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Zarnowski J, Treudler R. [Which augmentation and trigger factors are relevant in urticaria?]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:295-302. [PMID: 38347239 DOI: 10.1007/s00105-024-05306-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 03/27/2024]
Abstract
The aim of this review is to present relevant trigger as well as augmentation factors that can induce or exacerbate urticaria on the basis of a current, PubMed-based literature search. In addition to a brief description of relevant influencing factors in acute and chronic inducible urticaria, the focus will be on chronic spontaneous urticaria. In particular, the aggravating role of medication, stress, food, psychological and metabolic comorbidities, infections and inflammation as well as hormonal processes will be discussed.
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Affiliation(s)
- Julia Zarnowski
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig A.ö.R., Philipp-Rosenthal-Str. 69, 04103, Leipzig, Deutschland.
| | - Regina Treudler
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig A.ö.R., Philipp-Rosenthal-Str. 69, 04103, Leipzig, Deutschland
- Institut für Allergieforschung, Charité Universitätsklinikum Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland
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2
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Liu Z, Al-Quran L, Tong J, Cao X. Analysis of clinical features and inflammatory-related molecules with the disease in acute infectious urticaria. Arch Dermatol Res 2023; 315:1915-1925. [PMID: 36853509 PMCID: PMC10366306 DOI: 10.1007/s00403-023-02564-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/05/2022] [Accepted: 02/01/2023] [Indexed: 03/01/2023]
Abstract
Acute infectious urticaria, a subset of acute urticaria, with severe persistence wheals and systemic symptoms, response well to corticosteroids treatment in combination with antibiotics. The exact pathogenic mechanisms are not fully understood. In this study, we aim to analyze the different clinical features, compare the level of neutrophil activation, and investigate the expression of inflammatory related cytokine in patients with acute urticaria and acute infectious urticaria. Eighteen patients with acute infectious urticaria and eighteen patients with acute urticaria were included in this study. We analyzed the difference between the clinical features and the serum expressions of pro-inflammatory factors in the two groups, then examined the levels of inflammation-associated cytokines before and after treatment of acute infectious urticaria. Hematoxylin & eosin (HE) staining and immunohistochemistry (IHC) were used to further study the relationship between neutrophil and neutrophil-derived Myeloperoxidase (MPO) of lesions in the two groups. The expression levels of C-reactive protein (CRP), D-dimer, interleukin 6 (IL-6), IL-8 and chemokine ligand 8 (CCL8) in serum were significantly higher in acute infectious urticaria than acute urticaria. In acute infectious urticaria, the serum expression levels of CCL8 were significantly decreased after the treatment, a significant correlation observed between CRP levels and IL-6, both CCL8 and CRP were positively correlated with neutrophil granulocytes. Neutrophils infiltration were not observed by HE stains in two groups, but in IHC stains we found a positive expression of MPO in acute infectious urticaria lesions. Elevated neutrophil in the serum, which is associated with the levels of IL-8 & CCL8, and positively expressed MPO in lesions, may be involved in the pathogenic mechanism of acute infectious urticaria.
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Affiliation(s)
- Zhezhang Liu
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Dermatology, Jiangxi Academy of Clinical Medical Sciences, No. 17 Yongwaizheng Street, Nanchang City, Jiangxi Province, China
| | - Lina Al-Quran
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute of Dermatology, Jiangxi Academy of Clinical Medical Sciences, No. 17 Yongwaizheng Street, Nanchang City, Jiangxi Province, China
| | - Jianbo Tong
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Institute of Dermatology, Jiangxi Academy of Clinical Medical Sciences, No. 17 Yongwaizheng Street, Nanchang City, Jiangxi Province, China.
| | - Xianwei Cao
- Department of Dermatology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Institute of Dermatology, Jiangxi Academy of Clinical Medical Sciences, No. 17 Yongwaizheng Street, Nanchang City, Jiangxi Province, China.
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3
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Ates H, Firat S, Buhari GK, Keren M, Cifci B, Erkekol FÖ. Relationships between quality of life, sleep problems, and sleep quality in patients with chronic idiopathic urticaria. J Cosmet Dermatol 2022; 21:4072-4079. [PMID: 35166020 DOI: 10.1111/jocd.14851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 01/30/2022] [Accepted: 02/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND In this study, we aimed to evaluate the sleep quality among chronic urticaria patients using the Chronic Urticaria Quality-of-Life Questionnaire (CU-Q2oL), sleep quality assessment tools, and polysomnography and to investigate any relationships between the obtained results. METHODS The study included 21 patients diagnosed with chronic spontaneous urticaria and 19 healthy controls. We recorded the patients' sleep quality data, including CU-Q2 oL, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and polysomnography results. RESULT Patients in the chronic urticaria group were more likely to have an ESS score of ≥10 (52.4% vs. 5.3%, p = 0.004) and an apnea-hypopnea index of ≥5 (44.4% vs. 5.3%, p = 0.017) compared to the control group. In the patient group, the CU-Q2 oL total score was positively correlated with sleep latency (r = 0.713, p = 0.004) and PSQI-C1 score (r = 0.726, p = 0.005), while it was negatively correlated with urticaria duration (r = -0.579, p = 0.015), apnea-hypopnea index (r = -0.607, p = 0.021), longest apnea duration (r = -0.583, p = 0.029), total number of respiratory events (r = -0.618, p = 0.018), and apnea count (r = -0.686, p = 0.007). CONCLUSION We conclude that sleep-related problems exist among a considerably large proportion of patients with chronic spontaneous urticaria.
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Affiliation(s)
- Hale Ates
- Department of Allergy and Immunology, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Selma Firat
- Sleep Disorders Center, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Gozde Koycu Buhari
- Department of Allergy and Immunology, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Metin Keren
- Department of Pulmonary Diseases, Süreyyapaşa Pulmonary Diseases Education and Research Hospital, Istanbul, Turkey
| | - Bulent Cifci
- Department of Chest Diseases, Medical School, Turkiye Yuksek Ihtisas University, Ankara, Turkey
| | - Ferda Öner Erkekol
- Department of Allergy and Immunology, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Health Sciences University, Ankara, Turkey
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Vurgun E, Memet B, Etikan P, Guntas G, Kocaturk E. Serum clusterin levels are not associated with chronic spontaneous urticaria regardless of serum lipids. Ital J Dermatol Venerol 2022; 157:325-329. [PMID: 35373780 DOI: 10.23736/s2784-8671.22.07222-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Clusterin is related to immunity and inflammation via regulation of complement activation and bidirectional regulation of and by major proinflammatory cytokines. Clusterin levels have been the subject of a few researches both in patients with hyperlipidemia and those with chronic spontaneous urticaria (CSU) separately. The aims of this study were evaluate the levels of clusterin levels and serum lipids and the relationships between them in patients with CSU. METHODS Fifty patients with CSU and 30 healthy controls were enrolled into the study. The activity of urticaria of the patients was determined by urticaria activity score (UAS7). Serum clusterin, total cholesterol, HDL, LDL and triglyceride levels of the participants were measured and compared. The relationships between UAS, lipids and clusterin were examined. RESULTS There was no difference in clusterin levels between CSU patients and controls. Clusterin level was not related to activity of urticaria. Clusterin levels were not correlated with any of lipid parameters neither in CSU patients nor in controls. CONCLUSIONS Findings of this study show that clusterin levels do not change due to CSU. Serum clusterin levels cannot be used as a diagnostic or a disease activity marker in CSU patients, regardless of the lipid profile.
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Affiliation(s)
- Eren Vurgun
- Department of Medical Biochemistry, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey -
| | - Bachar Memet
- Department of Dermatology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.,Department of Dermatology, Koc University School of Medicine, Istanbul, Turkey
| | - Piril Etikan
- Department of Dermatology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.,Department of Dermatology, Kyrenia Dr. Akcicek Government Hospital, Kyrenia, Cyprus
| | - Gulcan Guntas
- Department of Medical Biochemistry, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.,Kirklareli University School of Health, Kirklareli, Turkey
| | - Emek Kocaturk
- Department of Dermatology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.,Department of Dermatology, Koc University School of Medicine, Istanbul, Turkey
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Baysak S, Sevim Kecici A, Dogan B. Long-term follow-up effect of omalizumab in chronic spontaneous urticaria and its association with serum C-reactive protein levels. Dermatol Ther 2020; 33:e13663. [PMID: 32447802 DOI: 10.1111/dth.13663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/08/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
This study aims to determine the efficacy of omalizumab, a humanized monoclonal anti-immunoglobulin E antibody, in patients with chronic spontaneous urticaria (CSU) refractory to conventional therapy, together with the evaluation of serum CRP levels. All the patients with a diagnosis of CSU who were continuously treated with omalizumab (300 mg/mo) for at least 3 months between June 2016 and July 2019 were included in this study. Urticaria activity score (UAS-7) was used for assessment of disease activity. Serum CRP levels were also retrospectively analyzed. When UAS-7 scores before the initiation of therapy were compared to the week 4, 12, 24, and 36 scores after the treatment, each were significantly different from the pretreatment results (P < .01). CRP level prior to treatment was found to be strongly correlated with baseline UAS scores of the patients' (P = .00). At the 12th week of treatment, decline of CRP level was positively and strongly correlated with the decline of UAS (P = .037). In this study, mean UAS decreased, mean rescue medication use declined, and overall therapeutic response improved with omalizumab treatment. Additionally, significant correlation between the decline of CRP levels and treatment response was found.
