Transgenerational occurrence of allergic disease and autoimmunity: general practice-based epidemiological research

T. Maas*, C. Nieuwhof, V. Lima Passos, C. Robertson, A. Boonen, R.B. Landewé, J.W. Voncken, J.A. Knottnerus, J.G. Damoiseaux

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Corresponding with the T helper cell type 1/T helper cell type 2 hypothesis, autoimmune and allergic diseases are considered pathologically distinct and mutually exclusive conditions. Co-occurrence of autoimmune disorders and allergy within patients, however, has been reported. Transgenerational co-occurrence of autoimmune and allergic disease has been less often described and may differ from the intra-patient results..

Aims: To test the hypothesis that autoimmune disorders in parents are a risk factor for the development of an allergic disease in their offspring.

Methods: Prospectively registered (by academic general practitioners) International Classifications of Primary Care (ICPC) for diagnoses of autoimmune disorders and allergy within families were evaluated (n=5,604 families) by performing multiple logistic regression analyses.

Results: The presence of any ICPC-encoded autoimmune disorder in fathers appeared to be associated with an increased risk in their eldest children of developing an allergy (odds ratio (OR) 1.4, 95% Cl 1.042 to 1.794). Psoriasis in fathers was particularly shown to be of influence (OR 1.5, 95% CI 1.061 to 2.117) and, although any ICPC-encoded autoimmune disease in mothers was found not to be of significance, the combined international code for registering rheumatoid arthritis/ankylosing spondylitis in mothers was OR 1.7 (95% Cl 1.031 to 2.852).

Conclusions: The occurrence of ICPC-encoded autoimmune disorders in parents, especially psoriasis and rheumatoid arthritis/ankylosing spondylitis, significantly increases the occurrence of allergic disease in their children. After validation in follow-up research in a larger sample, these results may lead to the inclusion of 'parental autoimmune condition' as a risk factor in the general practitioner's diagnostics of allergic disease. (C) 2013 Primary Care Respiratory Society UK. All rights reserved.

Original languageEnglish
Pages (from-to)14-21
Number of pages8
JournalPrimary Care Respiratory Journal
Issue number1
Publication statusPublished - Mar 2014


  • allergy
  • asthma
  • diagnosis
  • environmental
  • epidemiology
  • guideline
  • primary care
  • survey

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