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Relationship between circulating white blood cell count and inflammatory skin disease: a bidirectional mendelian randomization study

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Abstract

Observational studies have shown a strong association between circulating white blood cell counts (WBC) and inflammatory skin diseases such as acne and psoriasis. However, the causal nature of this relationship is unclear. We performed a two-way two-sample Mendelian randomization (MR) analysis to investigate potential causal relationships between leukocytes and inflammatory skin diseases. The circulating white blood cell count, basophil cell count, leukocyte cell count, lymphocyte cell count, eosinophil cell count, and neutrophil cell count data were obtained from the Blood Cell Consortium (BCX). The data for inflammatory skin disorders, including acne, atopic dermatitis (AD), hidradenitis suppurativa (HS), psoriasis, and seborrheic dermatitis (SD), were obtained from the FinnGen Consortium R10. The primary analysis utilized inverse variance weighting (IVW) along with additional methods such as MR-Egger, weighted mode, and weighted median estimator. To assess heterogeneity among instrument variables, Cochran’s Q test was employed, while MR-Egger intercept and MR-PRESSO were used to test for horizontal pleiotropy. IVW demonstrated that an elevated monocyte count was significantly associated with a decreased risk of psoriasis (OR = 0.897, 95% CI: 0.841–0.957, P = 0.001, FDR = 0.016). Additionally, an increased eosinophil count was causally associated with a higher risk of AD (OR = 1.188, 95% CI: 1.093–1.293, P = 0.000, FDR = 0.002). No inverse causal relationship between inflammatory skin disease and circulating white blood cell count was found. In conclusion, this study provides evidence that increased monocyte count is associated with a reduced risk of psoriasis and that there is a causal relationship between increased eosinophil counts and an increased risk of AD. These findings help us understand the potential causal role of specific white blood cell counts in the development of inflammatory skin diseases.

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Data availability

The circulating white blood cell count datasets mentioned in the study can be accessed at the Blood Cell Consortium’s online repository (http://www.mhi-humangenetics.org/en/resources/) or the IEU Open GWAS project (https://gwas.mrcieu.ac.uk/). For the inflammatory skin disease datasets, they can be found in the FinnGen Consortium’s repository (https://r10.finngen.fi).

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Acknowledgements

We would like to express our gratitude to all the participants and investigators involved in the Blood Cell Consortium and FinnGen studies. We also want to acknowledge the MRC Integrated Epidemiology Unit (IEU) at the University of Bristol for their invaluable contribution in developing the IEU Open GWAS Project.

Funding

Science and Technology Development Foundation of Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (Project number: 21MZ07).

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Author notes

  1. Jinyao Yuan, Yuhui Che and Qian Wang contributed equally to this work.

Authors and Affiliations

  1. Depatment of Tradition Chinese Medicine, West China Second Hospital of Sichuan University, Chengdu, China

    Jinyao Yuan & Qinwen Xiao

  2. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China

    Jinyao Yuan & Qinwen Xiao

  3. Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China

    Yuhui Che & Qian Wang

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  1. Jinyao Yuan
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Contributions

J.Y. contributed to the original draft, data curation, investigation, and methodology. Y.C. and Q.W. contributed to the original draft, methodology, and visualization. Q.X. contributed to the review and editing, conceptualization, project administration, resources, and supervision. All authors take responsibility for the content of the work and agree to be held accountable.

Corresponding author

Correspondence to Qinwen Xiao.

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Ethical approval

No further ethical approval was necessary for this study as we solely utilized publicly available summary-level data for the Mendelian randomization analysis. The original publications of each included study provide information on the ethical approval and informed consent obtained. Moreover, all detailed studies adhered to the principles outlined in the Declaration of Helsinki.

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Yuan, J., Che, Y., Wang, Q. et al. Relationship between circulating white blood cell count and inflammatory skin disease: a bidirectional mendelian randomization study. Arch Dermatol Res 316, 504 (2024). https://doi.org/10.1007/s00403-024-03241-4

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