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Affiliation(s)
- Sevim Baysak
- Dermatology Department, Istanbul Sultan 2.Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | | | - Bilal Dogan
- Dermatology Department, Istanbul Sultan 2.Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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Does adiponectin play a role in the pathogenesis of chronic spontaneous urticaria? Cent Eur J Immunol 2020; 45:56-59. [PMID: 32425680 PMCID: PMC7226560 DOI: 10.5114/ceji.2020.94678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/26/2018] [Indexed: 01/03/2023] Open
Abstract
Introduction Chronic spontaneous urticaria constitutes an interdisciplinary problem and its pathogenesis is still a subject of debate. Overweight and hyperlipidemia are supposed to be related to chronic spontaneous urticaria. Fatty tissue can be the source of adipokines. Aim of the study To assess the potential role of adiponectin in chronic spontaneous urticaria pathogenesis. Material and methods The study included 52 chronic spontaneous urticaria patients and 43 healthy controls. The patients were divided into two subgroups: patients with wheals only, and patients with urticaria and an accompanying angioedema. The adiponectin concentration was measured in all studied subjects. Results No statistically significant difference in adiponectin level was determined between the studied groups and subgroups. Conclusions We are among the first to present the results of study to determine a possible role of adipokines in chronic spontaneous urticaria pathogenesis. We did not observe any difference in adiponectin level. In our opinion, it is necessary to conduct further analyses in this field.
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de Medeiros VLS, Silva LFT. Follow-up of skin lesions during the evolution of COVID-19: a case report. Arch Dermatol Res 2020; 313:603-606. [PMID: 32409976 PMCID: PMC7221337 DOI: 10.1007/s00403-020-02091-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 12/22/2022]
Abstract
The disease caused by the new coronavirus (COVID-19) has many systemic manifestations affecting the upper airways, lungs, gastrointestinal tract and inducing hematological repercussions. With the evolution of the pandemic, skin lesions were observed. However, there is little information about the evolution of the lesions at this moment. The authors report a case of a patient who had more than one exposure to the coronavirus during the evolution of the disease and manifested different types of edematous lesions. The lesions started in the prodromal period and changed their presentation and localization during the evolution of COVID-19. The lesions regressed quickly with the use of corticoid cream and antihistamine. Viral skin lesions are frequent causes of exanthema. However, viral etiology is not always investigated in acute urticarial and atypical erythematous-edematous conditions. The immunological basis of acute urticaria has points in common with COVID-19, justifying the appearance of lesions. Investigation of viral etiology should always be remembered in acute urticarial and edematous conditions.
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Affiliation(s)
- Vanessa Lucilia Silveira de Medeiros
- Dermatology Clinic, Tropical Medicine Department of Federal, Clinics Hospital, University of Pernambuco, Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, 50670-901, PE, Brazil.
| | - Lucas Fagundes Teixeira Silva
- Medical Faculty of Recife, Centro de Ciências Médicas, Federal University of Pernambuco, Av. da Engenharia, 531-611 - Cidade Universitária, Recife, 50730-120, PE, Brazil
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8
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Mohamed AA, Hussein MS, Salah EM, Eldemery A, Darwish MM, Ghaith DM, Attala RA, El Borolossy R. Efficacy and safety of active vitamin D supplementation in chronic spontaneous urticaria patients. J DERMATOL TREAT 2020; 33:427-432. [PMID: 32345077 DOI: 10.1080/09546634.2020.1762838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background: Chronic spontaneous urticaria (CSU) is a common skin disorder affecting negatively patients' lives. Vitamin D deficiency has been reported to be associated to many allergic skin disorders.Objective: This study aimed to evaluate the association between the serum level of 25 hydroxy vitamin D and CSU and to assess the efficacy and safety of active vitamin D in management of CSU.Methods: The study was conducted on 77 patients with CSU and 67 healthy controls, then the 77 CSU patients were randomized to either the study group that received 0.25 µg alfacalcidol daily or the placebo group that received oral placebo for 12 weeks.Results: Serum 25(OH) D was significantly lower in CSU as compared to healthy controls and was negatively correlated to the urticarial severity. After alfacalcidol administration, the study group showed significant higher level of 25(OH) D compared to the placebo group. In addition, the mean serum level of IL6, hsCRP and TNFα significantly decreased in the study group in comparison to the placebo group and as compared to their baseline results.Conclusion: Vitamin D deficiency is more common in CSU patients as compared to healthy people and hence, alfacalcidol might have a beneficial role as add on therapy in CSU management with no reported side effects.
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Affiliation(s)
- Amal Ahmed Mohamed
- Department of Biochemistry, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Maha S Hussein
- Department of Dermatology and Andrology, National Research Centre, Cairo, Egypt
| | - Eman Mohamed Salah
- Department of Dermatology, Andrology, Sexual Medicine and STDs, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Ahmed Eldemery
- Medical Biochemistry, Faculty of medicine October 6 University, Cairo, Egypt
| | | | - Doaa M Ghaith
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rasha A Attala
- Department of Dermatology, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Radwa El Borolossy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
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9
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Cosansu NC. Haematological parameters in patients with chronic spontaneous urticaria. Cutan Ocul Toxicol 2019; 39:72. [PMID: 31809603 DOI: 10.1080/15569527.2019.1701486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Nur Cihan Cosansu
- Department of Dermatology, Sakarya University, Education and Research Hospital, Sakarya, Turkey
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10
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Grzanka R, Damasiewicz-Bodzek A, Kasperska-Zajac A. Tumor necrosis factor-alpha and Fas/Fas ligand signaling pathways in chronic spontaneous urticaria. Allergy Asthma Clin Immunol 2019; 15:15. [PMID: 30911316 PMCID: PMC6417283 DOI: 10.1186/s13223-019-0332-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 03/06/2019] [Indexed: 01/24/2023] Open
Abstract
Background There is increasing evidence pointing to the important role of tumor necrosis factor-alpha (TNF-α), a key inflammatory and apoptotic mediator in urticarial inflammation. However, the role of the TNF-α system and Fas/Fas ligand (FasL) in the apoptosis-inducing pathways in chronic spontaneous urticaria (CSU), remain unclear. Aim To determine circulating concentrations of TNF-α, soluble TNF-α receptor type 1 and type 2 (sTNF-R1 and sTNF-R2, respectively) as well as soluble Fas (sFas) and FasL (sFasL) in CSU subjects. Methods Serum TNF-α, sTNF-R1, sTNF-R2, sFas, sFasL concentrations were measured using enzyme-linked immunosorbent assay in CSU subjects and in the healthy subjects. Results TNF-α concentrations were significantly higher in CSU subjects and moderate-to-severe CSU than in the controls, while there were no significant differences in TNF-α concentrations between subjects with mild CSU and the controls. sTNF-R1 and sTNF-R2 concentrations were significantly higher in all CSU and moderate-severe CSU subjects vs. the controls. Serum concentrations were also significantly higher in mild CSU vs. the controls, but not in moderate-severe CSU vs. mild CSU. No significant differences were observed in sFas and sFasL concentrations between CSU subjects and the healthy controls. Significant correlations were found between concentrations of TNF-α and its receptors, as well as sTNF-R1 and sTNF-R2, but not with the urticaria activity score (UAS). There was no relationship between TNF-α/sTNF-R1/sTNF-R2 and sFas/sFasL pathways in CSU. Conclusions CSU is associated with the activation of the TNF-α/receptors signaling pathway, marked by increased circulating concentrations of TNF-α, sTNF-R1 and sTNF-R2, which are related to each other in this disease. In contrast, the circulating sFas/FasL system is not up-regulated in CSU, and sFas/sFasL may not be a useful marker of the activity/severity of urticarial processes. Considering the lack of significant changes in sFas/sFasL (mainly reflecting systemic apoptosis) in CSU patients, it appears that elevated serum TNF-α concentrations are related to its pro-inflammatory function rather than an enhanced systemic apoptotic response in CSU.
