{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T08:43:36Z","timestamp":1782809016806,"version":"3.54.5"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"Janssen Corporation","award":["Janssen Corporation"],"award-info":[{"award-number":["Janssen Corporation"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Esophagus"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1007\/s10388-026-01212-4","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T06:58:12Z","timestamp":1779346692000},"page":"545-553","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bidirectional risk of autoimmune disease and eosinophilic esophagitis in Sweden"],"prefix":"10.1007","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0655-8702","authenticated-orcid":false,"given":"Ashley L.","family":"Pyne","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amiko M.","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Carlson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bergman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn A.","family":"Peterson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soran R.","family":"Bozorg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Garber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjorn","family":"Roelstraete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas F.","family":"Ludvigsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"1212_CR1","doi-asserted-by":"publisher","unstructured":"Lawson LP, Parameswaran S, Panganiban RA, Constantine GM, Weirauch MT, Kottyan LC. Update on the genetics of allergic diseases. J Allergy Clin Immunol. Published online March 2025. https:\/\/doi.org\/10.1016\/j.jaci.2025.03.012","DOI":"10.1016\/j.jaci.2025.03.012"},{"issue":"6","key":"1212_CR2","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.1016\/j.jaci.2021.10.011","volume":"148","author":"SE Pacheco","year":"2021","unstructured":"Pacheco SE, Guidos-Fogelbach G, Annesi-Maesano I, et al. Climate change and global issues in allergy and immunology. J Allergy Clin Immunol. 2021;148(6):1366\u201377. https:\/\/doi.org\/10.1016\/j.jaci.2021.10.011.","journal-title":"J Allergy Clin Immunol"},{"issue":"1","key":"1212_CR3","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1038\/s41392-023-01344-4","volume":"8","author":"J Wang","year":"2023","unstructured":"Wang J, Zhou Y, Zhang H, et al. Pathogenesis of allergic diseases and implications for therapeutic interventions. Signal Transduct Target Ther. 2023;8(1):138. https:\/\/doi.org\/10.1038\/s41392-023-01344-4.","journal-title":"Signal Transduct Target Ther"},{"issue":"3","key":"1212_CR4","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1016\/j.jaci.2023.11.918","volume":"153","author":"I Bartha","year":"2024","unstructured":"Bartha I, Almulhem N, Santos AF. Feast for thought: a comprehensive review of food allergy 2021\u20132023. J Allergy Clin Immunol. 2024;153(3):576\u201394. https:\/\/doi.org\/10.1016\/j.jaci.2023.11.918.","journal-title":"J Allergy Clin Immunol"},{"key":"1212_CR5","doi-asserted-by":"publisher","first-page":"102266","DOI":"10.1016\/j.coi.2022.102266","volume":"80","author":"FW Miller","year":"2023","unstructured":"Miller FW. The increasing prevalence of autoimmunity and autoimmune diseases: an urgent call to action for improved understanding, diagnosis, treatment, and prevention. Curr Opin Immunol. 2023;80:102266. https:\/\/doi.org\/10.1016\/j.coi.2022.102266.","journal-title":"Curr Opin Immunol"},{"key":"1212_CR6","doi-asserted-by":"publisher","unstructured":"Shaheen NJ, Mukkada V, Eichinger CS, Schofield H, Todorova L, Falk GW. Natural history of eosinophilic esophagitis: a systematic review of epidemiology and disease course. Dis Esophagus. 