Associations between allergic conditions and pediatric brain tumors in Neurofibromatosis type 1

Abstract

Background Individuals with Neurofibromatosis type 1 (NF1) are at increased risk for pediatric brain tumors (PBTs), especially optic gliomas; however, factors influencing their development are largely unknown. Extensive research suggests that allergic conditions protect against brain tumors, particularly gliomas in individuals without NF1. In this large cross-sectional study, we employed two different data sources to evaluate evidence for the hypothesis that allergic conditions (allergies, asthma, and eczema) may protect against PBT development in individuals with NF1. Methods We used self- and parent/legal guardian reported questionnaire data from participants in the NF1 Patient Registry Initiative (NPRI, n=1660) born from 1933–2014 to ascertain allergic condition and PBT diagnosis histories. Medical records (MRs) of 629 NF1 patients at a large medical center born from 1930–2012 were also reviewed for PBT and allergic condition diagnoses to evaluate additional evidence for our hypothesis. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between allergic condition diagnoses and PBTs. Results Both data sources provided limited to no support for a protective effect of allergies or eczema on PBT development. Non-significant inverse associations between asthma and PBTs were observed (NPRI: OR=0.80, 95% CI 0.55–1.17; MR: OR=0.71, 95% CI 0.40–1.28) with stronger associations for optic gliomas specifically. Additionally, a significant inverse association was observed in an NPRI subgroup analysis where the reported asthma diagnosis age was younger than the reported PBT diagnosis age (OR=0.57; 95% CI 0.36–0.89). Conclusion Our study supports the hypothesis that asthma protects against PBT development in NF1.

Optic Pathway Gliomas in Neurofibromatosis Type 1

“…Collectively, these findings indicate that the biological behavior of these tumors is heavily influenced by a myriad of factors, which each might be actionable. As such, the ability to incorporate sex and the germline NF1 gene mutation in combination with other factors, like asthma and genomic background, [77][78][79][80] into predicable risk assessment models is likely to improve our ability to manage children at risk for NF1-OPG. In addition, some of these factors may yield actionable outcomes, including new therapeutic approaches.…”

Melanoma in individuals with neurofibromatosis type 1: a retrospective study

“…A retrospective case review was conducted to identify individuals with NF1 and melanoma following approval by the Washington University Institutional Review Board spanning visits between July 1997 and July 2017. We used a previously compiled neurofibromatosis patient medical record registry [14][15] as the initial patient cohort and added additional patients seen during the expanded study period. We used a REDCap database (https://projectredcap.org/software/) to capture all study data.…”

Current status and perspectives regarding the association between allergic disorders and cancer

“…Recently, Porcelli et al in a cross‐sectional study reported that allergic disorders may protect against pediatric brain tumors (PBTs) development in individuals with Neurofibromatosis type 1. In another study, a nonsignificant inverse relationships between asthma and PBTs were reported, although this association was stronger in the younger than in the older age group 139 . Brenner et al in a multicenter hospital‐based study among adults reported a 2.4‐fold increased risk of having a history of hay fever for acoustic neuroma (95% CI: 1.4 to 4.0) 60 …”

“…In another study, a nonsignificant inverse relationships between asthma and PBTs were reported, although this association was stronger in the younger than in the older age group. 139 Brenner et al in a multicenter hospitalbased study among adults reported a 2.4-fold increased risk of having a history of hay fever for acoustic neuroma (95% CI: 1.4 to 4.0). 60 Overall, the evidence, suggests that allergic diseases appear to be associated with a lower risk of brain tumors (Tables 1 and 2).…”