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Affiliation(s)
- R Grzanka
- 1Clinical Department of Internal Diseases, Dermatology and Allergology, SMDZ in Zabrze, Medical University of Silesia in Katowice, ul. M. Curie-Skłodowskiej 10, 41-800 Zabrze, Poland
| | - A Damasiewicz-Bodzek
- 2Department of Chemistry, SMDZ in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - A Kasperska-Zajac
- 1Clinical Department of Internal Diseases, Dermatology and Allergology, SMDZ in Zabrze, Medical University of Silesia in Katowice, ul. M. Curie-Skłodowskiej 10, 41-800 Zabrze, Poland.,European Center for Diagnosis and Treatment of Urticaria (GA2LEN UCARE), Zabrze, Poland
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Cao Y, Xu S, Kong W, Cai H, Xu Y. Identification and validation of differentially expressed proteins in serum of CSU patients with different duration of wheals using an iTRAQ labeling, 2D-LC-MS/MS. Exp Ther Med 2018; 16:4527-4536. [PMID: 30542401 PMCID: PMC6257644 DOI: 10.3892/etm.2018.6818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/14/2018] [Indexed: 11/28/2022] Open
Abstract
Chronic spontaneous urticaria (CSU) is one of the most common types of chronic urticaria (CU), with symptoms that recur easily, migrate and are refractory. It is unclear whether association between the differentiation of protein expression levels in the serum of CSU patients and the different duration of wheals exists. In the present study the samples were divided according to the duration of the wheals into group A (wheal duration <2 h) and group B (wheal duration 12–24 h). Differentially expressed proteins in sera of CSU patients with different durations of wheals were identified and validated with isobaric tags for relative and absolute quantitation (iTRAQ) in combination with two-dimensional liquid chromatography/tandem mass spectrometry (2D-LC-MS/MS). Three hundred and seventy CSU serum-related proteins were initially identified. Among these proteins, ~30 had significant differences between the groups. According to the classification of biological functions and upregulated/downregulated values, serum amyloid A (SAA), CFL1, TPM4 and monocyte differentiation antigen (CD14) were chosen and validated by enzyme-linked immunosorbent assay (ELISA). The expression levels of CD14 in sera were not significantly different among the groups. SAA, CFL1 and TPM4 were associated with the wheal duration in CSU patients and therefore could be considered as new potential inflammatory biomarkers associated with CSU.
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Affiliation(s)
- Yanyun Cao
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Shunming Xu
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Wei Kong
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Haibin Cai
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Yang Xu
- Department of Dermatology, Pudong New Area People's Hospital, Shanghai 201299, P.R. China
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12
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Evaluation of carotid intima media thickness and hematologic inflammatory markers in patients with chronic spontaneous urticaria. Postepy Dermatol Alergol 2018; 37:214-220. [PMID: 32489357 PMCID: PMC7262809 DOI: 10.5114/ada.2018.79567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 10/15/2018] [Indexed: 12/26/2022] Open
Abstract
Introduction Low grade inflammation is associated with chronic spontaneous urticaria (CSU) and atherosclerosis. There are little data on the relationship between urticarial inflammation and atherosclerosis. The neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and mean platelet volume (MPV) have recently been studied in many diseases as a biomarker of inflammation. Aim To evaluate hematologic inflammatory parameters and subclinical atherosclerosis in CSU patients. Material and methods C-reactive protein (CRP), NLR, PLR, MPV and carotid intima media thickness (CIMT) in CSU patients were compared with healthy controls. Thirty CSU patients and 30 healthy controls participated in the study. Results Thirty CSU patients and 30 healthy controls participated in the study. 53.3% of the patient group were females, 46.7% were males and the mean age was 37.7 ±7.7. 53.3% of the healthy control group were females, 46.7% were males and the mean age was 37.1 ±7.2. Body mass index was 24.63 ±2.7 kg/m2 in the patient group and 24.83 ±2.5 kg/m2 in the control group. Left and right CIMT and CRP values were higher in CSU patients and high-density lipoproteins (HDL) values were lower in the CSU patients. There was a positive correlation between the right and left CIMT and urticaria activity severity 4 (UAS4), disease severity, and triglycerides in the patient group, also a negative correlation was found between the right and left CIMT and the HDL values. C-reactive protein was also correlated with UAS4 and disease severity. Conclusions This is the first study to evaluate subclinical atherosclerosis in CSU patients. Chronic spontaneous urticaria may be associated with an increased atherosclerotic risk. Serum CRP concentration can also be used as an objective parameter to evaluate disease severity.
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Acute-phase response and its biomarkers in acute and chronic urticaria. Postepy Dermatol Alergol 2018; 35:400-407. [PMID: 30206455 PMCID: PMC6130146 DOI: 10.5114/ada.2018.77672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/12/2017] [Indexed: 11/17/2022] Open
Abstract
Introduction Since urticaria is a persisting inflammatory disease it is important to establish the prognostic factors for the duration and severity of the disease. Aim To evaluate serum concentrations of selected acute-phase proteins (APP) in patients with various forms of urticaria as compared to healthy volunteers and also to analyze these concentrations in different types of urticaria. Additionally, to evaluate the correlation between serum levels of selected APP and disease activity. Material and methods Serum concentrations of C-reactive protein (CRP), α1-acid glycoprotein (AGP), α1-antichymotrypsin (ACT), α1-antitrypsin (AT), ceruloplasmin (Cp), transferrin (Tf), α2-macroglobulin (α2M) and haptoglobin (Hp) were measured. Quantitative measurement was conducted using the rocket immunoelectrophoresis. Disease activity was assessed with the use of total symptom score. Results Analysis of serum APP concentrations revealed statistically higher serum concentrations of CRP, AGP and ACT in the entire group of patients with urticaria in comparison with the control group. In the entire group of patients with urticaria, CRP, AGP, ACT, Cp and Hp correlated positively with disease activity, intensity of pruritus and the number and size of urticarial wheals. Statistically lower serum concentrations of CRP, ACT, Cp and Hp were detected in the group of patients with acute urticaria (AU) and angioedema together, compared to the patients suffering from AU only. Conclusions Patients with symptoms of various forms of urticaria present a distinct profile of serum APP concentrations. A significant correlation observed between CRP, AGP, ACT, Cp, Hp and clinical activity score points to the potential role of APP as markers of the urticarial activity.
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14
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He GY, Tsai TF, Lin CL, Shih HM, Hsu TY. Association between sleep disorders and subsequent chronic spontaneous urticaria development: A population-based cohort study. Medicine (Baltimore) 2018; 97:e11992. [PMID: 30142836 PMCID: PMC6112928 DOI: 10.1097/md.0000000000011992] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Patients with chronic spontaneous urticaria (CSU) often have sleep disorders (SDs) because of pruritus. However, SDs might also contribute to the development of CSU. Here, we present the first population-based cohort study on the association between SDs and subsequent CSU development.This study investigated whether SDs increase the risk of CSU by using a population-based database in Taiwan.This retrospective matched-cohort study included 105,892 patients with new-onset SDs (SD cohort) and 105,892 randomly selected controls (control cohort). Each patient was monitored for 10 years to individually identify patients who were subsequently diagnosed as having CSU during the follow-up period. A Cox proportional hazard regression analysis was conducted to determine the risk of CSU in patients with SDs compared with the controls.All relevant comorbidities were more prevalent in the SD cohort than in the control cohort (P < .001). During the follow-up period, the incidence rates of CSU among the patients with SDs and controls were 53.4 and 28.3 per 10,000 person-years, respectively. After adjustment for age, sex, and comorbidities, the adjusted hazard ratio for CSU in the SD cohort was 1.83 (95% confidence interval = 1.73-1.93, P < .001).The risk of CSU was higher in the patients with SDs than in the controls.
