Asthma, Rhinitis, other Respiratory Diseases
Concordance and interrelationship of atopic diseases and markers of allergic sensitization among adult female twins,☆☆

https://doi.org/10.1067/mai.2001.119408Get rights and content

Abstract

Background: Previous twin studies of asthma and allergy implicate both genetic and environmental factors in disease risk, but few have related the occurrence of clinical disease to objective markers of allergic sensitization in twins. Objective: We sought to investigate the concordance and interrelationships of self-reported allergic disease and total and aeroallergen-specific IgE levels within pairs of British adult female twins. Methods: Three hundred forty monozygotic and 533 dizygotic pairs, aged 18 to 72 years, completed questionnaires about allergic disease. Of these, 282 monozygotic and 270 dizygotic pairs were tested for total IgE and specific IgE to Der p 1, mixed grass pollen, and cat dander by means of fluoroimmunoassay. Results: Concordance rates for all variables were higher for monozygotic than for dizygotic twins, significantly (P < .05) so for hay fever, eczema, and specific IgE positivity but not (P > .05) for self-reported asthma or allergies. Within-pair correlations of log-transformed IgE were 0.59 for monozygotic twins and 0.29 for dizygotic twins, implying heritability of 60%. Within both monozygotic and dizygotic pairs discordant for hay fever or reported allergies, the affected twin had significantly higher total and specific IgE levels. Within pairs who were doubly discordant for 3 allergic diseases, associations between diseases were of similar strength for monozygotic and dizygotic pairs. Conclusions: These results confirm that genetic factors influence susceptibility to aeroallergen sensitization and clinical allergic disease. However, genetically identical twins are often discordant in their expression of atopy, suggesting a substantial modifying role for environmental factors. (J Allergy Clin Immunol 2001;108:901-7.)

Section snippets

Methods

The St Thomas's UK Adult Twin Registry was used as the source of twins.8 Briefly, this comprises mainly female twins from throughout the United Kingdom who were recruited by means of media campaigns9, 10 without specifying the diseases for study or the hypotheses to be tested. Pairs were invited to attend the Twin Research Unit, St Thomas's Hospital, London, for a full day of clinical tests, including a self-completed questionnaire relating to allergic diseases. The questions on asthma and

Results

Questionnaires were completed by both members of 873 female twin pairs (340 monozygotic and 533 dizygotic pairs), of whom 552 pairs (282 monozygotic and 270 dizygotic) were tested for total and specific IgE. Their ages at examination ranged from 18 to 72 years (mean, 47 years). Some results are presented separately for the pairs aged less than 50 years (140 monozygotic and 325 dizygotic pairs) and those aged greater than 50 years (200 monozygotic and 208 dizygotic pairs).

Discussion

This is the largest twin study yet published that has included objective markers of allergic sensitization. Our sample of twins was recruited mainly by means of advertisement and therefore in theory may be less representative of all twins than series derived from comprehensive national registers. The most likely type of volunteer bias is toward a higher degree of concordance, particularly among monozygotic pairs.19 It is unlikely that this would seriously affect comparisons of affected and

Acknowledgements

We thank the twins who took part in this study and study nurses Karen Smith and Liz Tomlin for administering the questionnaires, cleaning the data, and collecting and processing blood samples. We also thank Rosemary Fulljames for her diligent attention to the laboratory assays and Sarah Moran for assistance with the statistical analyses.

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    Supported by the Wellcome Trust (project grant No. 047232/Z/96/Z). At the time of this study the St Thomas's Hospital Twin Research and Genetic Epidemiology Unit received funding from the Chronic Diseases Research Foundation, The British Heart Foundation, the Arthritis and Rheumatism Council, and Gemini Genomics Limited.

    ☆☆

    Reprint requests: David Strachan, MD, Department of Public Health Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, United Kingdom.

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