Increased rate of positive penicillin skin tests among patients with glioma: insights into the association between allergies and glioma risk

Clinical article

Sheng Han M.D., Ph.D., Yanming Huang M.S., Zixun Wang M.S., Zhonghua Li M.D., Xiaofei Qin M.D., Ph.D., and Anhua Wu M.D., Ph.D.
View More View Less
  • Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

Object

Allergy and immunoglobulin E levels are inversely associated with glioma risk. Previous studies have focused on respiratory and food allergies, and little information is available regarding drug allergies. This study evaluated the rate of positive penicillin skin tests (PenSTs) and blood eosinophil counts in a large population of patients with glioma compared with nontumor controls to provide evidence for the relationship between drug allergies and glioma risk.

Methods

A retrospective case-control study was conducted in patients diagnosed with glioma (n = 913) between January 2004 and June 2013. The study patients were matched with nontumor controls (n = 1091) for age, sex, and date of admission to the hospital. Preoperative results of the PenST and eosinophil counts were obtained, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using conditional logistic regression models, while a Kaplan-Meier analysis was used to assess overall survival.

Results

The percentage of positive PenSTs was higher among patients with glioma than in control subjects. The age-, sex-, and admission date–adjusted OR for positive versus negative PenSTs was 2.392 (95% CI 1.891–3.026). Eosinophil counts were also higher in glioma cases than in controls: the OR for eosinophil > 0.06 × 109/L versus ≤ 0.06 × 109/L was 1.923 (95% CI 1.608–2.301). There was no association between positive PenST/eosinophil counts and glioma grade or patient survival (n = 105).

Conclusions

In contrast to previously reported relationships between allergy and glioma, in the present study a significantly higher rate of positive PenSTs and higher eosinophil counts were found in patients with glioma than in nontumor controls. These results suggest a complex relationship between allergies and glioma development.

Abbreviations used in this paper:AVM = arteriovenous malformation; CI = confidence interval; OR = odds ratio; PenST = penicillin skin test.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address correspondence to: Anhua Wu, M.D., Ph.D., Department of Neurosurgery, The First Hospital of China Medical University, Nanjing St. 155, Heping District, Shenyang 110001, China. email: cmuwuanhua@aliyun.com.

Please include this information when citing this paper: published online August 29, 2014; DOI: 10.3171/2014.7.JNS1412.

  • 1

    Allan SE, , Broady R, , Gregori S, , Himmel ME, , Locke N, & Roncarolo MG, : CD4+ T-regulatory cells: toward therapy for human diseases. Immunol Rev 223:391421, 2008

    • Search Google Scholar
    • Export Citation
  • 2

    Avril T, , Vauleon E, , Tanguy-Royer S, , Mosser J, & Quillien V: Mechanisms of immunomodulation in human glioblastoma. Immunotherapy 3:4 Suppl 4244, 2011

    • Search Google Scholar
    • Export Citation
  • 3

    Black MH, , Smith N, , Porter AH, , Jacobsen SJ, & Koebnick C: Higher prevalence of obesity among children with asthma. Obesity (Silver Spring) 20:10411047, 2012

    • Search Google Scholar
    • Export Citation
  • 4

    Brooks WH, , Caldwell HD, & Mortara RH: Immune responses in patients with gliomas. Surg Neurol 2:419423, 1974

  • 5

    Buckner JC, , Brown PD, , O'Neill BP, , Meyer FB, , Wetmore CJ, & Uhm JH: Central nervous system tumors. Mayo Clin Proc 82:12711286, 2007

  • 6

    Calboli FC, , Cox DG, , Buring JE, , Gaziano JM, , Ma J, & Stampfer M, : Prediagnostic plasma IgE levels and risk of adult glioma in four prospective cohort studies. J Natl Cancer Inst 103:15881595, 2011

    • Search Google Scholar
    • Export Citation
  • 7

    Carey OJ, , Cookson JB, , Britton J, & Tattersfield AE: The effect of lifestyle on wheeze, atopy, and bronchial hyperreactivity in Asian and white children. Am J Respir Crit Care Med 154:537540, 1996

