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. 2023 Jan 26:14:1071616.
doi: 10.3389/fimmu.2023.1071616. eCollection 2023.

Causal association between inflammatory bowel disease and hidradenitis suppurativa: A two-sample bidirectional Mendelian randomization study

Bingzhou Bao  1 , Chao Zhu  2 , Jian Shi  1 , Canxing Lu  1
Affiliations

Causal association between inflammatory bowel disease and hidradenitis suppurativa: A two-sample bidirectional Mendelian randomization study

Bingzhou Bao et al. Front Immunol. .

Abstract

Background: Epidemiological studies have revealed a link between inflammatory bowel disease (IBD) and hidradenitis suppurativa (HS). To determine whether IBD and HS are causally related, we used the Mendelian randomization (MR) approach.

Methods: A two-sample MR was performed using an analysis of 12,882 patients and 21,770 controls with IBD and its main subtypes, ulcerative colitis (UC) and Crohn's disease (CD). A total of 409 cases and 211,139 controls without hidradenitis suppurativa (HS) were included in the data for this condition from various GWAS investigations. Odds ratios (ORs) with 95% confidence intervals (CIs) are used to estimate causal effects.

Results: The study assessed the causal relationship between HS and IBD in both directions. The risk of HS was increased by IBD (IVW OR = 1.34, 95% CI = 1.20-1.49, p = 2.15E-07) and, in addition, HS was affected by UC (IVW OR = 1.27, 95% CI = 1.13-1.43, p = 8.97E-04) and CD (IVW OR = 1.18, 95% CI = 1.08-1.29, p = 4.15E-04). However, there was no evidence of a causal relationship between HS and IBD or its subtypes (IBD IVW OR = 1.00, 95% CI = 0.96-1.05, p = 0.85; UC IVW OR = 0.99, 95% CI = 0.95-1.03, p = 0.65; CD IVW OR = 1.03, 95% CI = 0.98- 1.07, p = 0.28).

Conclusion: This study demonstrates that IBD and its subtypes have a causal effect on HS, whereas HS does not affect IBD. Gut-skin axis interactions may help to understand this association. Nevertheless, further studies are needed to clarify the pathophysiology of the causal relationship between IBD and HS.

Keywords: Crohn’s disease; Mendelian randomization; hidradenitis suppurativa; inflammatory bowel disease; ulcerative colitis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Diagram of critical assumptions for MR analysis. The solid line indicates that genetic instruments (SNPs) are related to exposure and can only affect the results through exposure. The dashed line indicates genetic instruments (SNPs) independent of any confounding variables between the results. IBD, inflammatory bowel disease; UC, ulcerative colitis; CD, Crohn’s disease; HS, hidradenitis suppurativa.
Figure 2
Figure 2
Scatter plot of the MR analysis. The slope of each line corresponds to the MR effect estimated by the IVW model. (A) IBD on HS; (B) UC on HS; (C) CD on HS; (D) HS on IBD; (E) HS on UC; (F) HS on CD.
Figure 3
Figure 3
For the effects of inflammatory bowel disease, ulcerative colitis, and Crohn’s disease on hidradenitis suppurativa, causal estimates are given as odds ratio (OR) and 95% confidence interval (CI). IBD, inflammatory bowel disease; UC, ulcerative colitis; CD, Crohn’s disease; HS, hidradenitis suppurativa.
Figure 4
Figure 4
For the effect of hidradenitis suppurativa on inflammatory bowel disease, ulcerative colitis and Crohn’s disease, causal estimates are given as odds ratio (OR) and 95% confidence interval (CI). IBD, inflammatory bowel disease; UC, ulcerative colitis; CD, Crohn’s disease; HS, hidradenitis suppurativa.
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