2018;31(8). https:\/\/doi.org\/10.1093\/dote\/doy015.","DOI":"10.1093\/dote\/doy015"},{"issue":"11","key":"1212_CR7","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1080\/17474124.2020.1806054","volume":"14","author":"\u00c1 Arias","year":"2020","unstructured":"Arias \u00c1, Lucendo AJ. Epidemiology and risk factors for eosinophilic esophagitis: lessons for clinicians. Expert Rev Gastroenterol Hepatol. 2020;14(11):1069\u201382. https:\/\/doi.org\/10.1080\/17474124.2020.1806054.","journal-title":"Expert Rev Gastroenterol Hepatol"},{"issue":"6","key":"1212_CR8","doi-asserted-by":"publisher","first-page":"1466","DOI":"10.1111\/all.14148","volume":"75","author":"A Cianferoni","year":"2020","unstructured":"Cianferoni A, Warren CM, Brown-Whitehorn T, Schultz\u2010Matney F, Nowak\u2010Wegrzyn A, Gupta RS. Eosinophilic esophagitis and allergic comorbidities in a US\u2010population\u2010based study. Allergy. 2020;75(6):1466\u20139. https:\/\/doi.org\/10.1111\/all.14148.","journal-title":"Allergy"},{"issue":"1","key":"1212_CR9","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.cgh.2018.06.028","volume":"17","author":"J Robson","year":"2019","unstructured":"Robson J, O\u2019Gorman M, McClain A, et al. Incidence and prevalence of pediatric eosinophilic esophagitis in utah based on a 5-year population-based study. Clin Gastroenterol Hepatol. 2019;17(1):107\u2013e1141. https:\/\/doi.org\/10.1016\/j.cgh.2018.06.028.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"7","key":"1212_CR10","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1038\/ajg.2016.185","volume":"111","author":"K Peterson","year":"2016","unstructured":"Peterson K, Firszt R, Fang J, Wong J, Smith KR, Brady KA. Risk of autoimmunity in EoE and families: a population-based cohort study. Am J Gastroenterol. 2016;111(7):926\u201332. https:\/\/doi.org\/10.1038\/ajg.2016.185.","journal-title":"Am J Gastroenterol"},{"key":"1212_CR11","doi-asserted-by":"publisher","unstructured":"Xue Z, Miller TL, Abramson L, et al. Association of eosinophilic esophagitis with autoimmune and connective tissue disorders, and the impact on treatment response. Dis Esophagus. 2022;36(1). https:\/\/doi.org\/10.1093\/dote\/doac043.","DOI":"10.1093\/dote\/doac043"},{"issue":"22","key":"1212_CR12","doi-asserted-by":"publisher","first-page":"7389","DOI":"10.2169\/internalmedicine.7389-21","volume":"60","author":"M Ayaki","year":"2021","unstructured":"Ayaki M, Manabe N, Fujita M, et al. Prevalence of autoimmune disease in patients with eosinophilic esophagitis: a cross-sectional study of three hospitals in Japan. Intern Med. 2021;60(22):7389\u201321. https:\/\/doi.org\/10.2169\/internalmedicine.7389-21.","journal-title":"Intern Med"},{"issue":"5","key":"1212_CR13","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.jbspin.2015.11.006","volume":"83","author":"M Lecouffe-Desprets","year":"2016","unstructured":"Lecouffe-Desprets M, Groh M, Bour B, Le Jeunne C, Pu\u00e9chal X. Eosinophilic gastrointestinal disorders associated with autoimmune connective tissue disease. Joint Bone Spine. 2016;83(5):479\u201384. https:\/\/doi.org\/10.1016\/j.jbspin.2015.11.006.","journal-title":"Joint Bone Spine"},{"issue":"6","key":"1212_CR14","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.anai.2018.08.022","volume":"121","author":"P Capucilli","year":"2018","unstructured":"Capucilli P, Cianferoni A, Grundmeier RW, Spergel JM. Comparison of comorbid diagnoses in children with and without eosinophilic esophagitis in a large population. Ann Allergy Asthma Immunol. 