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Affiliation(s)
- Guan-Yi He
- Department of Dermatology, National Taiwan University Hospital Yunlin Branch, Douliou
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital
- School of Medicine, College of Medicine, China Medical University
| | - Hong-Mo Shih
- School of Medicine, College of Medicine, China Medical University
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Tai-Yi Hsu
- School of Medicine, College of Medicine, China Medical University
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
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Grzanka R, Damasiewicz-Bodzek A, Kasperska-Zajac A. Interplay between acute phase response and coagulation/fibrinolysis in chronic spontaneous urticaria. Allergy Asthma Clin Immunol 2018; 14:27. [PMID: 30026764 PMCID: PMC6050720 DOI: 10.1186/s13223-018-0255-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/11/2018] [Indexed: 11/10/2022] Open
Abstract
Background Chronic spontaneous urticaria (CSU) is associated with activation of systemic inflammatory response and coagulation/fibrinolysis. Aim To study whether there is a relationship between the acute phase response and coagulation/fibrinolysis in chronic spontaneous urticaria (CSU) patients. Methods Serum concentrations of C-reactive protein (CRP) and interleukin 6 (IL-6), key markers of acute phase response and of D-dimer, a marker of fibrin turnover were investigated in 58 CSU patients assessed with the urticaria activity score (UAS) and the controls. Results Serum concentrations of IL-6, CRP, and D-dimer were significantly higher in CSU patients as compared with the controls. We found statistically significant correlations between D-dimers concentrations and the inflammatory markers: CRP and IL-6 as well as UAS. Conclusions Markers of inflammation (IL-6 and CRP) and of fibrinolysis (D-dimer) are related to each other in CSU, suggesting a possible cross-talk between inflammation and coagulation/fibrinolysis. It might be implicated in pathogenesis of the disease and may be associated with higher risks of cardiovascular diseases in CSU patients.
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Affiliation(s)
- R Grzanka
- 1Department of Internal Diseases, Dermatology and Allergology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - A Damasiewicz-Bodzek
- 2Department of Chemistry, SMDZ in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - A Kasperska-Zajac
- 1Department of Internal Diseases, Dermatology and Allergology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland.,European Center for Diagnosis and Treatment of Urticaria, Zabrze, Poland.,Department of Internal Diseases, Dermatology and Allergology, ul. M. Curie-Skłodowskiej 10, 41-800 Zabrze, Poland
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Zbiciak-Nylec M, Wcisło-Dziadecka D, Kasprzyk M, Kulig A, Laszczak J, Noworyta M, Adamus S, Brzezińska-Wcisło L, Rogala B, Brzoza Z. Overweight and obesity may play a role in the pathogenesis of chronic spontaneous urticaria. Clin Exp Dermatol 2018; 43:525-528. [DOI: 10.1111/ced.13368] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 12/26/2022]
Affiliation(s)
- M. Zbiciak-Nylec
- Department of Dermatology; School of Medicine in Katowice; Medical University of Silesia; Katowice Poland
| | - D. Wcisło-Dziadecka
- Department of Skin Structural Studies; Chair of Cosmetology; School of Pharmacy with Division of Laboratory Medicine in Sosnowiec; Medical University of Silesia; Katowice Poland
| | - M. Kasprzyk
- Department of Internal Diseases, Allergology and Clinical Immunology; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - A. Kulig
- Department of Internal Diseases, Allergology and Clinical Immunology; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - J. Laszczak
- Department of Internal Diseases, Allergology and Clinical Immunology; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - M. Noworyta
- Department of Internal Diseases, Allergology and Clinical Immunology; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - S. Adamus
- Department of Internal Diseases, Allergology and Clinical Immunology; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - L. Brzezińska-Wcisło
- Department of Dermatology; School of Medicine in Katowice; Medical University of Silesia; Katowice Poland
| | - B. Rogala
- Department of Internal Diseases, Allergology and Clinical Immunology; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
| | - Z. Brzoza
- Department of Internal Diseases, Allergology and Clinical Immunology; School of Medicine with the Division of Dentistry in Zabrze; Medical University of Silesia; Katowice Poland
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Shalom G, Magen E, Babaev M, Tiosano S, Vardy D, Linder D, Horev A, Saadia A, Comaneshter D, Agmon-Levin N, Cohen A. Chronic urticaria and the metabolic syndrome: a cross-sectional community-based study of 11 261 patients. J Eur Acad Dermatol Venereol 2017; 32:276-281. [DOI: 10.1111/jdv.14548] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/03/2017] [Indexed: 12/26/2022]
Affiliation(s)
- G. Shalom
- Department of Dermatology and Venereology; Soroka Medical Center; Beer-Sheva Israel
- Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - E. Magen
- Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer-Sheva Israel
- Leumit Health Services; Barzilai Medical Center; Medical Director of South Region; Ashkelon Israel
| | - M. Babaev
- Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - S. Tiosano
- Department of Medicine ‘B’; Sheba medical center and Sackler School of Medicine; Tel-Aviv University; Tel Aviv Israel
| | - D.A. Vardy
- Department of Dermatology and Venereology; Soroka Medical Center; Beer-Sheva Israel
- Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - D. Linder
- Section of Biostatistics; University of Oslo; Oslo Norway
- Medical University of Graz; Graz Austria
| | - A. Horev
- Department of Dermatology and Venereology; Soroka Medical Center; Beer-Sheva Israel
- Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - A. Saadia
- Department of Dermatology and Venereology; Soroka Medical Center; Beer-Sheva Israel
- Faculty of Health Sciences; Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - D. Comaneshter
- Chief Physician's Office; Clalit Health Services; Tel Aviv Israel
| | - N. Agmon-Levin
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
- The Zabludowicz Center for Autoimmune Diseases; Sheba Medical Center; Tel Aviv Israel
| | - A.D. Cohen
- Medical University of Graz; Graz Austria
- Division of Community Health; Faculty of Health Sciences; Siaal Research Center for Family Medicine and Primary Care; Ben-Gurion University of the Negev; Beer-Sheva Israel
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Mediators of Inflammation and Angiogenesis in Chronic Spontaneous Urticaria: Are They Potential Biomarkers of the Disease? Mediators Inflamm 2017; 2017:4123694. [PMID: 29038618 PMCID: PMC5605794 DOI: 10.1155/2017/4123694] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/07/2017] [Indexed: 01/19/2023] Open
Abstract
In chronic spontaneous urticaria (CSU), different pathophysiological mechanisms, potentially responsible for the development of the disease, have been recently described. It is likely that the activation of skin mast cells with consequent release of histamine and other proinflammatory mediators is responsible for vasodilation in the lesional skin of CSU. However, the underlying causes of mast cell activation in the disease are largely unknown and remain to be identified. Thus, in this review, we discuss new insights in the pathogenesis of CSU, focusing on inflammation and angiogenesis. The understanding of these mechanisms will enable the identification of biomarkers useful for the diagnosis, follow-up, and management of CSU and will allow the development of novel, more specific, and patient-tailored therapies.
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19
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Grzanka A, Damasiewicz-Bodzek A, Kasperska-Zajac A. The relationship between circulating concentrations of interleukin 17 and C reactive protein in chronic spontaneous urticaria. Allergy Asthma Clin Immunol 2017; 13:25. [PMID: 28491102 PMCID: PMC5424388 DOI: 10.1186/s13223-017-0197-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/05/2017] [Indexed: 01/12/2023] Open
Abstract
Background Up-regulation of interleukin 17 (IL-17) family cytokines and acute phase response have been observed in patients with chronic spontaneous urticaria (CSU). It has been demonstrated that IL-17 stimulates C-reactive protein (CRP) expression. Aim To determine relationship between circulating concentrations of IL-17 and CRP in CSU. Methods Concentrations of IL-17 in plasma and CRP in serum were measured in patients with CSU of varying severity and in the healthy subjects. Results IL-17 and CRP concentrations were significantly higher in CSU patients as compared to the healthy subjects. In addition, there were significant differences in IL-17 and CRP concentrations between CSU patients with mild, moderate-severe symptoms and the healthy subjects. CRP did not correlate significantly with IL-17. Conclusions Increased circulating IL-17 concentration may represent an independent index of systemic inflammatory response in CSU, which is not related to increased CRP concentration.
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Affiliation(s)
- A Grzanka
- Department of Internal Diseases, Dermatology and Allergology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - A Damasiewicz-Bodzek
- Department of Chemistry, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - A Kasperska-Zajac
- Department of Internal Diseases, Dermatology and Allergology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
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20
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Oświęcimska J, Malczyk Ż, Szymlak A, Mikołajczak A, Ziora K, Zamlynski J, Machura E, Zajac P, Koczy B, Kasperska-Zajac A. Changes in Platelet Count and Size Indices in Adolescent Patients With Anorexia Nervosa. Clin Appl Thromb Hemost 2017; 23:562-566. [PMID: 28449596 DOI: 10.1177/1076029617705727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The significance of platelet size indices has not been widely analyzed in anorexia nervosa (AN). It seems important to get more knowledge on the easily available indices of platelet function obtained by routine complete blood count analysis in patients with AN. We analyzed platelet count (PLT), platelet distribution width (PDW), and mean platelet volume using an automated blood cell counter in 25 females with AN and healthy age- and gender-matched nonatopic controls. Mean PLT was significantly lower in patients with AN than in the control group. Platelet distribution width values in patients with AN were significantly higher than those in the controls. Platelet distribution width values significantly correlated with the disease duration and rate of body weight loss in the anorectic patients. Anorexia nervosa in adolescents is associated with a decrease in PLT along with an increased PDW, which may be an indicator of dysregulated thrombopoiesis.
