The potential for malignancy from atopic disorders and allergic inflammation: A systematic review and meta‐analysis

Abstract

Objective: While chronic inflammation is a well-established risk factor for malignancy, studies evaluating the relationship between allergic inflammation and cancer have revealed conflicting results. Here, we aimed to assess the association between allergic inflammation in the lung (asthma), skin (eczema) or oesophagus (eosinophilic oesophagitis; EoE) and cancer at the organ site. Design:We conducted a systematic review of the literature to identify observational studies (case-control, cohort and cross-sectional) evaluating the association between asthma and lung cancer, eczema and skin cancer, or EoE and oesophageal cancer.Random-effects meta-analysis was performed to define pooled estimates of effects. Data sources: PubMed, EMBASE and Web of Science.Eligibility criteria for selection: Included studies evaluated the incidence of cancer. Results:Thirty-two studies met the inclusion criteria, 27 in the lung, four in the skin and one in the oesophagus. Meta-analysis of the three studies with prospective data collection of asthma diagnosis revealed a positive association with incident lung cancer (OR 1.27, 95% CI 1.09-1.44); however, this result was not consistently supported by the larger dataset of retrospective studies (OR 1.37, 95% CI 0.90-1.83). Overall, studies in the lung displayed significant heterogeneity (I 2 98%, P < .0001), but no significant effect modification on the association between asthma and lung cancer was identified for the variables of sex, smoking or study design. Meta-analysis could not be applied to the four papers reviewed in the skin, but three suggested an association between eczema and non-melanoma skin cancer, while the remaining study failed to identify an association between melanoma and eczema. A single study meeting inclusion criteria showed no association between EoE and oesophageal malignancy. Conclusions:The current data cannot exclude the possibility of an association between atopy and malignancy the lung, skin and oesophagus. The relationship between allergy and cancer should be explored further in prospective studies that any association identified between these conditions has the potential for significant public health implications.

Tumor Suppressors—HTRA Proteases and Interleukin-12—in Pediatric Asthma and Allergic Rhinitis Patients

“…The main finding of this study is that the levels of tumor suppressors, the apoptotic regulators of HTRA family and of interleukin 12 known to inhibit tumorigenesis and induce regression of established tumors, were importantly higher in children with IgE-dependent allergy. It correlates with the general clinical observation that atopic patients are less prone to develop certain types of neoplasms [ 4 ]. These results were found interesting since the HTRA protein levels and anti-HTRA antibodies in mast cell–related disorders were analyzed in our earlier study concerning pediatric patients with cutaneous mastocytosis (CM), a disease due to abnormal accumulation of MCs [ 30 ].…”

“…On the other hand, asthma appeared to be a risk factor for lung cancer [ 3 ]. A positive association between asthma and lung cancer was also found in a group of studies analyzed by Muir et al [ 4 ], however, such association was not observed in another data set [ 4 ]. Many studies also indicated the increased risk of breast cancer in patients with AR and atopic dermatitis [ 5 ].…”

“…The influence of allergic reactions on carcinogenesis has become an important scientific issue. The link between allergies, tolerance and cancer risk is deeply analyzed to find some new solutions in preventing or even treating neoplastic diseases [ 1 , 2 , 3 , 4 ]. There are four main allergy types according to Gell–Coombs classification.…”

“…Both allergies belong to a group of mast cell-related diseases mediated by IgE and are connected with a not well described cytokine imbalance which over the long-term might influence the processes of oncogenesis. Associations between allergies and cancer have been analyzed in recent reviews of the relevant quantitative studies [ 3 , 4 ]. Cui and Hill (2016) reported that in most studies an inverse association between atopy and non-Hodgkin lymphoma or colorectal cancer was found [ 3 ].…”

Antitumor, Anti-inflammatory and Antiallergic Effects of Agaricus blazei Mushroom Extract and the Related Medicinal Basidiomycetes Mushrooms, Hericium erinaceus and Grifola frondosa: A Review of Preclinical and Clinical Studies

“…Moreover, since allergy and asthma can be regarded as topic inflammation induced by different allergens, e.g., in the eyes and nose for pollen, in the throat or skin for food components, and in the lungs for inhalants, these atopic conditions could also predispose for cancer. In fact, a recent meta-analysis could not rule out a possible association between atopy and malignancy of lung, skin and oesophagus [30]. The hygiene hypothesis has also established a link between protection by early presence of bacterial and parasitic infections against allergy and asthma development in childhood [31].…”