People with asthma and eczema are more likely to develop osteoarthritis

Scientists at Stanford Medicine and their colleagues found that having asthma or eczema increases your chances of developing osteoarthritis. This indicates that there may be allergic pathways that can be targeted with existing drugs.

Our findings lay the foundation for future intervention studies that could identify first-line treatments that slow the progression of osteoarthritis. ”

Matthew Baker, MD, Assistant Professor of Immunology and Rheumatology

Baker is lead author of a research paper published March 27. A Chronicle of Rheumatic Diseasedescribes the connection.

Osteoarthritis is widespread, affecting more than 50 million people in the United States, and there are no known treatments that can prevent its progression. This condition requires expensive joint replacement surgery, can lead to disability, and can have a significant impact on quality of life. Baker said the strain on the healthcare system continues to grow as the population ages and obesity rates rise.

clear up common misconceptions

Scientists previously thought that osteoarthritis developed from the wear and tear of cartilage. However, William Robinson, MD, PhD and James W. Raitt, MD, professor and senior author of the paper, found inflammation in the tissue. people with arthritis.

Robinson found that mast cells activated by foreign invader-detecting antibodies called IgE release histamine and tryptase, key factors contributing to allergic inflammation. Tryptase, in particular, appears to play an important role in exacerbating osteoarthritis. This study was published in 2019.

Because osteoarthritis appeared to be caused by allergic inflammation, Baker and other researchers studied insurance claims data to find patients with atopic disease who develop an exaggerated immune response to harmless substances. They decided to trace it retrospectively. They focused on asthma and eczema.

The researchers found and followed people who had been osteoarthritis-free for two years and then were diagnosed with asthma or eczema. tracked. Diagnosis of asthma Or eczema. The researchers then matched each diagnosed patient with a control group of patients who were similar in demographics, frequency of visits, presence of other diseases, and several other factors, and who had osteoarthritis. It was confirmed that In the primary cohort, each group had approximately 110,000 patients.

Paving the way for therapeutic success

The authors found that patients with asthma or eczema had a 58% increased risk of developing osteoarthritis over about 10 years. Having both asthma and eczema increased the risk to 115%.

To confirm the effects of other lung diseases not mediated by allergens, researchers compared chronic obstructive pulmonary disease, in which airflow from the lungs is constricted, to asthma. They found that asthma patients had an 83% higher risk of developing osteoarthritis compared with COPD patients. , again suggesting that the activation of allergic pathways is an important factor.

Because the primary analysis claim data did not include body mass index, a risk factor for osteoarthritis, the researchers validated the results with an independent dataset using the Stanford Research Repository.The results were similar. , indicating that allergic diseases increase the risk of developing osteoarthritis, even after considering the important variables of BMI.

According to Dr. Baker, existing drugs for asthma attacks and mast cell activation syndrome (a condition in which patients repeatedly experience anaphylactic symptoms) may be candidates for treatment of osteoarthritis. Inhibits cells and allergic cytokines (byproducts of mast cells that cause inflammation).

“There is strong potential to study this as an intervention to see if targeting pathways such as inhibiting mast cells or allergic cytokines can actually reduce the onset and progression of osteoarthritis.” We have a solid foundation,” said Baker.

Researchers at Chinook Therapeutics in Seattle, Boston University School of Medicine, and VA Palo Alto Health Care System contributed to this work.

This study was funded by the National Institutes of Health (grant R25 AI 147369 and P30 072571), Veterans Affairs, Department of Defense, Stanford Center for Clinical and Translational Research and Education.