Background: Our aim was to observe factors associated with IL13 rs20541 polymorphism and other factors with or without allergic comorbidities such as subject-reported allergic rhinitis (AR) and/or allergic conjunctivitis (AC) symptoms in adult asthmatics. Methods: A population-based sample of Finnish adult asthma patients (n = 1,156) and matched controls (n = 1,792) filled in a questionnaire. Asthma was diagnosed based on a typical history of asthma symptoms and lung function tests. Skin prick tests with 17 aeroallergens and blood tests including analysis of interleukin 13 (IL13) rs20541 (G/A) genotypes were performed for a subsample (n = 193). Results: The proportion of asthmatics reporting AR was 61.9% and reporting AC was 40.7%. After adjustments, the presence of the IL13 rs20541A- allele (OR 3.06, 95% CI 1.42-6.58, p = 0.004) or multisensitization (adjusted OR 4.59, 95% CI 1.48-14.26, p = 0.008) was associated with AR/AC asthma. Nasal polyps and acetylsalicylic acid-exacerbated respiratory disease was also associated with AR/AC asthma. Conclusions: Adult AR/AC asthma could putatively be a phenotype, characterized by the presence of atopic and/or eosinophilic factors and a high prevalence of the IL13 rs20541A- allele. Studies on the mechanisms behind this and in other populations are needed.

Keywords:
Allergic rhinitis, Allergic conjunctivitis, Asthma, Interleukin 13, Sensitization
1.
To T, Stanojevic S, Moores G, Gershon AS, Bateman ED, Cruz AA, et al: Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC Public Health 2012;12:204.
2.
Tan DJ, Walters EH, Perret JL, Lodge CJ, Lowe AJ, Matheson MC, et al: Age-of-asthma onset as a determinant of different asthma phenotypes in adults: a systematic review and meta-analysis of the literature. Expert Rev Respir Med 2015;9:109-123.
3.
Laatikainen T, von Hertzen L, Koskinen J-P, Mäkelä MJ, Jousilahti P, Kosunen TU, et al: Allergy gap between Finnish and Russian Karelia on increase. Allergy 2011;66:886-892.
4.
Bjerg A, Hedman L, Perzanowski M, Wennergren G, Lundbäck B, Rönmark E: Decreased importance of environmental risk factors for childhood asthma from 1996 to 2006. Clin Exp Allergy 2015;45:146-153.
5.
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al: Allergic rhinitis and its impact on asthma (ARIA) 2008. Allergy 2008;63:8-160.
6.
Burte E, Bousquet J, Varraso R, Gormand F, Just J, Matran R, et al: Characterization of rhinitis according to the asthma status in adults using an unsupervised approach in the EGEA Study. PLoS One 2015;10:e0136191.
7.
Pefura-Yone EW, Kengne AP, Balkissou AD, Boulleys-Nana JR, Efe-de-Melingui NR, Ndjeutcheu-Moualeu PI, et al: Prevalence of asthma and allergic rhinitis among adults in Yaounde, Cameroon. PLoS One 2015;10: e0123099.
8.
Pallasaho P, Juusela M, Lindqvist A, Sovijärvi A, Lundbäck B, Rönmark E: Allergic rhinoconjunctivitis doubles the risk for incident asthma - results from a population study in Helsinki, Finland. Respir Med 2011;105:1449-1456.
9.
Li J, Zhang Y, Zhang L: Discovering susceptibility genes for allergic rhinitis and allergy using a genome-wide association study strategy. Curr Opin Allergy Clin Immunol 2015;15:33-40.
10.
Rael EL, Lockey RF, Masoli M, Fabian D, Holt S, Beasley R, et al: Interleukin-13 signaling and its role in asthma. World Allergy Organ J 2011;4:54-64.
11.
Vladich FD, Brazille SM, Stern D, Peck ML, Ghittoni R, Vercelli D: IL-13 R130Q, a common variant associated with allergy and asthma, enhances effector mechanisms essential for human allergic inflammation. J Clin Invest 2005;115:747-754.
12.
Heinzmann A, Mao XQ, Akaiwa M, Kreomer RT, Gao PS, Ohshima K, et al: Genetic variants of IL-13 signalling and human asthma and atopy. Hum Mol Genet 2000;9:549-559.
13.
Narożna B, Hoffmann A, Sobkowiak P, Schoneich N, Bręborowicz A, Szczepankiewicz A: Polymorphisms in the interleukin 4, interleukin 4 receptor and interleukin 13 genes and allergic phenotype: a case control study. Adv Med Sci 2016;61:40-45.
14.
Accordini S, Calciano L, Bombieri C, Malerba G, Belpinati F, Lo Presti AR, et al: An interleukin 13 polymorphism is associated with symptom severity in adult subjects with ever asthma. PLoS One 2016;11:e0151292.
15.
Nakamura Y, Suzuki R, Mizuno T, Abe K, Chiba S, Horii Y, et al: Therapeutic implication of genetic variants of IL13 and STAT4 in airway remodelling with bronchial asthma. Clin Exp Allergy 2016;46:1152-1161.
16.
Toppila-Salmi S, Huhtala H, Karjalainen J, Renkonen R, Mäkelä MJ, Wang DY, et al: Sensitization pattern affects the asthma risk in Finnish adult population. Allergy 2015;70:1112-1120.
17.
Karjalainen J, Nieminen MM, Aromaa A, Klaukka T, Hurme M: The IL-1β genotype carries asthma susceptibility only in men. J Allergy Clin Immunol 2002;109:514-516.
18.
Karjalainen J, Joki-Erkkilä V-P, Hulkkonen J, Pessi T, Nieminen MM, Aromaa A, et al: The IL1A genotype is associated with nasal polyposis in asthmatic adults. Allergy 2003;58:393-396.
19.
Chung KF: Targetting the interleukin pathway in the treatment of asthma. Lancet 2015;386:1086-1096.
20.
Just J, Saint-Pierre P, Gouvis-Echraghi R, Laoudi Y, Roufai L, Momas I, et al: Childhood allergic asthma is not a single phenotype. J Pediatr 2014;164:815-820.
21.
Zein JG, Erzurum SC: Asthma is different in women. Curr Allergy Asthma Rep 2015;15:28.
22.
Simpson A, Tan VYF, Winn J, Svensén M, Bishop CM, Heckerman DE, et al: Beyond atopy. Am J Respir Crit Care Med 2010;181:1200-1206.
23.
Black S, Teixeira AS, Loh AXW, Vinall L, Holloway JW, Hardy R, et al: Contribution of functional variation in the IL13 gene to allergy, hay fever and asthma in the NSHD longitudinal 1946 birth cohort. Allergy 2009;64:1172-1178.
24.
Nie W, Liu Y, Bian J, Li B, Xiu Q: Effects of polymorphisms -1112C/T and +2044A/G in interleukin-13 gene on asthma risk: a meta-analysis. PLoS One 2013;8:e56065.
25.
Liu Y, Liu T, Nie W, Lai G, Xiu Q, Liu Y, et al: Interleukin-13 +1923C/T polymorphism is associated with asthma risk: a meta-analysis. Biomed Res Int 2013;2013:394316.
26.
Bagnasco D, Ferrando M, Varricchi G, Passalacqua G, Canonica GW: A critical evaluation of anti-IL-13 and anti-IL-4 strategies in severe asthma. Int Arch Allergy Immunol 2016;170:122-131.
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2017
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