Abstract

BackgroundAn inverse relationship between allergies with glioma risk has been reported in several but not all epidemiological observational studies. We performed an analysis of genetic variants associated with atopy to assess the relationship with glioma risk using Mendelian randomisation (MR), an approach unaffected by biases from temporal variability and reverse causation that might have affected earlier investigations.MethodsTwo-sample MR was undertaken using genome-wide association study data. We used single nucleotide polymorphisms (SNPs) associated with atopic dermatitis, asthma and hay fever, IgE levels, and self-reported allergy as instrumental variables. We calculated MR estimates for the odds ratio (OR) for each risk factor with glioma using SNP-glioma estimates from 12,488 cases and 18,169 controls, using inverse-variance weighting (IVW), maximum likelihood estimation (MLE), weighted median estimate (WME) and mode-based estimate (MBE) methods. Violation of MR assumptions due to directional pleiotropy were sought using MR-Egger regression and HEIDI-outlier analysis.ResultsUnder IVW, MLE, WME and MBE methods, associations between glioma risk with asthma and hay fever, self-reported allergy and IgE levels were non-significant. An inverse relationship between atopic dermatitis and glioma risk was found by IVW (OR 0.96, 95% confidence interval (CI) 0.93–1.00, P = 0.041) and MLE (OR 0.96, 95% CI 0.94–0.99, P = 0.003), but not by WME (OR 0.96, 95% CI 0.91–1.01, P = 0.114) or MBE (OR 0.97, 95% CI 0.92–1.02, P = 0.194).ConclusionsOur investigation does not provide strong evidence for relationship between atopy and the risk of developing glioma, but findings do not preclude a small effect in relation to atopic dermatitis. Our analysis also serves to illustrate the value of using several MR methods to derive robust conclusions.

Highlights

  • An inverse relationship between allergies with glioma risk has been reported in several but not all epidemiological observational studies

  • The atopic dermatitis risk single nucleotide polymorphism (SNP) rs909341, which is highly correlated with the chromosome 20q13.33 glioma risk SNP rs2297440 (D’ = 0.89, r2 = 0.77), was strongly associated with risk of glioma (P = 2.10 × 10−34)

  • We confined our analysis of the relationship between atopic dermatitis and glioma to a dataset excluding this SNP

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Summary

Introduction

An inverse relationship between allergies with glioma risk has been reported in several but not all epidemiological observational studies. Over the past three decades the search for an immune-mediated risk factor that might influence risk has led to studies of a possible relationship between multiple allergic conditions and autoimmune disorders with glioma [3]. Several case-control studies have shown that selfreported allergic conditions may protect against glioma [4]. In the International Adult Brain Tumour Study, based on 1178 glioma patients, an odds ratio (OR) of 0.59 was found for any self-reported allergy [5]. In contrast to case-control studies, evidence for an association between glioma and allergy from cohort-based analyses has been less forthcoming [7], such studies have been poorly powered to demonstrate a relationship

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