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Association between allergies and reduced risk of glioma
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According to a Danish nationwide cohort study, rosacea (an inflammatory skin disease) is associated with a substantial increase in the risk of glioma, a common primary brain tumor in adults. Alexander Egeberg (University of Copenhagen, Hellerup, Denmark) and colleagues noted that matrix metalloproteinases (MMPs)—enzymes involved in inflammatory process regulation, organ development, and tissue remodelling—are overexpressed both in skin with rosacea and in tumour tissue from patients with glioma. Findings from a previous study have also linked rosacea with an increased risk of thyroid cancer and basal cell carcinoma; however, that study only included data from women, and no additional evidence exists of links between rosacea and cancer. To assess the link between rosacea and the risk of glioma, Egeberg
and colleagues analysed data for all 5 484 910 Danish citizens who were aged 18 years or older between Jan 1, 1997, and Dec 31, 2011. 68 372 of these patients had rosacea, and the remaining population (n=5 416 538) served as a reference population. During the study period, 20 934 patients in the reference population and 184 patients who had rosacea developed glioma, giving an incidence of glioma of 3·34 per 10 000 person–years (95% CI 3·30–3·39) in the reference population and 4·99 per 10 000 person–years (4·32–5·76) in the group of patients with rosacea. The adjusted incidence ratio of glioma in patients with rosacea was 1·36 per 10 000 person–years (95% CI 1·18–1·58); however, among the 5964 patients for whom the primary diagnosis of rosacea was made by a hospital dermatologist, the adjusted incidence ratio of glioma was 1·82 (95% CI 1·16–2·86).
According to Egeberg, “emerging data suggest that rosacea may be linked with certain form of malignancies, such as thyroid cancer and now also glioma”, adding that “an unexpected finding in our study was that the risk of glioma was highest among men, since rosacea is generally more common in women. Yet, it is important to remember that while rosacea is a common disorder, gliomas were still rare in both sexes”. In response to these findings, Diptendra Sarkar (Institute of Post Graduate Medical Education and Research, Kolkata, India) recommends that “patients with rosacea, particularly those with specific symptoms such as neurological symptoms, should be investigated for cancers, such as thyroid cancer and glioma”.
Cavallini James/Science Photo Library
Link between rosacea and glioma in nationwide cohort
Published Online February 4, 2016 http://dx.doi.org/10.1016/ S1470-2045(16)00082-6 For the study by Egeberg and colleagues see JAMA Dermatol 2016; published online Jan 27. DOI:10.1001/ jamadermatol.2015.5549
Sanjeet Bagcchi
Association between allergies and reduced risk of glioma Authors of a new study have noted an inverse association between the risk of developing glioma and a history of allergies. The researchers drew data from the Glioma International Case Control Study, which contains detailed information about atopic disorders for 4533 cases and 4171 controls in 14 sites and five countries. They concluded that a history of respiratory allergies reduces the risk of developing glioma (meta-analysis odds ratio 0·72 [95% CI 0·58–0·90]), as does having asthma (OR 0·77 [0·64–0·93]) and eczema (OR 0·71 [0·56–0·89]), compared with patients without allergies. “Our current study adds substantially to the weight of the already existing evidence for a true relationship between allergies and glioma”, explained lead author Melissa Bondy (Baylor College of www.thelancet.com/oncology Vol 17 March 2016
Medicine, Houston, TX, USA). But she cautioned that until the underlying biological mechanism is identified, definitive confirmation of this relationship will not be possible. One possibility is that the heightened state of immunosurveillance that prompts allergic reactions forestalls development of tumours. “More specifically, it has been proposed that IgE antibodies, which are involved in allergic reactions, may have some cross-reactivity to brain tumours, quickly triggering an immune response against new or forming tumours”, said Bondy. She posits that individuals who have a strong allergic response might find it easier to expel toxins and carcinogens from their systems. “It is very difficult to know at what level the interaction is working; it may be something very fundamental in people’s immune systems that
makes the difference; we do not have any idea at the moment”, points out Susan Short (Leeds University, Leeds, UK). She places the findings in the context of the increasing recognition that the immune environment strongly affects tumour response in patients with gliomas. “So it is not very surprising that it may make a difference to tumour initiation”, she said. For now, clinical practice is unlikely to be affected—doctors can hardly advise patients to develop protective allergies. “But if we can determine which aspect of the allergic response may be protective against glioma, we might be able to take advantage of that aspect of the immune response to help prevent or treat glioma in the future”, Bondy added.