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Affiliation(s)
- Joanna Oświęcimska
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Żaneta Malczyk
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Agnieszka Szymlak
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Agata Mikołajczak
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Katarzyna Ziora
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Jacek Zamlynski
- 2 Department of Gynaecology, Obstetrics and Oncological Gynaecology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Bytom, Poland
| | - Edyta Machura
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Piotr Zajac
- 3 Department of Trauma and Orthopaedics, District Trauma and Orthopaedic Hospital, Piekary Sląskie, Poland
| | - Bogdan Koczy
- 3 Department of Trauma and Orthopaedics, District Trauma and Orthopaedic Hospital, Piekary Sląskie, Poland
| | - Alicja Kasperska-Zajac
- 4 Clinical Department of Internal Diseases, Dermatology and Allergology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
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21
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Maouia A, Youssef M, Leban N, Ben Chibani J, Helal AN, Kassab A. CRP relevance in clinical assessment of chronic spontaneous urticaria Tunisian patients. Cutan Ocul Toxicol 2017; 36:387-392. [PMID: 28351163 DOI: 10.1080/15569527.2017.1311338] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic spontaneous urticaria (CSU) is a common dermatological condition defined by the sudden occurrence of daily wheals and pruritus for at least six weeks. Multifactorial origin is suggested such as oxidative stress. This latter may play a double role as a trigger and remnant agent. OBJECTIVES The first aim of this study is to investigate antioxidant status, inflammatory proteins, hematologic counts and clinical assessment in CSU patients. The second aim is to evaluate the effect of a first-line treatment: desloratadine 5 mg/d on these different parameters. PATIENTS AND METHODS This study enrolled 30 CSU patients and same number of controls. We assessed the urticaria activity score (UAS), total antioxidant status (TAS), glutathione S-transferase (GST), superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), albumin, alpha1, alpha2, beta1 beta2, gamma globulins, c-reactive protein (CRP) and hematologic numeration. RESULTS At baseline alpha1, alpha2, beta1, beta2, gamma globulins, CRP, SOD activity, leukocytes and basophils were significantly higher in patients versus controls (p < 0.05). TAS, GST, CAT, GPx and albumin were significantly low in patients versus controls (p < 0.05). After treatment, TAS, GST and GPx were significantly increased in patients versus patients before treatment (p < 0.001). SOD, alpha1, alpha2, beta1, beta2, gamma globulins, CRP, albumin, leukocytes and basophils were significantly decreased after treatment versus before treatment (p < 0.05). A significant correlation between CRP and UAS (r = 0.3; p = 0.011) was noted. UAS assessment revealed the efficacy of 30 d-antihistaminic treatment. CONCLUSIONS Desloratadine exerted anti-inflammatory and antioxidant effects on CSU patients revealed by CRP. Patients' remission was synergistic to CRP attenuation emphasizing CRP relevance for CSU clinical assessment.
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Affiliation(s)
- A Maouia
- a Laboratory of Bioressources, Integrative Biology and Valorization, Higher Institute of Biotechnology of Monastir , Monastir , Tunisia
| | - M Youssef
- b Department of Dermatology , CHU Fattouma Bourguiba , Monastir , Tunisia , and
| | - N Leban
- c Faculty of Pharmacy Biochemistry and Molecular Biology Laboratory, University of Monastir , Monastir , Tunisia
| | - J Ben Chibani
- c Faculty of Pharmacy Biochemistry and Molecular Biology Laboratory, University of Monastir , Monastir , Tunisia
| | - A N Helal
- a Laboratory of Bioressources, Integrative Biology and Valorization, Higher Institute of Biotechnology of Monastir , Monastir , Tunisia
| | - A Kassab
- c Faculty of Pharmacy Biochemistry and Molecular Biology Laboratory, University of Monastir , Monastir , Tunisia
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Maurer M, Vena GA, Cassano N, Zuberbier T. Current and future therapies for treating chronic spontaneous urticaria. Expert Opin Pharmacother 2016; 17:1131-9. [DOI: 10.1517/14656566.2016.1159298] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Marcus Maurer
- Department of Dermatology and Allergy, Allergy Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Gino A. Vena
- Dermatology and Venereology Private Practice, Bari and Barletta, Italy
| | - Nicoletta Cassano
- Dermatology and Venereology Private Practice, Bari and Barletta, Italy
| | - Torsten Zuberbier
- Department of Dermatology and Allergy, Allergy Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Chung SD, Wang KH, Tsai MC, Lin HC, Chen CH. Hyperlipidemia Is Associated with Chronic Urticaria: A Population-Based Study. PLoS One 2016; 11:e0150304. [PMID: 26964045 PMCID: PMC4786290 DOI: 10.1371/journal.pone.0150304] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/04/2016] [Indexed: 11/21/2022] Open
Abstract
The etiology of chronic urticaria (CU) is diverse, with chronic infections and inflammation being reported as considerable contributing factors. Although the prevalence of metabolic syndrome was found to be significantly elevated in patients with CU, no one has specifically estimated the effects on CU following hyperlipidemia. This study aimed to examine the association between hyperlipidemia and CU using a population-based dataset in Taiwan. This study included 9798 adults with CU as cases and 9798 sex- and age-matched controls. These patients were examined for whether they had received a prior diagnosis of hyperlipidemia. We used conditional logistic regression analyses to calculate the odds ratio (OR) and its corresponding 95% confidence interval (CI) for having been previously diagnosed with hyperlipidemia between cases and controls. In total, 7066 (36.1%) patients had received a prior diagnosis of hyperlipidemia, including 4287 (43.8%) among CU cases and 2779 (28.4%) among controls. The conditional logistic regression revealed that the OR of prior hyperlipidemia for cases was 1.97 (95% CI: 1.85~2.09) compared to the controls. Furthermore, compared to patients without CU, patients with CU independently experienced a 1.65-fold (95% CI = 1.55~1.76; p<0.001) increased risk of having a prior hyperlipidemia diagnosis, after adjustments were made. We concluded that CU was associated with having received a prior diagnosis of hyperlipidemia.
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Affiliation(s)
- Shiu-Dong Chung
- Department of Surgery, Far Eastern Memorial Hospital, Banciao, Taipei, Taiwan
- Graduate Program in Biomedical Informatics, College of Informatics, Yuan-Ze University, Chung-Li, Taiwan
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Kuo-Hsien Wang
- Department of Dermatology, Taipei Medical University and Hospital, Taipei, Taiwan
| | - Ming-Chieh Tsai
- School of Healthcare Administration, Taipei Medical University, Taipei, Taiwan
- Department of Internal Medicine, Cathay General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Herng-Ching Lin
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- School of Healthcare Administration, Taipei Medical University, Taipei, Taiwan
- * E-mail:
| | - Chao-Hung Chen
- Department & Institute of Physiology, National Yang-Ming University, Taipei, Taiwan
- Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Department of Thoracic Surgery, MacKay Memorial Hospital, Taipei, Taiwan
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Kasperska-Zajac A, Grzanka A, Kowalczyk J, Wyszyńska-Chłap M, Lisowska G, Kasperski J, Jarząb J, Misiołek M, Kalarus Z. Refractory chronic spontaneous urticaria and permanent atrial fibrillation associated with dental infection: Mere coincidence or something more to it? Int J Immunopathol Pharmacol 2015; 29:112-20. [PMID: 26634403 DOI: 10.1177/0394632015617770] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/21/2015] [Indexed: 11/15/2022] Open
Abstract
Controversy surrounds the role of dental infection/inflammation in the oral cavity in chronic spontaneous urticaria (CSU) and atrial fibrillation (AF), which is mainly due to scarce literature in this area. Therefore, this case report and review of literature illustrate a possible association between the acute-phase response (APR) and clinical conditions, such as CSU and dental infection/inflammation of oral cavity and AF.We describe a 36-year-old man with an 8-year history of difficult-to-treat, uncontrolled CSU, co-existent with dental infection/inflammatory processes of oral cavity and permanent atrial fibrillation (AF). In the presented case, the most likely triggering or aggravating/maintaining factor of the symptoms was the inflammation/dental infection of the oral cavity because of rapid reduction of the urticarial symptoms, drug doses, and serum CRP levels after the dental therapy. Dental treatment may have a beneficial effect on the systemic inflammatory response, reducing/normalizing the circulating levels of APR markers. APR activation appears to worsen CSU course, early identification and treatment of infectious/inflammatory foci in the oral cavity would form the mainstay of supportive therapy for CU probably through reduction of the systemic inflammatory burden. APR associated with infectious/inflammatory foci in the oral cavity could be taken into account as a predisposing agents to AF.
