背景:先前的研究已经探索了炎症性皮肤病与乳腺癌(BC)之间的关系,然而,这种关联的因果关系仍然不确定。
方法:利用双向双样本孟德尔随机化(MR)方法,这项研究旨在阐明各种炎性皮肤状况之间的因果动力学-即痤疮,特应性皮炎,寻常型牛皮癣,荨麻疹,酒渣鼻和BC.与这些疾病有关的遗传变异来自代表欧洲血统的全面全基因组关联研究。在前MR中,BC被假定为暴露,而反向MR治疗每种炎症性皮肤病作为暴露。一套分析方法,包括随机效应逆方差加权(IVW),加权中位数(WME),和MR-Egger,用于探索炎症性皮肤病与BC之间的因果关系。敏感性分析,除了对异质性和多效性的评估,是为了证实调查结果。
结果:MR分析显示与BC相关的痤疮风险增加(IVW:OR=1.063,95%CI=1.011-1.117,p=0.016),同时注意到BC患者特应性皮炎(AD)的风险降低(IVW:OR=0.941,95%CI=0.886-0.999,p=0.047)。未观察到BC和寻常型银屑病之间的显著关联,荨麻疹,或者酒渣鼻.相反,反向MR分析未发现BC对炎症性皮肤病的发病率有影响.缺乏多效性和这些结果的一致性加强了研究的结论。
结论:研究结果表明,在欧洲人群中,BC患者的痤疮发病率升高,AD发病率降低。
BACKGROUND: Prior research has explored the relationship between inflammatory skin disorders and breast cancer (BC), yet the causality of this association remains uncertain.
METHODS: Utilizing a bidirectional two-sample Mendelian randomization (MR) approach, this study aimed to elucidate the causal dynamics between various inflammatory skin conditions-namely acne, atopic
dermatitis, psoriasis vulgaris, urticaria, and rosacea-and BC. Genetic variants implicated in these disorders were sourced from comprehensive genome-wide association studies representative of European ancestry. In the forward MR, BC was posited as the exposure, while the reverse MR treated each inflammatory skin disease as the exposure. A suite of analytical methodologies, including random effects inverse variance weighted (IVW), weighted median (WME), and MR-Egger, were employed to probe the causative links between inflammatory skin diseases and BC. Sensitivity analyses, alongside evaluations for heterogeneity and pleiotropy, were conducted to substantiate the findings.
RESULTS: The MR analysis revealed an increased risk of acne associated with BC (IVW: OR = 1.063, 95% CI = 1.011-1.117, p = 0.016), while noting a decreased risk of atopic
dermatitis (AD) in BC patients (IVW: OR = 0.941, 95% CI = 0.886-0.999, p = 0.047). No significant associations were observed between BC and psoriasis vulgaris, urticaria, or rosacea. Conversely, reverse MR analyses detected no effect of BC on the incidence of inflammatory skin diseases. The absence of pleiotropy and the consistency of these outcomes strengthen the study\'s conclusions.
CONCLUSIONS: Findings indicate an elevated incidence of acne and a reduced incidence of AD in individuals with BC within the European population.