A familial study of filaggrin mutation in atopic dermatitis

摘要

with any severity of egg allergy and that these patients can be vaccinated safely with a single dose of IIV, without requiring administration by an allergist, which otherwise poses an unnecessary barrier to immunization and is not justified based on available safety data.Two new influenza vaccines not grown in eggs have been approved for patients 18 years and older; Flucelvax,6 prepared from virus propagated in cell culture, and Flublok,7 recombinant hemagglutinin proteins produced in an insect cell line.Filaggrin is an epidermal structural protein critical for the development of a functional skin barrier. People who have null mutations in the FLG gene are at increased susceptibility of atopic dermatitis (AD), peanut allergy, and asthma associated with AD.1-4 AD has a high familial occurrence evidenced by concordance rates of 0.72 to 0.77 in monozygotic and 0.15 to 0.23 in dizygotic twin pairs.5 These studies were primarily carried out in Northern Europe, particularly in large cohorts in Ireland, where there is a high prevalence of FLG mutations in AD.The identification of a genetic defect as a key event in the path-ophysiology of AD and allergic sensitization has brought up many clinical questions among sufferers. On reading "Filaggrin Mutations Associated with Skin and Allergic Diseases" by Irvine, McLean, and Leung, published in 2011 The New England Journal of Medicine, a 91-year-old physician who suffered from lifelong atopic disease contacted the authors to determine whether FIG mutation could predict which of his 4 generations of family members were prone to AD or asthma and whether any environmental factors increased or decreased the risk of developing disease. Only early life cat exposure and exposure to other children have shown an additional interactive risk of AD in patients with FLG mutation.These studies were birth cohort studies, and no family pedigree study has been used to study gene-environment interactions for FLG mutation.