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Asthma and atopic dermatitis may increase the risk of developing osteoarthritis

A collage of a woman with itchy skin and a man using an asthma inhaler
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  • Osteoarthritis is a chronic condition that can lead to pain, mobility difficulties, and diminished quality of life. 
  • Researchers are still working to understand what factors may increase someone’s risk of developing osteoarthritis. 
  • Data from a recent study suggests that people with asthma and atopic dermatitis may be at a higher risk for developing osteoarthritis. 

Osteoarthritis is an inflammatory condition that impacts people’s joints and mobility.

Treatment often focuses on symptom management, but researchers are still working to fully understand the condition and potential preventative measures. 

A​ recent study published in Annals of the Rheumatic Diseases looked at how osteoarthritis may be related to asthma or atopic dermatitis (commonly known as eczema). These conditions are forms of atopic disease.

Researchers said they found that people with atopic dermatitis or asthma may be at a higher risk for developing osteoarthritis.

They said further understanding of the allergic pathways involved could help prevent and treat osteoarthritis. 

The impact of osteoarthritis

Osteoarthritis Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source  is a disorder that impacts the joints. People with osteoarthritis can have different joints affected, such as their knees or hips.

They can experience various symptoms, including stiffness, pain, and limited mobility. 

Dr. Elizabeth Park, MSc, a rheumatology expert with the Columbia University Irving Medical Center in New York who was not involved in the study, explained to Medical News Today:

“Osteoarthritis is a degenerative arthritis primarily affecting weight-bearing joints, most commonly hips and knees. It is the major cause of disability worldwide and leads to joint replacements. Why [osteoarthritis] occurs is poorly understood. It is thought to involve destruction of the cartilage (the lining of the joints), synovium (the lining surrounding the joint cavity), as well as detrimental internal bone structural changes.”

Treatment for osteoarthritis Trusted Source National Institute of Arthritis and Musculoskeletal and Skin Diseases Governmental authority Go to source  often focuses on symptom management.

People can do certain exercises to help maintain their range of motion and strengthen their surrounding muscles. Certain medications can help with pain relief. In more severe situations, people with osteoarthritis may require surgical intervention. 

The authors of the current study note that treatment for osteoarthritis is often limited. More understanding of why some people develop osteoarthritis could be helpful. 

A​topic disease and an increased risk for osteoarthritis

T​his particular study was a retrospective cohort study.

The authors wanted to conduct further research into how certain allergic pathways are involved in people developing osteoarthritis.

They noted that previous research has found that activation of mast cells may be critical in developing osteoarthritis. Mast cells are involved in allergic reactions. 

Park noted the following: 

“The premise of this study is very interesting. It started from several laboratory based studies which demonstrated that mast cells – big regulator cells of allergic responses in diseases like asthma and atopic dermatitis – were noted to be present in the synovium of people with OA [osteoarthritis].”

The study authors wanted to see if people with certain conditions such as asthma and atopic dermatitis were more likely to develop osteoarthritis. 

Researchers used data from the Clinformatics Data Mart database. They compared a group of 117,346 exposed individuals to a control group of 1,247,196 participants. The exposed individuals had asthma, atopic dermatitis, or both. 

Researchers reported that people with asthma or atopic dermatitis were more likely to develop osteoarthritis. In the nationwide insurance claims data set, they found people with atopic dermatitis or asthma were 58% more likely to develop osteoarthritis.

When researchers looked at another dataset and adjusted for co-variables, the participants with these conditions were 42% more likely to develop osteoarthritis. 

In one cohort, the researchers found the highest risk for developing osteoarthritis was among participants with asthma and atopic dermatitis. Participants with both conditions had a 115% increased risk for osteoarthritis.

Dr. Matthew Baker, a study author and the clinical chief of the Division of Immunology and Rheumatology at Stanford University in California, noted to Medical News Today

“The main takeaway of our study is that we found an association between having allergic diseases such as asthma and atopic dermatitis and having an increased risk of developing osteoarthritis. Before this study, our group has done work showing that mast cells (a type of allergic cell) are increased in numbers in the joints of people with osteoarthritis, and their activity contributes to the development of osteoarthritis. Our current study provides epidemiological support for this observation.”

Baker also offered further speculation into why they found this strong association between atopic diseases and osteoarthritis:

“We believe that mast cells are critical contributors to [osteoarthritis], and people with allergic disease likely have either 1.) increased numbers and/or 2.) increased activity of mast cells in the joint, leading to an increased incidence of OA.” 

Study limitations and continued research

The study had a few key limitations.

First, this study cannot prove that having atopic dermatitis or asthma causes osteoarthritis. Like other types of observational studies, retrospective cohort studies can only suggest an association between certain factors and an outcome.

Second, researchers acknowledged that there is still the risk of confounding factors, even though they were able to account for several covariates. 

Some data, such as participants’ body mass index, was also unavailable because of the data collection methods. There was the potential for certain biases, the possibility of missing certain diagnoses of osteoarthritis, and a limited ability to generalize the findings.

The researchers also did not have information on how severe people’s atopic disease or osteoarthritis was. Certain over-the-counter treatments such as NSAIDs could account for some of the results.

It’s also possible that the data is more accurate for when participants developed symptomatic osteoarthritis rather than when the osteoarthritis truly started.

Finally, researchers note that the results could be because of the medications people used to treat their atopic disease rather than the atopic disease directly. 

The data from this study could lead to further investigation into the potential treatment and prevention of osteoarthritis. Baker explained: 

“We are hopeful that in the future this observation will lead to interventional studies to investigate whether inhibition of allergic pathways may be beneficial in preventing or treating osteoarthritis.”

This article originally appeared on Medical News Today.

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