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Affiliation(s)
- Alicja Kasperska-Zajac
- Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia in Katowice, Poland
| | - Alicja Grzanka
- Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia in Katowice, Poland
| | - Jacek Kowalczyk
- Department of Cardiology, Congenital Heart Disease and Electrotherapy, Silesian Medical University, Silesian Centre for Heart Diseases, Poland
| | | | - Grażyna Lisowska
- Chair and Clinical Department of Otolaryngology in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jacek Kasperski
- Department of Prosthetic Dentistry in Bytom, Medical University of Silesia, Katowice, Poland
| | - Jerzy Jarząb
- Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia in Katowice, Poland
| | - Maciej Misiołek
- Chair and Clinical Department of Otolaryngology in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Zbigniew Kalarus
- Department of Cardiology, Congenital Heart Disease and Electrotherapy, Silesian Medical University, Silesian Centre for Heart Diseases, Poland
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26
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Asero R, Pinter E, Marra AM, Tedeschi A, Cugno M, Marzano AV. Current challenges and controversies in the management of chronic spontaneous urticaria. Expert Rev Clin Immunol 2015; 11:1073-82. [DOI: 10.1586/1744666x.2015.1069708] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pentraxin-3 as a local inflammatory marker in chronic spontaneous urticaria. Cytokine 2015; 76:566-568. [PMID: 25982553 DOI: 10.1016/j.cyto.2015.04.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/07/2015] [Accepted: 04/28/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND The pentraxin family plays an important role in the acute phase response to immune-inflammatory processes. The short pentraxin, C-reactive protein (CRP) is a marker of chronic spontaneous urticaria (CSU) activity, reflecting the systemic effects of inflammatory mediators associated with the disease. It is known, that the long pentraxin, pentraxin 3 (PTX3) is produced at the sites of inflammation, therefore may better reflect activity of the local inflammatory processes. To assess the relevance of PTX3 in CSU patients and its association with CRP. METHODS Plasma PTX3 and serum CRP concentrations were measured in patients with CSU of varying severity as well as in the healthy subjects. RESULTS The concentrations of PTX3 and CRP were significantly increased in more severe CSU patients, when compared to mild CSU and the healthy controls. There was a significant correlation between concentrations of PTX3 and CRP. CONCLUSIONS In contrast to CRP, PTX3 is produced at the sites of inflammation, therefore it seems that elevated PTX3 may result from activation of cells involved in local urticarial processes. Finally, the correlation between these two pentraxins suggests that they may be upregulated by the same mechanisms associated with acute phase response in CSU.
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28
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Jasinska T, Wyszynska-Chlap M, Kasperski J, Kasperska-Zajac A. Plasma soluble CD40 concentration in patients with delayed pressure urticaria. EUR J INFLAMM 2015. [DOI: 10.1177/1721727x15582309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Very little is known about the immune-inflammatory cascade in delayed pressure urticaria (DPU). It has been suggested that increased activation/expression of CD40 may result in enhanced release of soluble CD40 (sCD40) in chronic urticaria. To investigate release of sCD40 in the course of DPU, plasma sCD40 concentration was measured using ELISA method in 18 adult patients with DPU and 27 age- and sex-matched healthy controls. Plasma sCD40 concentration did not differ significantly in the DPU group as compared to healthy subjects. The present study as well as the earlier contributions, suggest that distinct CD40-signalling activity manifested by sCD40 release may be identified in different types of urticaria. Delayed pressure urticaria is not associated with increased circulating sCD40 concentration, contrary to chronic spontaneous urticaria with positive response to autologous serum skin test.
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Affiliation(s)
- T Jasinska
- Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland
| | - M Wyszynska-Chlap
- Department of Prosthetic Dentistry in Bytom, Medical University of Silesia, Katowice, Poland
| | - J Kasperski
- Department of Prosthetic Dentistry in Bytom, Medical University of Silesia, Katowice, Poland
| | - A Kasperska-Zajac
- Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland
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Eli M, Joseph M, Kuznik B, Menachem S. Chronic idiopathic angioedema: a single center experience. Int J Dermatol 2014; 53:e421-7. [PMID: 25209993 DOI: 10.1111/ijd.12601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Chronic idiopathic angioedema (CIA) is defined as three or more episodes of angioedema in a period of > 6 months without a clear etiology. In the study, we tried to explore clinical and laboratory characteristics of patients with CIA unaccompanied by urticaria. METHODS We retrospectively reviewed clinical and laboratory characteristics of 1238 patients with chronic urticaria and/or angioedema referred to our allergy clinic. RESULTS Eight hundred and forty-one (67.9%) subjects had chronic urticaria without angioedema (CU Group), 323 (26.1%) had both urticaria and angioedema (CU + CA group), and 74 (5.9%) had chronic angioedema without urticaria (CA). In 29 (39.2%) cases of CA, no etiologic factor of angioedema was discovered, thus the patients were defined as having chronic idiopathic angioedema (CIA Group). Twenty-two (75.8%) subjects had antihistamine-responsive CIA and seven (24.1%) had antihistamine-unresponsive CIA. There were no statistically significant differences in clinical (except of urticarial eruptions) and laboratory characteristics between CU, CA + CU, and CIA groups. Antihistamine responsive and antihistamine-unresponsive CIA groups had no distinguishable clinical or laboratory features. CONCLUSIONS We suppose that CIA, at least its antihistamine-responsive form, represents a rare form of chronic spontaneous urticaria. The reasons why in CIA there are no other clinical signs of mast cell/basophil activation, such as pruritus, urticarial, and dermatographism, are largely unknown and have to be elucidated in future studies.
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Affiliation(s)
- Magen Eli
- Leumit Health Services, Barzilai Medical Center, Ben Gurion University of Negev, Ashkelon, Israel; Medicine B Department, Barzilai Medical Center, Ben Gurion University of Negev, Ashkelon, Israel; Allergy and Clinical Immunology Unit, Barzilai Medical Center, Ben Gurion University of Negev, Ashkelon, Israel
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Baek YS, Jeon J, Kim JH, Oh CH. Severity of acute and chronic urticaria correlates with D-dimer level, but not C-reactive protein or total IgE. Clin Exp Dermatol 2014; 39:795-800. [PMID: 25196271 DOI: 10.1111/ced.12413] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although various scoring systems for measuring urticaria severity have been introduced, most rely on subjective criteria. Therefore, additional objective criteria such as laboratory markers would be helpful adjuncts in making this assessment. AIM To evaluate the usefulness of three laboratory markers [D-dimer, C-reactive protein (CRP), and total IgE] in assessing disease severity of both acute urticaria (AU) and chronic urticaria (CU). METHODS We conducted a retrospective analysis of 94 patients with urticaria. Correlations between the aforementioned laboratory markers and the Urticaria Activity Score (UAS) were calculated. RESULTS A substantial proportion of patients with urticaria (acute 43.5%; chronic 39.6%) had an increased D-dimer level. Additionally, there was a significant correlation between D-dimer level and UAS (AU r = 0.60, P < 0.001; CU r = 0.37, P < 0.05). However, there was no significant correlation between UAS and either CRP or total IgE. CONCLUSIONS D-dimer level could be used as a marker of disease severity for both AU and CU. However, CRP and total IgE are not as reliable in predicting disease severity.
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Affiliation(s)
- Y S Baek
- Department of Dermatology, College of Medicine, Korea University, Seoul, Korea
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31
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Chronic spontaneous urticaria is characterized by lower serum advanced glycation end-products. BIOMED RESEARCH INTERNATIONAL 2014; 2014:974154. [PMID: 25180195 PMCID: PMC4144150 DOI: 10.1155/2014/974154] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 01/18/2023]
Abstract
Background. Chronic spontaneous urticaria (CSU) is associated with activation of acute phase response. On the other hand, it is known that systemic inflammation may lead to increased formation of advanced glycation end-products (AGEs), associated with pathogenesis of various diseases. Aim. We aim to test whether chronic inflammation manifested by activated acute phase response may provide a mechanism for increased serum AGEs concentration in CSU. Methods. Concentrations of AGEs were measured spectrofluorimetrically in serum of CSU patients and the healthy subjects. Results. Serum AGEs and albumin concentrations in CSU patients were significantly lower as compared with the healthy subjects. Serum CRP concentration was significantly higher in patients with CSU than in the controls. Significant positive correlation was observed between AGEs and albumin concentrations in the subjects. Conclusions. CSU is not associated with increased circulating AGEs concentrations, despite the enhanced systemic inflammatory response. Paradoxical decrease of serum AGEs concentrations is probably a reflection of lower concentration of “negative acute phase proteins” such as albumin.
