Association between alcohol consumption and skin prick test reactivity to aeroallergens

doi:10.1016/S1081-1206(10)60862-9

Annals of Allergy, Asthma & Immunology

Volume 98, Issue 1, January 2007, Pages 70-74

https://doi.org/10.1016/S1081-1206(10)60862-9 Get rights and content

Background

A few studies have indicated a positive association between consumption of alcohol and allergic sensitization in age and socioeconomically heterogeneous populations.

Objective

To investigate the association between consumption of alcohol and allergic sensitization in a young homogenous population of high social class (a group with a suspected high prevalence of sensitization).

Methods

A total of 1,668 students aged 18 to 35 years recruited from universities in Copenhagen, Denmark, underwent skin prick testing (SPT) in October or November 2002 and completed a questionnaire about respiratory disease and lifestyle habits, including alcohol consumption. SPT positivity was defined as a positive reaction (≥3 mm) against at least 1 of 10 common inhalant allergens.

Results

Before and after adjustment for sex, age, smoking, atopic predisposition, and pet keeping, no significant association was found between alcohol consumption (including type of beverage) and SPT positivity. Increasing alcohol consumption was significantly negatively associated with asthma symptoms and hay fever symptoms.

Conclusions

Alcohol consumption does not favor SPT positivity, but cumulated effects were not addressed in the present study. Individuals with asthma or hay fever symptoms seem to reduce alcohol intake (a healthy drinkers' effect).

Section snippets

INTRODUCTION

Alcohol consumption has been linked to an increased prevalence of IgE sensitization.1, 2, 3, 4 Increasing alcohol consumption is known to increase total IgE levels, the ethanol metabolite acetaldehyde has a direct histamine-releasing effect,⁵ and alcohol is a common trigger of exacerbations in asthmatic white patients⁶ and flushing syndrome in Asian individuals.⁵ Yet the impact of alcohol use on specific IgE synthesis is still controversial, because the available studies present contradictory

Participants

Students aged 18 to 35 years from the universities in the area of Copenhagen, Denmark, underwent SPT in October or November 2002. On location, our SPT facility was strategically situated near lecture halls or large canteens. Passers-by were asked to participate and complete a questionnaire. All participants were informed that the aim of the survey was to study the pathogenesis of allergic disorders. The local ethics committee of Copenhagen approved the study.

Skin Prick Testing

Two technicians (K.A. and a study

RESULTS

In total, 1,668 volunteering individuals (61% female) aged 18 to 35 years were enrolled in the study. Approximately 58,000 students (56% female) were attached to the universities in the Copenhagen area in 2002, but we have no relevant data on these nonattenders. Table 1 indicates that SPT positivity was positively associated with male sex, increasing age, atopic predisposition, and absent history of pet ownership (Table 1). Concerning alcohol consumption patterns, men consumed significantly

DISCUSSION

Our study suggests that alcohol consumption is not positively related to either pollen or overall SPT positivity as previously suggested.^2,³ The strengths of our study are the sample size and homogeneity. Of the comparable studies, ours presents the largest population with the narrowest span of age and social class: university students aged 18 to 35 years.¹ Half of the previous studies did not consider the impact of social differences in their conclusions^1,²; only Linneberg et al^3,⁴ adjusted

ACKNOWLEDGMENTS

We thank study nurses Anna Durst-Andersen, Birgit Sorensen, and Rita Beier for their exquisite assistance.