2018;121(6):711\u20136. https:\/\/doi.org\/10.1016\/j.anai.2018.08.022.","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"10391","key":"1212_CR15","doi-asserted-by":"publisher","first-page":"1878","DOI":"10.1016\/S0140-6736(23)00457-9","volume":"401","author":"N Conrad","year":"2023","unstructured":"Conrad N, Misra S, Verbakel JY, et al. Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. Lancet. 2023;401(10391):1878\u201390. https:\/\/doi.org\/10.1016\/S0140-6736(23)00457-9.","journal-title":"Lancet"},{"issue":"2","key":"1212_CR16","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.jaci.2014.04.022","volume":"134","author":"E Volpe","year":"2014","unstructured":"Volpe E, Pattarini L, Martinez-Cingolani C, et al. Thymic stromal lymphopoietin links keratinocytes and dendritic cell\u2013derived IL-23 in patients with psoriasis. J Allergy Clin Immunol. 2014;134(2):373\u2013e3814. https:\/\/doi.org\/10.1016\/j.jaci.2014.04.022.","journal-title":"J Allergy Clin Immunol"},{"issue":"4","key":"1212_CR17","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/j.jaci.2012.04.041","volume":"130","author":"X Li","year":"2012","unstructured":"Li X, Ampleford EJ, Howard TD, et al. Genome-wide association studies of asthma indicate opposite immunopathogenesis direction from autoimmune diseases. J Allergy Clin Immunol. 2012;130(4):861\u2013e8687. https:\/\/doi.org\/10.1016\/j.jaci.2012.04.041.","journal-title":"J Allergy Clin Immunol"},{"key":"1212_CR18","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.cyto.2017.10.022","volume":"106","author":"M Hatami","year":"2018","unstructured":"Hatami M, Salmani T, Arsang-Jang S, et al. STAT5a and STAT6 gene expression levels in multiple sclerosis patients. Cytokine. 2018;106:108\u201313. https:\/\/doi.org\/10.1016\/j.cyto.2017.10.022.","journal-title":"Cytokine"},{"issue":"1","key":"1212_CR19","doi-asserted-by":"publisher","first-page":"5593","DOI":"10.1038\/ncomms6593","volume":"5","author":"PMA Sleiman","year":"2014","unstructured":"Sleiman PMA, Wang ML, Cianferoni A, et al. GWAS identifies four novel eosinophilic esophagitis loci. Nat Commun. 2014;5(1):5593. https:\/\/doi.org\/10.1038\/ncomms6593.","journal-title":"Nat Commun"},{"key":"1212_CR20","doi-asserted-by":"publisher","first-page":"156015","DOI":"10.1016\/j.cyto.2022.156015","volume":"158","author":"L Shakerian","year":"2022","unstructured":"Shakerian L, Kolahdooz H, Garousi M, et al. IL-33\/ST2 axis in autoimmune disease. Cytokine. 2022;158:156015. https:\/\/doi.org\/10.1016\/j.cyto.2022.156015.","journal-title":"Cytokine"},{"issue":"5","key":"1212_CR21","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1016\/j.jaci.2024.01.017","volume":"153","author":"MY Masuda","year":"2024","unstructured":"Masuda MY, Pyon GC, Luo H, et al. Epithelial overexpression of IL-33 induces eosinophilic esophagitis dependent on IL-13. J Allergy Clin Immunol. 2024;153(5):1355\u201368. https:\/\/doi.org\/10.1016\/j.jaci.2024.01.017.","journal-title":"J Allergy Clin Immunol"},{"issue":"5","key":"1212_CR22","doi-asserted-by":"publisher","first-page":"2673","DOI":"10.4049\/jimmunol.179.5.2673","volume":"179","author":"AL Christy","year":"2007","unstructured":"Christy AL, Brown MA. The multitasking mast cell: positive and negative roles in the progression of autoimmunity. J Immunol. 2007;179(5):2673\u20139. https:\/\/doi.org\/10.4049\/jimmunol.179.5.2673.","journal-title":"J Immunol"},{"issue":"6","key":"1212_CR23","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1016\/j.jaci.2010.08.050","volume":"126","author":"SS Aceves","year":"2010","unstructured":"Aceves SS, Chen D, Newbury RO, Dohil R, Bastian JF, Broide DH. Mast cells infiltrate the esophageal smooth muscle in patients with eosinophilic esophagitis, express TGF-\u03b21, and increase esophageal smooth muscle contraction. J Allergy Clin Immunol. 