Association between allergic or autoimmune diseases and incidence of endometriosis: A nested case‐control study using a health insurance claims database

Abstract

Problem Immune responses were reported to be associated with the pathogenesis of endometriosis. However, previous studies of an association between allergic or autoimmune diseases and endometriosis have reported inconsistent results. We investigated the association between allergic or autoimmune diseases and the incidence of endometriosis. Method of study Using a large‐scale health insurance claims database in Japan, we identified patients with endometriosis diagnosed between April 2011 and August 2018. For each case, we identified up to four controls with the same age and registration month. Conditional logistic regression analyses were conducted to evaluate the incidence rate ratio (IRR) of endometriosis in women with allergic diseases (asthma, allergic rhinitis, urticaria, atopic dermatitis, allergic conjunctivitis, and type 1 allergies combined), systemic lupus erythematosus, and rheumatoid arthritis compared with women without these diseases. Results We identified 30 516 cases with endometriosis and 120 976 control participants. Mean age at registration was 30 years. There were significant positive associations between type 1 allergy and endometriosis (IRR, 1.10; 95% confidence interval, 1.06–1.13) and between rheumatoid arthritis and endometriosis (IRR, 1.31; 95% confidence interval, 1.05–1.64). Diagnosis of systemic lupus erythematosus was not associated with increased incidence of endometriosis. Among the different allergic diseases, allergic rhinitis, urticaria, and allergic conjunctivitis were associated with the increased incidence. Conclusion Several allergic diseases were associated with an increased incidence of endometriosis. A higher incidence was also observed in patients with rheumatoid arthritis. Further studies are warranted to elucidate the influence of immune responses on the development of endometriosis.

Identifying therapeutic candidates for endometriosis through a transcriptomics-based drug repositioning approach

“…Seven conditions were targeted by two or more of the top drugs: uveitis, allergic conjunctivitis, pneumocystosis, cardiovascular disease, schizophrenia, schizophreniform disorder, and schizoaffective disorder. Endometriosis is not classified as an autoimmune disease, but studies have found an association between endometriosis and several autoimmune diseases, including rheumatoid arthritis, 31 , 32 as well as between endometriosis and allergy conditions like allergic conjunctivitis, asthma, and rhinitis. 32 Moreover, associations between endometriosis and infections 33 , 34 as well as between endometriosis and cancers 33 , 35 , 36 , 37 have been found.…”

“…Endometriosis is not classified as an autoimmune disease, but studies have found an association between endometriosis and several autoimmune diseases, including rheumatoid arthritis, 31 , 32 as well as between endometriosis and allergy conditions like allergic conjunctivitis, asthma, and rhinitis. 32 Moreover, associations between endometriosis and infections 33 , 34 as well as between endometriosis and cancers 33 , 35 , 36 , 37 have been found. There has been increasing evidence of a relationship between endometriosis and cardiovascular disease, a condition associated with two or more of our top drug candidates, where proposed pathophysiological mechanisms shared by these two diseases include pro-inflammatory, pro-angiogenic, and aberrant immune-endocrine function.…”

“…As recent research supports, endometriosis is a systemic disorder that transcends the reproductive organs and can more broadly affect mood, metabolism, autoimmune disorders, cancer risk, and the cardiovascular system. 57 , 58 , 59 Rheumatoid arthritis, a chronic autoimmune disease characterized by joint inflammation and for which our top drug candidate fenoprofen is an FDA-approved treatment, has been found to be significantly associated with endometriosis in recent large case-control and cohort studies 32 , 60 , 61 and efforts to explore features that may be shared between these diseases and understand associations on a molecular level have been made. 62 , 63 , 64 …”

Associations between endometriosis and allergy‐related diseases as well as different specific immunoglobulin E allergy: A cross‐sectional study

“…A nested case-control study revealed that patients with allergic diseases were associated with increased incidence of endometriosis. 19 Another study indicated that increased risk of endometriosis was observed in patients with systemic lupus erythematosus. 20 Yuk et al conducted an 11-year population-based nested case-control study and found that nickel allergy was a risk factor for endometriosis.…”

“…On the other hand, immune responses were identified to be associated with the pathogenesis of endometriosis. A nested case–control study revealed that patients with allergic diseases were associated with increased incidence of endometriosis 19 . Another study indicated that increased risk of endometriosis was observed in patients with systemic lupus erythematosus 20 .…”