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The Association between Allergy and Rheumatoid Arthritis in the Canadian Population



Antagonism between Th1 and Th2 lymphocyte mediated responses has been proposed to explain the observed 20th Century population increase in Th2 mediated allergic disease and reciprocal decrease in infectious disease, which stimulates a Th1 mediated response.


To determine if Th1/Th2 antagonism would be consistent with associations between non-infectious diseases, we tested the hypothesis that the population prevalence of Th2 mediated allergies is inversely related to the prevalence of Th1 mediated rheumatoid arthritis.


The analysis was based on data from the Canadian Community Health Survey conducted by Statistics Canada in 2000–2001 of those at least 12 years of age from 125,129 households. Each subject was asked if he or she had certain chronic health conditions that had been diagnosed by a health professional. Logistic regression models were used to evaluate the association between rheumatoid arthritis and allergies with consideration of other important variables.


Allergy history was positively related to the prevalence of rheumatoid arthritis both in women (adjusted odds ratio (OR): 1.57, 95% CI: 1.43, 1.73) and in men (adjusted OR: 1.55, 95% CI: 1.36, 1.77).


The reported population prevalences of allergies and rheumatoid arthritis were positively associated and not explained by Th1/Th2 anatagonism suggesting that this mechanism may only be applicable to the association between an infectious and an immunologic disease. Mechanisms accounting for positive associations between immunologic diseases deserve further study.

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TH cells:

T-helper cells


CD4 Lymphocyte T-helper cell


Canadian Community Health Survey


confidence intervals




  1. 1.

    Statistics Canada. CCHS Cycle 1.1 (2000–2001), Public Use Microdata File Documentation, 2002. Ottawa, Ontario, Canada.

  2. 2.

    Y Chen R Dales D Krewski K Breithaupt ( 1999) ArticleTitleIncreased effects of smoking and obesity on asthma among female Canadians: The National Population Health Survey, 1994–1995 Am J Epidemiol 150 255–262 Occurrence Handle10430229

    PubMed  Google Scholar 

  3. 3.

    GT Henry (1990) Practical Sampling. Applied Social Research Methods Series Sage Publications Newbury Park

    Google Scholar 

  4. 4.

    CJ Skinner D Holt TMF Smith (1989) Analysis of Complex Surveys John Wiley & Sons Ltd New York, NY

    Google Scholar 

  5. 5.

    JNK Rao CFJ Wu (1988) ArticleTitleResampling inference with complex survey data J Am Statist Assoc 83 231–241

    Google Scholar 

  6. 6.

    JNK Rao CFJ Wu K Yue (1992) ArticleTitleSome recent work on resampling for complex surveys Surv Methodol 18 209–217

    Google Scholar 

  7. 7.

    SAS Institute I. SAS/ETS Software: Changes and Enhancements. Cary, NC: SAS Institute, 2001.

  8. 8.

    Felson DT. Epidemiology of the rheumatic diseases. In: Koopman WJ (ed.), Arthritis and Allied Conditions. Philadelphia: Lippincott William and Wilkins, 2001: 3–38.

  9. 9.

    J Kero M Gissler E Hemminki E Isolauri (2001) ArticleTitleCould TH1 and TH2 diseases coexist? Evaluation of asthma incidence in children with coelica disease, type 1 diabetes, or rheumatoid arthritis: A registered study J Allergy Clin Immunol 108 IssueID5 781–784 Occurrence Handle10.1067/mai.2001.119557 Occurrence Handle11692104

    Article  PubMed  Google Scholar 

  10. 10.

    CR Simpson WJA Anderson PJ Helms et al. (2002) ArticleTitleCoincidence of immune-mediated diseases driven by Th1 and Th2 subsets suggests a common aetiology. A population-based study using computerized General data Clin Exp Allergy 32 37–42 Occurrence Handle10.1046/j.0022-0477.2001.01250.x Occurrence Handle12002734

    Article  PubMed  Google Scholar 

  11. 11.

