inflammatory diseases and constitutes a high healthcare burden. Most patients develop AD in infancy. It is well established that many children with AD develop asthma and allergic rhinitis later in life. It has been speculated that AD might also modify the risk for the development of non-allergic inflammatory diseases, but carefully designed studies on this issue are still scarce.

In an article recently published in The Journal of Allergy & Clinical Immunology (JACI), Schmitt and colleagues investigated a large cohort of approximately 650,000 individuals aged 40 years or younger from Germany concerning the association between prevalent AD and the development of new-onset rheumatoid arthritis, Crohn disease, ulcerative colitis, and type 1 diabetes. The authors also explored potential genetic overlap between AD and these comorbidities of interest in another sample of 2,425 AD patients and 5,449 controls without AD.

The researchers found that patients with AD had an approximately 70% increased risk to develop rheumatoid arthritis. New-onset Crohn disease and ulcerative colitis were also significantly associated with previous AD, but the association was only modest with 34% and 25% increased risk, respectively. As hypothesized by the authors, patients with AD tended to develop type 1 diabetes less frequently than patients without AD. The authors further reported that the observed excess comorbidity cannot be attributed to shared major known genetic risk factors.

This study suggests a broad spectrum of non-allergic inflammatory diseases may be related to AD. The study published in The Journal of Allergy & Clinical Immunology (JACI) thus highlights the need for further etiological studies to get a better understanding of the underlying mechanisms of the observed comorbidities. This may ultimately allow the development and implementation of targeted preventive interventions for the subset of AD patients at highest risk for the development of non-allergic inflammatory comorbidities.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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