Published Online February 11, 2016 http://dx.doi.org/10.1016/ S1470-2045(16)00087-5 For the study by Amirian and colleagues see Cancer Epidemiol Biomarkers Prev 2016; 25: 282–90
Talha Khan Burki e94
According to a Danish nationwide cohort study, rosacea (an inflammatory skin disease) is associated with a substantial increase in the risk of glioma, a common primary brain tumor in adults. Alexander Egeberg (University of Copenhagen, Hellerup, Denmark) and colleagues noted that matrix metalloproteinases (MMPs)—enzymes involved in inflammatory process regulation, organ development, and tissue remodelling—are overexpressed both in skin with rosacea and in tumour tissue from patients with glioma. Findings from a previous study have also linked rosacea with an increased risk of thyroid cancer and basal cell carcinoma; however, that study only included data from women, and no additional evidence exists of links between rosacea and cancer. To assess the link between rosacea and the risk of glioma, Egeberg
and colleagues analysed data for all 5 484 910 Danish citizens who were aged 18 years or older between Jan 1, 1997, and Dec 31, 2011. 68 372 of these patients had rosacea, and the remaining population (n=5 416 538) served as a reference population. During the study period, 20 934 patients in the reference population and 184 patients who had rosacea developed glioma, giving an incidence of glioma of 3·34 per 10 000 person–years (95% CI 3·30–3·39) in the reference population and 4·99 per 10 000 person–years (4·32–5·76) in the group of patients with rosacea. The adjusted incidence ratio of glioma in patients with rosacea was 1·36 per 10 000 person–years (95% CI 1·18–1·58); however, among the 5964 patients for whom the primary diagnosis of rosacea was made by a hospital dermatologist, the adjusted incidence ratio of glioma was 1·82 (95% CI 1·16–2·86).
According to Egeberg, “emerging data suggest that rosacea may be linked with certain form of malignancies, such as thyroid cancer and now also glioma”, adding that “an unexpected finding in our study was that the risk of glioma was highest among men, since rosacea is generally more common in women. Yet, it is important to remember that while rosacea is a common disorder, gliomas were still rare in both sexes”. In response to these findings, Diptendra Sarkar (Institute of Post Graduate Medical Education and Research, Kolkata, India) recommends that “patients with rosacea, particularly those with specific symptoms such as neurological symptoms, should be investigated for cancers, such as thyroid cancer and glioma”.
Cavallini James/Science Photo Library
Link between rosacea and glioma in nationwide cohort
Published Online February 4, 2016 http://dx.doi.org/10.1016/ S1470-2045(16)00082-6 For the study by Egeberg and colleagues see JAMA Dermatol 2016; published online Jan 27. DOI:10.1001/ jamadermatol.2015.5549
Sanjeet Bagcchi
Association between allergies and reduced risk of glioma Authors of a new study have noted an inverse association between the risk of developing glioma and a history of allergies. The researchers drew data from the Glioma International Case Control Study, which contains detailed information about atopic disorders for 4533 cases and 4171 controls in 14 sites and five countries. They concluded that a history of respiratory allergies reduces the risk of developing glioma (meta-analysis odds ratio 0·72 [95% CI 0·58–0·90]), as does having asthma (OR 0·77 [0·64–0·93]) and eczema (OR 0·71 [0·56–0·89]), compared with patients without allergies. “Our current study adds substantially to the weight of the already existing evidence for a true relationship between allergies and glioma”, explained lead author Melissa Bondy (Baylor College of www.thelancet.com/oncology Vol 17 March 2016
Medicine, Houston, TX, USA). But she cautioned that until the underlying biological mechanism is identified, definitive confirmation of this relationship will not be possible. One possibility is that the heightened state of immunosurveillance that prompts allergic reactions forestalls development of tumours. “More specifically, it has been proposed that IgE antibodies, which are involved in allergic reactions, may have some cross-reactivity to brain tumours, quickly triggering an immune response against new or forming tumours”, said Bondy. She posits that individuals who have a strong allergic response might find it easier to expel toxins and carcinogens from their systems. “It is very difficult to know at what level the interaction is working; it may be something very fundamental in people’s immune systems that
makes the difference; we do not have any idea at the moment”, points out Susan Short (Leeds University, Leeds, UK). She places the findings in the context of the increasing recognition that the immune environment strongly affects tumour response in patients with gliomas. “So it is not very surprising that it may make a difference to tumour initiation”, she said. For now, clinical practice is unlikely to be affected—doctors can hardly advise patients to develop protective allergies. “But if we can determine which aspect of the allergic response may be protective against glioma, we might be able to take advantage of that aspect of the immune response to help prevent or treat glioma in the future”, Bondy added.
Published Online February 11, 2016 http://dx.doi.org/10.1016/ S1470-2045(16)00087-5 For the study by Amirian and colleagues see Cancer Epidemiol Biomarkers Prev 2016; 25: 282–90
Talha Khan Burki e94