    A Sheikh L Smeeth R Hubbard (2003) ArticleTitleThere is no evidence of an inverse relationship between TH2-mediated atopy and TH1-mediated autoimmune disorders: Lack of support for the hygiene hypothesis J Allergy Clin Immunol 111 IssueID1 131–135 Occurrence Handle10.1067/mai.2003.8 Occurrence Handle12532108

    Article  PubMed  Google Scholar 

  12. 12.

    BR O’Driscoll HJ Milburn DM Kemeny GM Cochrane GS Panayi (1985) ArticleTitleAtopy and rheumatoid arthritis Clin Allergy 15 IssueID6 547–553 Occurrence Handle3907887

    PubMed  Google Scholar 

  13. 13.

    Y Allanore P Hilliquin J Coste M Renoux CJ Menkes (1998) ArticleTitleDecreased prevalence of atopy in rheumatoid arthritis Lancet 351 497 Occurrence Handle10.1016/S0140-6736(05)78684-0

    Article  Google Scholar 

  14. 14.

    CM Verhoef JA Room Particlevan ME Vianen CA Bruijnzeel-Koomen FP Lafeber JW Bijlsma (1998) ArticleTitleMutual antagonism of rheumatoid arthritis and hay fever; a role for type 1/type 2 T cell balance Ann Rheum Dis 57 IssueID5 275–280 Occurrence Handle9741310

    PubMed  Google Scholar 

  15. 15.

    A Reckner Olsson T Skogh G Wingren (2001) ArticleTitleComorbidity and lifestyle, reproductive factors, and environmental exposures associated with rheumatoid arthritis Ann Rheum Dis 60 IssueID10 934–939 Occurrence Handle10.1136/ard.60.10.934 Occurrence Handle11557649

    Article  PubMed  Google Scholar 

  16. 16.

    M Rudwaleit B Andermann R Alten et al. (2002) ArticleTitleAtopic disorders in ankylosing spondylitis and rheumatoid arthritis Ann Rheum Dis 61 IssueID11 968–974 Occurrence Handle10.1136/ard.61.11.968 Occurrence Handle12379517

    Article  PubMed  Google Scholar 

  17. 17.

    E Krishnan K Murtagh B Bruce D Cline G Singh JF Fries (2004) ArticleTitleAttrition bias in rheumatoid arthritis databanks: a case study of 6346 patients in 11 databanks and 65,649 administrations of the Health Assessment Questionnaire J Rheumatol 31 IssueID7 1320–1326 Occurrence Handle15229950

    PubMed  Google Scholar 

  18. 18.

    S Akar M Birlik O Gurler et al. (2004) ArticleTitleThe prevalence of rheumatoid arthritis in an urban population of Izmir-Turkey Clin Exp Rheumatol 22 IssueID4 416–420 Occurrence Handle15301237

    PubMed  Google Scholar 

  19. 19.

    JF Bach (2002) ArticleTitleThe effect of infections on susceptibility to autoimmune and allergic diseases NEJM 347 IssueID12 911–920 Occurrence Handle10.1056/NEJMra020100 Occurrence Handle12239261

    Article  PubMed  Google Scholar 

  20. 20.

    DP Strachan (1989) ArticleTitleHay fever, hygiene, and household size Br Med J 299 1259–1260

    Google Scholar 

  21. 21.

    Martinez FD, Holt PG. Role of microbial burden in aetiology of allergy and asthma Lancet 1999; 354(SII12-5).

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Correspondence to Robert Dales.

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Karsh, J., Chen, Y., Lin, M. et al. The Association between Allergy and Rheumatoid Arthritis in the Canadian Population. Eur J Epidemiol 20, 783–787 (2005).

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  • Allergy
  • Epidemiology
  • Rheumatoid arthritis
  • Th1/Th2 paradigm