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The association between platelet count and acute phase response in chronic spontaneous urticaria. BIOMED RESEARCH INTERNATIONAL 2014; 2014:650913. [PMID: 25025065 PMCID: PMC4084584 DOI: 10.1155/2014/650913] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/18/2014] [Indexed: 11/26/2022]
Abstract
Background. The platelet parameters and C-reactive protein (CRP) are markers reflecting a systemic inflammatory response. Among those, CRP is one of the major proteins helpful in determination of severity/activity of chronic spontaneous urticaria (CSU). Aim. To determine relationships between platelet activation indices and serum concentration of CRP, the best marker of acute phase response, and their potential clinical use in CSU patients. Methods. Mean platelet volume (MPV), platelet distribution width (PDW), and platelet count as well as serum CRP concentration were measured in CSU patients, showing different degrees of urticarial severity, and in the healthy subjects. Results. No significant differences were found in MPV and PDW between CSU group and the healthy subjects. The platelet count was significantly higher in moderate-severe CSU than that of the controls and mild CSU patients. Serum CRP concentrations were significantly higher in CSU patients as compared with the healthy subjects and significantly correlated with the platelet count in CSU patients. Conclusions. Acute phase response in CSU is associated with the increased number of circulating platelets in patients with more severe symptoms. It seems that simple determination of platelet size indices is not a reliable indicator of CSU severity/activity.
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Tedeschi A, Kolkhir P, Asero R, Pogorelov D, Olisova O, Kochergin N, Cugno M. Chronic urticaria and coagulation: pathophysiological and clinical aspects. Allergy 2014; 69:683-91. [PMID: 24673528 DOI: 10.1111/all.12389] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2014] [Indexed: 01/28/2023]
Abstract
Chronic urticaria (CU) is a widespread skin disease, characterized by the recurrence of transient wheals and itch for more than 6 weeks. Besides autoimmune mechanisms, coagulation factors, in particular tissue factor and thrombin, might also participate in the disease pathophysiology. Tissue factor expressed by eosinophils can induce activation of blood coagulation generating thrombin which in turn can increase vascular permeability both directly, acting on endothelial cells, and indirectly, inducing degranulation of mast cells with release of histamine, as demonstrated in experimental models. D-dimer, a fibrin degradation product, generated following activation of the coagulation cascade and fibrinolysis, has been found to be increased during urticaria exacerbations; moreover, it has been proposed as a biomarker of severity and resistance to H1-antihistamines in CU patients. The possible role of coagulation in CU is also supported by case reports, case series and a small controlled study showing the efficacy of anticoagulant therapy in this disease. The purpose of this review was to summarize the available data on the possible contribution of coagulation to the pathophysiology of CU focusing on clinical aspects and possible future therapeutic developments.
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Affiliation(s)
- A. Tedeschi
- U.O. Allergologia e Immunologia Clinica; Fondazione IRCCS Ca' Granda; Ospedale Maggiore Policlinico; Milano Italy
| | - P. Kolkhir
- Department of Dermatology and Venereology; I. M. Sechenov First Moscow State Medical University; Moscow Russia
| | - R. Asero
- Ambulatorio di Allergologia; Clinica San Carlo; Paderno Dugnano (MI)
| | - D. Pogorelov
- Department of Dermatology and Venereology; I. M. Sechenov First Moscow State Medical University; Moscow Russia
| | - O. Olisova
- Department of Dermatology and Venereology; I. M. Sechenov First Moscow State Medical University; Moscow Russia
| | - N. Kochergin
- Department of Dermatology and Venereology; I. M. Sechenov First Moscow State Medical University; Moscow Russia
| | - M. Cugno
- Medicina Interna; Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti; Università degli Studi di Milano; Fondazione IRCCS Ca' Granda; Ospedale Maggiore Policlinico; Milano Italy
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Grzanka A, Machura E, Mazur B, Misiolek M, Jochem J, Kasperski J, Kasperska-Zajac A. Relationship between vitamin D status and the inflammatory state in patients with chronic spontaneous urticaria. JOURNAL OF INFLAMMATION-LONDON 2014; 11:2. [PMID: 24484740 PMCID: PMC3913618 DOI: 10.1186/1476-9255-11-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 01/30/2014] [Indexed: 11/10/2022]
Abstract
Background Chronic spontaneous urticaria (CSU) is an immune-inflammatory disease, characterized by acute phase response (APR) and immune activation. There has been increasing evidence showing that vitamin D deficiency/insufficiency is associated with increased incidence and/or severity of immune-inflammatory disorders. Aim To assess relationship between vitamin D status and C-reactive protein (CRP), a nonspecific inflammatory marker of CSU activity. Methods Concentrations of CRP and 25-hydroxyvitamin D [25(OH)D], a biomarker of vitamin D status were measured in serum of CSU patients and compared with the healthy controls. Results Serum 25(OH)D concentration was significantly lower in CSU group as compared with the normal subjects. The prevalence of vitamin D deficiency (< 20 ng/ml) was significantly higher in patients with CSU than among normal population. There were no significant differences in prevalence of 25(OH)D insufficiency between the groups. Serum CRP concentrations were significantly higher in CSU patients as compared with the healthy subjects. There were no significant correlations between CRP and 25(OH)D concentrations in CSU patients. Conclusions CSU is associated with lower serum 25(OH)D concentration and higher prevalence of its deficiency. The results failed to show any effect of vitamin D status on circulating CRP concentrations in CSU. A potential role of vitamin D in pathogenesis and/or additive therapy of CSU needs to be examined in other cohorts of CSU patients as well as in larger studies.
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Affiliation(s)
- Alicja Grzanka
- Department of Internal Diseases, Dermatology and Allergology in Zabrze, Medical University of Silesia in Katowice, M. Curie-Skłodowskiej 10, 41-800 Zabrze, Poland
| | - Edyta Machura
- Department of Pediatric in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Bogdan Mazur
- Department of Microbiology and Immunology in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Maciej Misiolek
- Clinical Department of Otolaryngology in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jerzy Jochem
- Department of Basic Medical Sciences in Bytom, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jacek Kasperski
- Department of Prosthetic Dentistry in Bytom, Medical University of Silesia in Katowice, Katowice, Poland
| | - Alicja Kasperska-Zajac
- Department of Internal Diseases, Dermatology and Allergology in Zabrze, Medical University of Silesia in Katowice, M. Curie-Skłodowskiej 10, 41-800 Zabrze, Poland
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Elevated levels of exhaled nitric oxide in patients with anorexia nervosa. Eur Child Adolesc Psychiatry 2014; 23:845-50. [PMID: 24276672 PMCID: PMC4152618 DOI: 10.1007/s00787-013-0467-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 08/15/2013] [Indexed: 01/23/2023]
Abstract
BACKGROUND Nitric oxide (NO) is involved in eating behavior and inflammatory response. Moreover, there is evidence that NO production is altered in patients with anorexia nervosa (AN). AIM To assess whether the overproduction of NO in AN can affect NO level in exhaled air. MATERIALS AND METHODS Exhaled NO level was studied in 23 girls with AN and compared with that of healthy age- and gender-matched nonatopic controls. RESULTS Exhaled NO levels were significantly higher in girls with AN compared with healthy age-matched controls. CONCLUSIONS It appears that anorexia nervosa was accompanied by a higher level of exhaled NO, likely resulting from a systemic increase in NO production because of the severe catabolic state.
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Is delayed pressure urticaria associated with increased systemic release of sCD40L? BIOMED RESEARCH INTERNATIONAL 2013; 2013:823798. [PMID: 24236294 PMCID: PMC3819883 DOI: 10.1155/2013/823798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 09/19/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Elevated levels of soluble CD40 Ligand (sCD40L) were found in serum but not in plasma of patients with chronic spontaneous urticaria (CU). What is important is that sCD40L has proinflammatory properties, and its elevated plasma level may indicate increased risk of cardiovascular events. These observations should stimulate further evaluation of sCD40L in different forms of urticaria. AIM In the present study, sCD40L plasma level was investigated in delayed pressure urticaria (DPU). METHODS As platelets are predominant and variable sources of sCD40L, we investigated sCD40L concentration in platelet-poor plasma (PPP), which seems the best way to minimize the potential contribution of these cells to the ligand level. RESULTS Plasma sCD40L concentration was significantly increased in the DPU group compared to the healthy controls. CONCLUSIONS It seems that DPU is associated with increased systemic release of sCD40L, which is believed to derive predominantly from activated platelets. The present study as well as the earlier contributions suggest that distinct cells activity, including platelets, may be identified in different types of urticaria.