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Alcohol consumption is associated with numerous negative social and health outcomes. These associations may be direct consequences of drinking, or they may reflect common genetic factors that influence both alcohol consumption and other outcomes.
We performed exploratory phenome-wide association studies (PheWAS) of three of the best studied protective single nucleotide polymorphisms (SNPs) in genes encoding ethanol metabolising enzymes (ADH1B: rs1229984-T, rs2066702-A; ADH1C: rs698-T) using up to 1109 health outcomes across 28 phenotypic categories (e.g., substance-use, mental health, sleep, immune, cardiovascular, metabolic) from a diverse 23andMe cohort, including European (N ≤ 2,619,939), Latin American (N ≤ 446,646) and African American (N ≤ 146,776) populations to uncover new and perhaps unexpected associations. These SNPs have been consistently implicated by both candidate gene studies and genome-wide association studies of alcohol-related behaviours but have not been investigated in detail for other relevant phenotypes in a hypothesis-free approach in such a large cohort of multiple ancestries. To provide insight into potential causal effects of alcohol consumption on the outcomes significant in the PheWAS, we performed univariable two-sample and one-sample Mendelian randomisation (MR) analyses.
The minor allele rs1229984-T, which is protective against alcohol behaviours, showed the highest number of PheWAS associations across the three cohorts (N = 232, European; N = 29, Latin American; N = 7, African American). rs1229984-T influenced multiple domains of health. We replicated associations with alcohol-related behaviours, mental and sleep conditions, and cardio-metabolic health. We also found associations with understudied traits related to neurological (migraines, epilepsy), immune (allergies), musculoskeletal (fibromyalgia), and reproductive health (preeclampsia). MR analyses identified evidence of causal effects of alcohol consumption on liability for 35 of these outcomes in the European cohort.
Our work demonstrates that polymorphisms in genes encoding alcohol metabolising enzymes affect multiple domains of health beyond alcohol-related behaviours. Understanding the underlying mechanisms of these effects could have implications for treatments and preventative medicine.
MVJ, NCK, SBB, SSR and AAP were supported by T32IR5226 and 28IR-0070. SSR was also supported by NIDA DP1DA054394. NCK and RBC were also supported by R25MH081482. ASH was supported by funds from NIAAA K01AA030083. JLMO was supported by VA 1IK2CX002095. JLMO and JJMM were also supported by NIDA R21DA050160. JJMM was also supported by the Kavli Postdoctoral Award for Academic Diversity. EGA was supported by K01MH121659 from the NIMH/NIH, the Caroline Wiess Law Fund for Research in Molecular Medicine and the ARCO Foundation Young Teacher-Investigator Fund at Baylor College of Medicine. MSA was supported by the Instituto de Salud Carlos III and co-funded by the European Union Found: Fondo Social Europeo Plus (FSE+) (P19/01224, PI22/00464 and CP22/00128).
Update on allergies in pregnancy, lactation, and early childhood
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Citation Excerpt :
High continuous alcohol intake through a liquid diet in a mouse model was shown to have a detrimental influence on the induction of high total IgE and TH2-type cytokine levels, as well as a suppressive effect on the TH1-type antibody IgG2a.21 However, controversial studies exist also for this factor, showing that alcohol does not increase skin test reactivity in students of high social class.22 Studies explicitly performed in pregnant women are still missing.
The factors responsible for the induction of allergic disease at an early age have not been completely identified. Therefore a major research focus is their identification to elaborate recommendations for prevention of sensitization in high-risk or atopic children. This review analyzes known or suspected reasons for sensitization in pregnant women and infants from both clinical and experimental animal studies. Recent studies and meta-analyses could not confirm the protective effect of an allergen-poor diet on the part of the mother during pregnancy and lactation. Likewise, the type of bottle feeding or the introduction of solid food into the child's diet might not significantly influence the development of atopy, allergy, or asthma in the child's life. Disappointingly, the few preventive measures remaining to reduce the risk of allergic sensitization and atopic diseases in mother and child are the avoidance of smoking and alcohol consumption during pregnancy and lactation and the avoidance of the impairment of gastric function. Further studies are urgently needed to address the influence of certain foods and nutrients, as well as environmental factors, for prevention of allergic diseases in the low- or high-risk infant.
Interference of cross-reactive carbohydrates in the determination of specific IgE in alcohol drinkers and strategies to minimize it: The example of latex
2008, Annals of Allergy, Asthma and Immunology
Citation Excerpt :
Furthermore, the risk of CCD interference is higher when heterogeneous allergens are mixed in the same reagent,2 as in multiallergen sIgE tests. Of note, heavy drinkers display an increased prevalence of multiallergen sIgE test positivity,22,48 but the association between heavy drinking and skin test positivity is more controversial.49 According to our results, this discrepancy could be due to CCD interference from plant allergens contained in multiallergen sIgE tests.
Cross-reactive carbohydrate determinants (CCDs) are N-glycans in plant and invertebrate proteins that interfere with specific IgE determinations. The prevalence of IgE to Man₂XylFucGlcNAc₂ (MUXF), the CCD from bromelain, may be increased in heavy drinkers.
To further investigate the relationship of alcohol consumption to CCD specific IgE. Latex was used as an example for investigating CCD interference with in vitro allergy testing and how to minimize the interference by using nonglycosylated recombinant allergens and inhibition assays.
We determined the levels of IgE to CCD markers (MUXF and ascorbate oxidase) and natural rubber latex in 270 adults without a history of latex allergy (73 abstainers or occasional drinkers, 76 light drinkers, 47 moderate drinkers, and 74 heavy drinkers). In cases with latex reactivity, we performed inhibition assays with MUXF and screened for IgE to a panel of recombinant latex allergens. Fourteen-day serologic follow-up was available for a subset of individuals.
Moderate to heavy drinkers displayed an increased prevalence of IgE to CCD markers. The presence of CCD specific IgE was closely associated with latex IgE reactivity. Inhibition studies and the absence of reactivity to nonglycosylated recombinant latex allergens indicated CCD interference in latex IgE determinations. Serum levels of specific IgE decreased with alcohol abstention.
In this population, alcohol consumption is associated with an increased prevalence of IgE reactivity to natural rubber latex due to CCD interference. The use of nonglycosylated recombinant allergens and inhibition assays may help to minimize CCD interference in populations in which IgE to CCDs is common.
Alcohol and allergy
2008, Trastornos Adictivos
Sex difference in IgE sensitization associated with alcohol consumption in the general population
2019, Scientific Reports
Lifestyle-related factors and atopy in seven danish population-based studies from different time periods
2015, PLoS ONE