2010;126(6):1198\u2013e12044. https:\/\/doi.org\/10.1016\/j.jaci.2010.08.050.","journal-title":"J Allergy Clin Immunol"},{"key":"1212_CR24","doi-asserted-by":"publisher","unstructured":"Uchida AM, Garber JJ, Pyne A, et al. Eosinophilic esophagitis is associated with increased risk of later inflammatory bowel disease in a nationwide Swedish population cohort. United Eur Gastroenterol J Published online Dec. 2023;7. https:\/\/doi.org\/10.1002\/ueg2.12493.","DOI":"10.1002\/ueg2.12493"},{"issue":"3","key":"1212_CR25","doi-asserted-by":"publisher","first-page":"100254","DOI":"10.1016\/j.jacig.2024.100254","volume":"3","author":"N Mitselou","year":"2024","unstructured":"Mitselou N, Uchida A, Roelstraete B, et al. Association of celiac disease with eosinophilic esophagitis: nationwide register-based cohort study with sibling analyses. J Allergy Clin Immunology: Global. 2024;3(3):100254. https:\/\/doi.org\/10.1016\/j.jacig.2024.100254.","journal-title":"J Allergy Clin Immunology: Global"},{"key":"1212_CR26","doi-asserted-by":"publisher","first-page":"101","DOI":"10.2147\/CLEP.S191914","volume":"11","author":"JF Ludvigsson","year":"2019","unstructured":"Ludvigsson JF, Lashkariani M. Cohort profile: ESPRESSO (Epidemiology Strengthened by histopathology reports in Sweden). Clin Epidemiol. 2019;11:101\u201314. https:\/\/doi.org\/10.2147\/CLEP.S191914.","journal-title":"Clin Epidemiol"},{"issue":"9","key":"1212_CR27","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1007\/s10654-017-0316-1","volume":"32","author":"HL Brooke","year":"2017","unstructured":"Brooke HL, Talb\u00e4ck M, H\u00f6rnblad J, et al. The Swedish cause of death register. Eur J Epidemiol. 2017;32(9):765\u201373. https:\/\/doi.org\/10.1007\/s10654-017-0316-1.","journal-title":"Eur J Epidemiol"},{"issue":"2","key":"1212_CR28","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1177\/140349489001800209","volume":"18","author":"S Cnattingius","year":"1990","unstructured":"Cnattingius S, Ericson A, Gunnarskog J, K\u00e4ll\u00e9n B. A quality study of a medical birth registry. Scand J Soc Med. 1990;18(2):143\u20138. https:\/\/doi.org\/10.1177\/140349489001800209.","journal-title":"Scand J Soc Med"},{"key":"1212_CR29","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1186\/1471-2458-11-450","volume":"11","author":"JF Ludvigsson","year":"2011","unstructured":"Ludvigsson JF, Andersson E, Ekbom A, et al. External review and validation of the Swedish national inpatient register. BMC Public Health. 2011;11:450. https:\/\/doi.org\/10.1186\/1471-2458-11-450.","journal-title":"BMC Public Health"},{"key":"1212_CR30","doi-asserted-by":"publisher","unstructured":"R\u00f6jler L, Glimberg I, Walker MM, Garber JJ, Ludvigsson JF. Validation of the diagnosis of eosinophilic esophagitis based on histopathology reports in Sweden. Ups J Med Sci. 2021;126. https:\/\/doi.org\/10.48101\/ujms.v126.7687.","DOI":"10.48101\/ujms.v126.7687"},{"issue":"2","key":"1212_CR31","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s10654-016-0117-y","volume":"31","author":"JF Ludvigsson","year":"2016","unstructured":"Ludvigsson JF, Almqvist C, Bonamy AKE, et al. Registers of the Swedish total population and their use in medical research. Eur J Epidemiol. 2016;31(2):125\u201336. https:\/\/doi.org\/10.1007\/s10654-016-0117-y.","journal-title":"Eur J Epidemiol"},{"key":"1212_CR32","doi-asserted-by":"publisher","first-page":"103170","DOI":"10.1016\/j.jaut.2024.103170","volume":"143","author":"S Yuan","year":"2024","unstructured":"Yuan S, Leffler D, Lebwohl B, et al. Older age of celiac disease diagnosis and risk of autoimmune disease: A nationwide matched case-control study. J Autoimmun. 