{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:21:39Z","timestamp":1747196499613,"version":"3.40.5"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground and aim<\/jats:title>\nThe involvement of mucosa associated lymphoid tissues (MALT) in the development of an autoimmune response in the skin is unclear and unstudied. In this study we sought to assess the relationship between removal of MALT tissues (MALTectomy) and the risk of development of psoriasis (overall or moderate-to-severe).<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nWe conducted a prospective observational study based on E3N, a French cohort composed of 98 995 women born between 1925 and 1950 and insured by the health insurance of the national education system (MGEN). The study population included the 90 119 women that completed the 1990 baseline questionnaire with available information on MALTectomy and a valid incident diagnostic date for psoriasis. During the 1990\u20132018 follow-up period 2 433 incident cases of psoriasis were identified through self-reports while during the period for which drug reimbursement data were available from the MGEN database (2004\u20132018), 120 cases of moderate-to-severe psoriasis were identified. Hazard ratios (HR) and their 95% confidence intervals were estimated by Cox proportional hazards models and adjusted for known or putative psoriasis risk factors.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nAppendectomy was associated with an increased risk of psoriasis both in the univariate [HR: 1.17 (95% CI: 1.08\u20131.27)] and multivariable models [HR: 1.14 (95% CI: 1.05\u20131.24)]. A suggestive association with appendectomy was observed for moderate-to-severe psoriasis risk [univariate HR: 1.40 (95%CI: 0.97\u20132.02); multivariable HR: 1.36 (95%CI: 0.94\u20131.96)]. No association was observed between tonsillectomy or adenoidectomy both for overall and moderate-to-severe psoriasis.<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nThe observed association between appendectomy and risk of psoriasis warrants further investigations as they may help to elucidate the disease etiology and improve risk prediction.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0310891","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T18:26:11Z","timestamp":1731954371000},"page":"e0310891","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["MALTectomy and psoriasis risk in women: A prospective study in the French E3N prospective cohort"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1691-2357","authenticated-orcid":true,"given":"Marco","family":"Conte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes","family":"Fournier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph A.","family":"Rothwell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Christine","family":"Boutron-Ruault","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8193-7529","authenticated-orcid":true,"given":"Laura","family":"Baglietto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Fornili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilie","family":"Sbidian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7157-419X","authenticated-orcid":true,"given":"Gianluca","family":"Severi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"pone.0310891.ref001","first-page":"4","article-title":"Psoriasis","author":"P Di Meglio","year":"2014","journal-title":"Cold Spring Harbor Perspectives in Medicine"},{"key":"pone.0310891.ref002","first-page":"167","article-title":"Obesity, waist circumference, weight change, and the risk of psoriasis in women: Nurses\u2019 health study II","author":"AR Setty","year":"2007","journal-title":"Archives of Internal Medicine"},{"key":"pone.0310891.ref003","first-page":"120","article-title":"Smoking and the Risk of Psoriasis in Women: Nurses\u2019 Health Study II","author":"AR Setty","year":"2007","journal-title":"American Journal of Medicine"},{"key":"pone.0310891.ref004","first-page":"154","article-title":"Association between mediterranean anti-inflammatory dietary profile and severity of psoriasis: Results from the NutriNet-Sant\u00e9 cohort","author":"C Phan","year":"2018","journal-title":"JAMA Dermatology"},{"key":"pone.0310891.ref005","article-title":"Tissue regulatory T cells: regulatory chameleons","author":"AR Mu\u00f1oz-Rojas","year":"2021","journal-title":"Nature Reviews Immunology"},{"key":"pone.0310891.ref006","first-page":"184","article-title":"Role of regulatory T cells in psoriasis pathogenesis and treatment","author":"L Nussbaum","year":"2021","journal-title":"British Journal of Dermatology"},{"key":"pone.0310891.ref007","article-title":"Regulatory T cell adaptation in the intestine and skin","author":"N Whibley","year":"2019","journal-title":"Nature Immunology"},{"key":"pone.0310891.ref008","article-title":"Thymic regulatory T cells","author":"E