View all citing articles on Scopus

: Drs Assing and Bodtger contributed equally to this work.

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ORIGINAL ARTICLES: MECHANISMS OF ALLERGIC AND IMMUNE DISEASESAssociation between alcohol consumption and skin prick test reactivity to aeroallergens

Background

Objective

Methods

Results

Conclusions

Section snippets

INTRODUCTION

Participants

Skin Prick Testing

RESULTS

DISCUSSION

ACKNOWLEDGMENTS

J Allergy Clin Immunol

J Allergy Clin Immunol

Ann Allergy Asthma Immunol

Influence of alcohol consumption on serum immunoglobulin E levels in atopic and nonatopic adults

Alcohol Clin Exp Res

Association of alcohol consumption with total serum immunoglobulin E levels and allergic sensitization in an adult population-based survey

Clin Exp Allergy

Factors related to allergic sensitization to aeroallergens in a cross-sectional study in adults: The Copenhagen Allergy Study

Clin Exp Allergy

The relationship of alcohol consumption to total immunoglobulin E and the development of immunoglobulin E sensitization: the Copenhagen Allergy Study

Clin Exp Allergy

Alcohol, IgE and allergy

Addict Biol

Alcohol, nutrition and health maintenance: selected aspects

Proc Nutr Soc

School education and allergic sensitization in adults

Allergy

Socioeconomic status and trends in alcohol drinking in the Danish MONICA population, 1982-92

Scand J Public Health

Socioeconomic status is a risk factor for allergy in parents but not in their children

Clin Exp Allergy

ORIGINAL ARTICLES: MECHANISMS OF ALLERGIC AND IMMUNE DISEASES
Association between alcohol consumption and skin prick test reactivity to aeroallergens