2024;143:103170. https:\/\/doi.org\/10.1016\/j.jaut.2024.103170.","journal-title":"J Autoimmun"},{"issue":"7","key":"1212_CR33","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1002\/pds.1294","volume":"16","author":"B Wettermark","year":"2007","unstructured":"Wettermark B, Hammar N, MichaelFored C, et al. The new Swedish prescribed drug register\u2014opportunities for pharmacoepidemiological research and experience from the first six months. Pharmacoepidemiol Drug Saf. 2007;16(7):726\u201335. https:\/\/doi.org\/10.1002\/pds.1294.","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"1212_CR34","unstructured":"R Core Team. R: A language and environment for statistical computing. Preprint posted online 2021."},{"key":"1212_CR35","unstructured":"Therneau T.  A package for survival analysis in R. Preprint posted online 2021."},{"key":"1212_CR36","doi-asserted-by":"publisher","unstructured":"Abend AH, He I, Bahroos N, et al. Estimation of prevalence of autoimmune diseases in the United States using electronic health record data. J Clin Invest. 2025;135(4). https:\/\/doi.org\/10.1172\/JCI178722.","DOI":"10.1172\/JCI178722"},{"issue":"2","key":"1212_CR37","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1016\/j.cgh.2024.09.031","volume":"23","author":"HL Thel","year":"2025","unstructured":"Thel HL, Anderson C, Xue AZ, Jensen ET, Dellon ES. Prevalence and costs of eosinophilic esophagitis in the United States. Clin Gastroenterol Hepatol. 2025;23(2):272\u2013e2808. https:\/\/doi.org\/10.1016\/j.cgh.2024.09.031.","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["Esophagus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10388-026-01212-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10388-026-01212-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10388-026-01212-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T07:44:16Z","timestamp":1782805456000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10388-026-01212-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":37,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["1212"],"URL":"https:\/\/doi.org\/10.1007\/s10388-026-01212-4","relation":{},"ISSN":["1612-9059","1612-9067"],"issn-type":[{"value":"1612-9059","type":"print"},{"value":"1612-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"assertion":[{"value":"3 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Stockholm Ethics Review Board Aug 27, 2014 (2014\/1287-31\/4) with an amendment May 7, 2018 (2018\/972\u2009\u2212\u200932).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}},{"value":"Dr. Uchida serves as an advisor\/consultant for Sanofi-Regeneron, AstraZeneca, Takeda, Areteia, and Uniquity (unrelated to this study). Dr. Carlson has received speaker\u2019s fees from ViforPharma and AbbVie. She is the national PI for clinical trials for AstraZeneca. None of these activities have any relation to the present study. Dr. Peterson has received grants from Regeneron and Sanofi, Takeda, BMS, and Uniquity, she holds stocks in Nexeos Bio, and serves on the medical advisors board on APFED. Dr. Ludvigsson has coordinated an unrelated study on behalf of the Swedish IBD (inflammatory bowel disease) quality register (SWIBREG), which received funding from Janssen corporation. He has also received financial support from Merck\/MSD to develop a paper reviewing national healthcare registers in China and has funding from Takeda for a celiac disease project. Dr Ludvigsson also has ongoing collaboration with Merck\/MSD about IBD. Dr. Pyne, Dr. Bergman, Dr. Bozorg, Dr. Garber and Dr. Roelstraete declare no conflict of interest to disclose.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}