Maggi","year":"2005","journal-title":"Autoimmunity Reviews"},{"key":"pone.0310891.ref009","article-title":"Guarding the immune system: Suppression of autoimmunity by CD4 +CD25+ immunoregulatory T cells","author":"TD Zwar","year":"2006","journal-title":"Immunology and Cell Biology"},{"key":"pone.0310891.ref010","first-page":"34","article-title":"Enhanced Histopathology of Mucosa-Associated Lymphoid Tissue","author":"SA Elmore","year":"2006","journal-title":"Toxicologic Pathology"},{"key":"pone.0310891.ref011","first-page":"36","article-title":"Modern assessment of tonsils and adenoids","author":"L. Brodsky","year":"1989","journal-title":"Pediatric Clinics of North America"},{"key":"pone.0310891.ref012","first-page":"163","article-title":"Expression and function of the autoimmune regulator (Aire) gene in non-thymic tissue","author":"SA Eldershaw","year":"2011","journal-title":"Clinical and Experimental Immunology"},{"key":"pone.0310891.ref013","first-page":"321","article-title":"Deletional tolerance mediated by extrathymic aire-expressing cells","author":"JM Gardner","year":"2008","journal-title":"Science"},{"key":"pone.0310891.ref014","first-page":"241","article-title":"Control of central and peripheral tolerance by Aire","author":"TC Metzger","year":"2011","journal-title":"Immunological Reviews"},{"key":"pone.0310891.ref015","article-title":"The immunology of the vermiform appendix: a review of the literature","author":"IA Kooij","year":"2016","journal-title":"Clinical and Experimental Immunology"},{"key":"pone.0310891.ref016","article-title":"The immunological functions of the Appendix: An example of redundancy","author":"MJH Girard-Madoux","year":"2018","journal-title":"Seminars in Immunology"},{"key":"pone.0310891.ref017","article-title":"Plasmacytoid DCs are gentle guardians of tonsillar epithelium","author":"M. Rescigno","year":"2013","journal-title":"European Journal of Immunology"},{"key":"pone.0310891.ref018","first-page":"8","article-title":"Incidental prophylactic appendectomy is associated with a profound microbial dysbiosis in the long-term","author":"L S\u00e1nchez-Alcoholado","year":"2020","journal-title":"Microorganisms"},{"key":"pone.0310891.ref019","article-title":"The multiple pathways to autoimmunity","author":"AN Theofilopoulos","year":"2017","journal-title":"Nature Immunology"},{"key":"pone.0310891.ref020","first-page":"8","article-title":"Passive smoking in childhood and adulthood and risk of rheumatoid arthritis in women: Results from the French E3N cohort study","author":"Y Nguyen","year":"2022","journal-title":"RMD Open"},{"key":"pone.0310891.ref021","first-page":"60","article-title":"Female hormonal exposures and risk of rheumatoid arthritis in the French E3N-EPIC cohort study","author":"C Salliot","year":"2021","journal-title":"Rheumatology (United Kingdom)"},{"key":"pone.0310891.ref022","first-page":"44","article-title":"Cohort Profile: The French E3N Cohort Study","author":"F. Clavel-Chapelon","year":"2015","journal-title":"International Journal of Epidemiology"},{"key":"pone.0310891.ref023","article-title":"Risk factors for the development of psoriasis","author":"K Kamiya","year":"2019","journal-title":"International Journal of Molecular Sciences"},{"key":"pone.0310891.ref024","first-page":"72","article-title":"Effect of tonsillectomy on psoriasis: A systematic review","author":"TD Rachakonda","year":"2015","journal-title":"Journal of the American Academy of Dermatology"},{"key":"pone.0310891.ref025","first-page":"72","article-title":"Tonsillectomy associated with an increased risk of autoimmune diseases: A national cohort study","author":"J Ji","year":"2016","journal-title":"Journal of Autoimmunity"},{"key":"pone.0310891.ref026","first-page":"85","article-title":"Tonsillectomy and the subsequent risk of psoriasis: A nationwide population-based cohort study","author":"ML Chen","year":"2021","journal-title":"Journal of the American Academy of Dermatology"},{"key":"pone.0310891.ref027","first-page":"31","article-title":"Appendectomy and risk of Parkinson\u2019s disease: A nationwide cohort study with more than 10 years of follow-up","author":"E Svensson","year":"2016","journal-title":"Movement Disorders"},{"key":"pone.0310891.ref028","first-page":"13","article-title":"Surgery and risk for multiple sclerosis: A systematic review and meta-analysis of case-control studies","author":"C Lunny","year":"2013","journal-title":"BMC Neurology"},{"key":"pone.0310891.ref029","article-title":"Appendicectomy, tonsillectomy, and inflammatory bowel disease: A case-control record linkage study","author":"LM Kurina","year":"2002","journal-title":"Journal of Epidemiology and Community Health"},{"key":"pone.0310891.ref030","first-page":"29","article-title":"Appendectomy is an independent protective factor for ulcerative colitis: Results of a multicentre case control study","author":"T Parrello","year":"1997","journal-title":"Italian Journal of