Filaggrin mutations, atopic eczema, hay fever, and asthma in children

Stephan Weidinger, Maureen O'Sullivan, Thomas Illig, Hansjoerg Baurecht, Martin Depner, Elke Rodriguez, Andreas Ruether, Norman Klopp, Christian Vogelberg, Stephan K. Weiland, W. H. Irwin McLean, Erika Von Mutius, Alan D. Irvine, Michael Kabesch

    Research output: Contribution to journalArticlepeer-review

    346 Citations (Scopus)


    Background: Mutations in the filaggrin gene (FLG) have been shown to play a significant role in ichthyosis vulgaris and eczema, 2 common chronic skin diseases. However, their role in the development of other atopic diseases such as asthma and rhinitis has not yet been clarified in large population-based studies.

    Objectives: To study the effect of FLG mutations at the population level and their effect on other atopic phenotypes.

    Methods: Association analysis of the 2 common FLG-null mutations R501X and 2282del4 and 3 recently identified rare FLG variants (R2447X, S3247X, 3702delG) was performed on our cross-sectional population of German children (n = 3099) recruited as part of the International Study of Asthma and Allergies in Childhood 11 in Munich (n = 1159) and Dresden (n = 1940).

    Results: FLG variants increased the risk for eczema more than 3-fold (odds ratio [OR], 3.12; 95% CI, 2.33-4.173; P = 2.5 X 10(-14); population-attributable risk, 13.5%). Independent of eczema, FLG mutations conferred a substantial risk for allergic rhinitis (OR, 2.64; 95% CI, 1.76-4.00; P = 2.5 X 10(-6); population-attributable risk, 10.8%). Nasal biopsies demonstrated strong filaggrin expression in the cornified epithelium of the nasal vestibular lining, but not the transitional and respiratory nasal epithelia. In contrast, the association with asthma (OR, 1.79; 95% CI, 1.19-2.68; P =.0048) was restricted to asthma occurring in the context of eczema, and there was a strong association with the complex phenotype eczema plus asthma (OR, 3.49; 95% CI, 2.00-6.08; P = 1.0 X 10(-5)).

    Conclusion: Our results suggest that FLG mutations are key organ specific factors predominantly affecting the development of eczema and confer significant risks of allergic sensitization and allergic rhinitis as well as asthma in the context of eczema.

    Original languageEnglish
    Pages (from-to)1203-1209
    Number of pages7
    JournalJournal of Allergy and Clinical Immunology
    Issue number5
    Publication statusPublished - May 2008


    • atopic eczema
    • rhinitis
    • asthma
    • filaggrin
    • children
    • GENE
    • SKIN


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