    • Search Google Scholar
    • Export Citation
  • 8

    Curran CS, & Bertics PJ: Eosinophils in glioblastoma biology. J Neuroinflammation 9:11, 2012

  • 9

    Curran CS, , Evans MD, & Bertics PJ: GM-CSF production by glioblastoma cells has a functional role in eosinophil survival, activation, and growth factor production for enhanced tumor cell proliferation. J Immunol 187:12541263, 2011

    • Search Google Scholar
    • Export Citation
  • 10

    Dix AR, , Brooks WH, , Roszman TL, & Morford LA: Immune defects observed in patients with primary malignant brain tumors. J Neuroimmunol 100:216232, 1999

    • Search Google Scholar
    • Export Citation
  • 11

    Ellinghaus D, , Baurecht H, , Esparza-Gordillo J, , Rodríguez E, , Matanovic A, & Marenholz I, : High-density genotyping study identifies four new susceptibility loci for atopic dermatitis. Nat Genet 45:808812, 2013

    • Search Google Scholar
    • Export Citation
  • 12

    Gupta RS, , Springston EE, , Warrier MR, , Smith B, , Kumar R, & Pongracic J, : The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics 128:e9e17, 2011

    • Search Google Scholar
    • Export Citation
  • 13

    Hagströmer L, , Ye W, , Nyrén O, & Emtestam L: Incidence of cancer among patients with atopic dermatitis. Arch Dermatol 141:11231127, 2005

    • Search Google Scholar
    • Export Citation
  • 14

    Han S, , Xia J, , Qin X, , Han S, & Wu A: Phosphorylated SATB1 is associated with the progression and prognosis of glioma. Cell Death Dis 4:e901, 2013

    • Search Google Scholar
    • Export Citation
  • 15

    Hardie GE, , Brown JK, & Gold WM: Bronchial hyperresponsiveness, word descriptors, and ethnicity: women with mild asthma. J Asthma 49:3644, 2012

    • Search Google Scholar
    • Export Citation
  • 16

    Hirano SA, , Murray SB, & Harvey VM: Reporting, representation, and subgroup analysis of race and ethnicity in published clinical trials of atopic dermatitis in the United States between 2000 and 2009. Pediatr Dermatol 29:749755, 2012

    • Search Google Scholar
    • Export Citation
  • 17

    Hjortlund J, , Mortz CG, , Skov PS, & Bindslev-Jensen C: Diagnosis of penicillin allergy revisited: the value of case history, skin testing, specific IgE and prolonged challenge. Allergy 68:10571064, 2013

    • Search Google Scholar
    • Export Citation
  • 18

    Horii KA, , Simon SD, , Liu DY, & Sharma V: Atopic dermatitis in children in the United States, 1997–2004: visit trends, patient and provider characteristics, and prescribing patterns. Pediatrics 120:e527e534, 2007

    • Search Google Scholar
    • Export Citation
  • 19

    Il'yasova D, , McCarthy B, , Marcello J, , Schildkraut JM, , Moorman PG, & Krishnamachari B, : Association between glioma and history of allergies, asthma, and eczema: a case-control study with three groups of controls. Cancer Epidemiol Biomarkers Prev 18:12321238, 2009

    • Search Google Scholar
    • Export Citation
  • 20

    Lee-Wong M, , Chou V, & Silverberg JI: A study of IgE sensitization and skin response to histamine in Asian-Pacific American adults. Allergy Asthma Proc 33:341347, 2012

    • Search Google Scholar
    • Export Citation
  • 21

    Li JJ, , Dickson D, , Hof PR, & Vlassara H: Receptors for advanced glycosylation endproducts in human brain: role in brain homeostasis. Mol Med 4:4660, 1998

    • Search Google Scholar
    • Export Citation
  • 22

    Linos E, , Raine T, , Alonso A, & Michaud D: Atopy and risk of brain tumors: a meta-analysis. J Natl Cancer Inst 99:15441550, 2007

  • 23

    Macy E, , Schatz M, , Lin C, & Poon KY: The falling rate of positive penicillin skin tests from 1995 to 2007. Perm J 13:1218, 2009