Gastroenterology and Hepatology"},{"key":"pone.0310891.ref031","article-title":"A role for the appendix in inflammatory bowel disease?","author":"MS Morelli","year":"2003","journal-title":"Cut it out. Gastroenterology"},{"key":"pone.0310891.ref032","first-page":"98","article-title":"Appendectomy and rheumatoid arthritis: A longitudinal follow-up study using a national sample cohort","author":"HG Choi","year":"2019","journal-title":"Medicine (United States)"},{"key":"pone.0310891.ref033","first-page":"65","article-title":"Factors involved in the degeneration of lymphoid tissue in the appendix","author":"T. Takeuchi","year":"2018","journal-title":"Kurume Medical Journal"},{"key":"pone.0310891.ref034","article-title":"Bacterial translocation in the normal human appendix parallels the development of the local immune system","author":"JO Gebbers","year":"2004","journal-title":"Annals of the New York Academy of Sciences"},{"key":"pone.0310891.ref035","article-title":"Regulatory T-cell abnormalities and the global epidemic of immuno-inflammatory disease","author":"De St Fazekas","year":"2012","journal-title":"Immunology and Cell Biology"},{"key":"pone.0310891.ref036","first-page":"141","article-title":"Gut-tropic T cells that express integrin \u03b14\u03b27 and CCR9 Are required for induction of oral immune tolerance in mice","author":"B Cassani","year":"2011","journal-title":"Gastroenterology"},{"key":"pone.0310891.ref037","article-title":"The origins of allergy from a systems approach","author":"JW Krempski","year":"2020","journal-title":"Annals of Allergy, Asthma and Immunology"},{"key":"pone.0310891.ref038","article-title":"Mechanisms underlying the skin-gut cross talk in the development of ige-mediated food allergy","author":"M van Splunter","year":"2020","journal-title":"Nutrients"},{"key":"pone.0310891.ref039","first-page":"33","article-title":"Sensitization increases esterase-positive macrophage number in appendix from an animal model of food allergy","author":"G Fontanella","year":"2005","journal-title":"Allergologia et Immunopathologia"},{"key":"pone.0310891.ref040","first-page":"77","article-title":"Skin tolerance is supported by the spleen","author":"M Buettner","year":"2013","journal-title":"Scandinavian Journal of Immunology"},{"key":"pone.0310891.ref041","first-page":"294","article-title":"The Cecal Appendix: One More Immune Component With a Function Disturbed By Post-Industrial Culture","author":"M Laurin","year":"2011","journal-title":"Anatomical Record"},{"key":"pone.0310891.ref042","article-title":"Bowel Biofilms: Tipping Points between a Healthy and Compromised Gut?","author":"HLP Tytgat","year":"2019","journal-title":"Trends in Microbiology"},{"key":"pone.0310891.ref043","first-page":"12","article-title":"Appendectomy Is Associated With Alteration of Human Gut Bacterial and Fungal Communities","author":"S Cai","year":"2021","journal-title":"Frontiers in microbiology"},{"key":"pone.0310891.ref044","first-page":"38","article-title":"The gut-skin axis in health and disease: A paradigm with therapeutic implications","author":"CA O\u2019Neill","year":"2016","journal-title":"BioEssays"},{"key":"pone.0310891.ref045","first-page":"8","article-title":"Gut microbial composition in patients with psoriasis","author":"FM Codo\u00f1er","year":"2018","journal-title":"Scientific Reports"},{"key":"pone.0310891.ref046","article-title":"Gut microbiome in psoriasis: An updated review","author":"M Sikora","year":"2020","journal-title":"Pathogens"},{"key":"pone.0310891.ref047","article-title":"The gut microbiome in psoriasis and psoriatic arthritis","author":"B Myers","year":"2019","journal-title":"Best Practice and Research: Clinical Rheumatology"},{"key":"pone.0310891.ref048","first-page":"369","article-title":"National, regional, and worldwide epidemiology of psoriasis: Systematic analysis and modelling study","author":"R Parisi","year":"2020","journal-title":"The BMJ"},{"key":"pone.0310891.ref049","first-page":"157","article-title":"Limitations of Using Questionnaires for Assessing the Prevalence of Psoriasis and Atopic Dermatitis among Adults","author":"LK Nymand","year":"2021","journal-title":"JAMA Dermatology"},{"key":"pone.0310891.ref050","first-page":"84","article-title":"Joint AAD\u2013NPF Guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures","author":"CA Elmets","year":"2021","journal-title":"Journal of the American Academy of Dermatology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310891","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T18:26:11Z","timestamp":1731954371000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310891"}},"subtitle":[],"editor":[{"given":"Karthika","family":"Paul","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,18]]},"references-count":50,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0310891","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2024,11,18]]}}}