  • 24

    Mar A, , Tam M, , Jolley D, & Marks R: The cumulative incidence of atopic dermatitis in the first 12 months among Chinese, Vietnamese, and Caucasian infants born in Melbourne, Australia. J Am Acad Dermatol 40:597602, 1999

    • Search Google Scholar
    • Export Citation
  • 25

    Mathur SK, , Fichtinger PS, , Kelly JT, , Lee WM, , Gern JE, & Jarjour NN: Interaction between allergy and innate immunity: model for eosinophil regulation of epithelial cell interferon expression. Ann Allergy Asthma Immunol 111:2531, 2013

    • Search Google Scholar
    • Export Citation
  • 26

    Mossman BT: Introduction to serial reviews on the role of reactive oxygen and nitrogen species (ROS/RNS) in lung injury and diseases. Free Radic Biol Med 34:11151116, 2003

    • Search Google Scholar
    • Export Citation
  • 27

    Mueller MM, , Herold-Mende CC, , Riede D, , Lange M, , Steiner HH, & Fusenig NE: Autocrine growth regulation by granulocyte colony-stimulating factor and granulocyte macrophage colony-stimulating factor in human gliomas with tumor progression. Am J Pathol 155:15571567, 1999

    • Search Google Scholar
    • Export Citation
  • 28

    Prussin C, & Metcalfe DD: 4. IgE, mast cells, basophils, and eosinophils. J Allergy Clin Immunol 111:2 Suppl S486S494, 2003

  • 29

    Sato R: [The role of beta 2-adrenoceptor gene polymorphisms in asthma]. Hokkaido Igaku Zasshi 75:8194, 2000. (Jpn)

  • 30

    Schoemaker MJ, , Swerdlow AJ, , Hepworth SJ, , McKinney PA, , van Tongeren M, & Muir KR: History of allergies and risk of glioma in adults. Int J Cancer 119:21652172, 2006

    • Search Google Scholar
    • Export Citation
  • 31

    Schwartzbaum J, , Ding B, , Johannesen TB, , Osnes LT, , Karavodin L, & Ahlbom A, : Association between prediagnostic IgE levels and risk of glioma. J Natl Cancer Inst 104:12511259, 2012

    • Search Google Scholar
    • Export Citation
  • 32

    Song GG, , Kim JH, & Lee YH: Association between ADAM33 S2 and ST+4 polymorphisms and susceptibility to asthma: a meta-analysis. Gene 524:7278, 2013

    • Search Google Scholar
    • Export Citation
  • 33

    van den Berge M, , ten Hacken NH, , van der Wiel E, & Postma DS: Treatment of the bronchial tree from beginning to end: targeting small airway inflammation in asthma. Allergy 68:1626, 2013

    • Search Google Scholar
    • Export Citation
  • 34

    Walker PR, , Calzascia T, & Dietrich PY: All in the head: obstacles for immune rejection of brain tumours. Immunology 107:2838, 2002

  • 35

    Wiemels JL, , Wiencke JK, , Patoka J, , Moghadassi M, , Chew T, & McMillan A, : Reduced immunoglobulin E and allergy among adults with glioma compared with controls. Cancer Res 64:84688473, 2004

    • Search Google Scholar
    • Export Citation
  • 36

    Wiemels JL, , Wiencke JK, , Sison JD, , Miike R, , McMillan A, & Wrensch M: History of allergies among adults with glioma and controls. Int J Cancer 98:609615, 2002

    • Search Google Scholar
    • Export Citation
  • 37

    Wiemels JL, , Wilson D, , Patil C, , Patoka J, , McCoy L, & Rice T, : IgE, allergy, and risk of glioma: update from the San Francisco Bay Area Adult Glioma Study in the temozolomide era. Int J Cancer 125:680687, 2009

    • Search Google Scholar
    • Export Citation
  • 38

    Yamaguchi T, , Kimura H, , Kurabayashi M, , Kozawa K, & Kato M: Interferon-gamma enhances human eosinophil effector functions induced by granulocyte-macrophage colony-stimulating factor or interleukin-5. Immunol Lett 118:8895, 2008

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 151 86 2
Full Text Views 266 6 1
PDF Downloads 197 6 0
EPUB Downloads 0 0 0