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Ucmak D, Akkurt M, Toprak G, Yesilova Y, Turan E, Yıldız I. Determination of dermatology life quality index, and serum C-reactive protein and plasma interleukin-6 levels in patients with chronic urticaria. Postepy Dermatol Alergol 2013; 30:146-51. [PMID: 24278066 PMCID: PMC3834718 DOI: 10.5114/pdia.2013.35615] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 03/25/2013] [Accepted: 05/10/2013] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION C-reactive protein (CRP) and interleukin-6 (IL-6), which is one of its most important simulators, were determined in great amounts in the sera of patients with chronic urticaria (CU). AIM To determine the levels of IL-6 in patients with urticaria, and evaluate its relationship with urticaria activity scores and Dermatology Life Quality Index (DLQI). MATERIAL AND METHODS Fifty-three patients with CU were included in the study successively by determining their urticaria activity scores (0-3) and DLQI (0-5). The CRP and IL-6 were measured by immune assay methods. Thirty-two healthy subjects were included as a control group. RESULTS Serum levels of IL-6 and CRP were significantly higher in patients with CU compared to healthy controls (p < 0.001, p = 0.026 respectively). There was a statistically significant correlation among urticaria activity scores and IL-6 and CRP concentration (p = 0.004, p = 0.042). This correlation was more significant in patients who had moderate and severe disease activity scores than in those who had mild disease activity score (p < 0.001, p < 0.001, respectively). There was a statistically significant association between DLQI and IL-6 (p = 0.025). This correlation was very significant in patients who had severe and very severe disease activity scores (p < 0.001, p < 0.001, respectively). DLQI scores and serum levels of IL-6 were significantly different in the very severe group compared to healthy controls (p = 0.024). CONCLUSIONS The levels of CRP and IL-6 are increased in patients with CU. A relationship of DLQI and urticaria activity scores with CRP and IL-6 was found. These findings support the relationship between the inflammatory process in CU and the clinical findings.
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Affiliation(s)
- Derya Ucmak
- Department of Dermatology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Meltem Akkurt
- Department of Dermatology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Gülten Toprak
- Department of Medical Biochemistry, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Yavuz Yesilova
- Department of Dermatology, Harran University Faculty of Medicine, Şanlıurfa, Turkey
| | - Enver Turan
- Department of Dermatology, Harran University Faculty of Medicine, Şanlıurfa, Turkey
| | - Ismail Yıldız
- Department of Biostatistics, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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Kasperska-Zajac A, Grzanka A, Machura E, Misiolek M, Mazur B, Jochem J. Increased serum complement C3 and C4 concentrations and their relation to severity of chronic spontaneous urticaria and CRP concentration. JOURNAL OF INFLAMMATION-LONDON 2013; 10:22. [PMID: 23706062 PMCID: PMC3680025 DOI: 10.1186/1476-9255-10-22] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 05/13/2013] [Indexed: 01/19/2023]
Abstract
Chronic spontaneous urticaria (CU) is associated with activation of the acute phase response (APR). Nevertheless, APR-associated proteins have not been well characterized as potential biomarkers of the disease severity. To assess the pattern of complement proteins C3 and C4 – the acute phase reactants in patients with CU. C3, C4 and CRP concentrations were measured in serum of 70 patients showing different degrees of urticarial severity as well as in 33 healthy subjects. Serum C3 and C4 concentrations were significantly increased in CU patients as compared with the healthy subjects and exceed the normal lab range by about 5% and 10%, respectively. Significant differences were found between patients with mild and increased CU severity. In addition, significant correlations were observed between C3, C4 and CRP concentrations. More severe CU is characterized by higher production of C3 and C4 complements accompanied by parallel changes in CRP concentration.
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Affiliation(s)
- Alicja Kasperska-Zajac
- Clinical Department of Internal Diseases, Allergology and Clinical Immunology, ul, Ceglana 35, 40-952 Katowice, Poland.
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Jasinska T, Kasperska-Zajac A. Increased plasma-soluble CD40 concentration in patients with chronic urticaria with positive autologous serum skin test. Br J Dermatol 2013; 168:1356-7. [DOI: 10.1111/bjd.12141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rajappa M, Chandrashekar L, Sundar I, Munisamy M, Ananthanarayanan PH, Thappa DM, Toi PC. Platelet oxidative stress and systemic inflammation in chronic spontaneous urticaria. Clin Chem Lab Med 2013; 51:1789-94. [DOI: 10.1515/cclm-2012-0897] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 03/18/2013] [Indexed: 11/15/2022]
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Kasperska-Zajac A, Grzanka A, Machura E, Mazur B, Misiolek M, Czecior E, Kasperski J, Jochem J. Analysis of procalcitonin and CRP concentrations in serum of patients with chronic spontaneous urticaria. Inflamm Res 2012. [PMID: 23207551 PMCID: PMC3569594 DOI: 10.1007/s00011-012-0580-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background Our previous findings showed the importance of analysing the peripheral markers of acute phase response (APR) activation, C-reactive protein (CRP) and IL-6 in the context of urticaria activity and severity. However, these biomarkers do not reliably differentiate between APR to infectious and the disease severity. Aim In order to investigate a possible association between the immune-inflammatory activation markers CRP and procalcitonin (PCT). Methods Serum PCT and CRP concentrations were measured in patients with CU of varying severity as well as in healthy subjects. Results Serum PCT and CRP concentrations were significantly increased in more severe CU patients when compared to healthy controls and mild CU, and within the CU population there was a significant correlation between concentrations of PCT and CRP. Serum PCT concentrations remained within normal ranges in most CU patients and were only slightly elevated in some severe CU cases. Conclusions PCT serum concentration may be only slightly elevated in some cases of severe CU. Upregulation of PCT synthesis accompanied by parallel changes in CRP concentration reflects a low-grade systemic inflammatory response in CU. PCT should be considered as a better marker than CRP to distinguish between APR to infection and an active non-specific urticarial inflammation.
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Affiliation(s)
- A Kasperska-Zajac
- Chair and Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, ul. Ceglana 35, 40-952 Katowice, Poland.
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Panahi Y, Sahebkar A, Parvin S, Saadat A. A randomized controlled trial on the anti-inflammatory effects of curcumin in patients with chronic sulphur mustard-induced cutaneous complications. Ann Clin Biochem 2012; 49:580-8. [DOI: 10.1258/acb.2012.012040] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Chronic cutaneous complications such as pruritus are among the very frequent complaints of sulphur mustard (SM)-exposed patients. The present trial investigated the impact of curcumin on serum inflammatory biomarkers and their association with pruritus severity and quality of life (QoL). Methods This was a randomized, double-blind trial among 96 male Iranian veterans (age 37–59 y) who were suffering from chronic SM-induced pruritic skin lesions. Patients were randomly assigned to curcumin (1 g/d, n = 46) or placebo ( n = 50) for four weeks. Serum concentrations of interleukins 6 (IL-6) and 8 (IL-8) together with high-sensitivity C-reactive protein (hs-CRP) and calcitonin gene-related peptide (CGRP) were measured at baseline and at the end of the trial. Assessment of pruritus severity was performed using the pruritus score and QoL using the Dermatology Life Quality Index (DLQI). Results Serum IL-8 and hs-CRP were significantly reduced in both groups but the magnitude of reduction was greater in the curcumin group ( P < 0.001). Serum CGRP was only decreased in the curcumin group ( P < 0.001). No significant change was observed in serum IL-6. There were significant correlations between CGRP and IL-6 changes ( P = 0.011) and between DLQI and IL-8 changes ( P = 0.026) in the curcumin group. In the curcumin group, changes in serum IL-8 concentrations were found as the significant predictor of DLQI scores ( P = 0.026) but none of the independent variables could predict pruritus scores. Conclusions Curcumin supplementation effectively mitigates inflammation in patients suffering from chronic SM-induced cutaneous complications. This anti-inflammatory effect might account for the observed pruritus alleviation and QoL improvement by this phytochemical.
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Affiliation(s)
- Yunes Panahi
- Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran 19945-581
| | - Amirhossein Sahebkar
- Biotechnology Research Center and School of Pharmacy, Mashhad University of Medical Sciences, Mashhad 91775-1365
| | - Shahram Parvin
- Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran 19945-581
| | - Alireza Saadat
- Department of Internal Medicine, Baqiyatallah University of Medical Sciences, Tehran 19945-581, Iran
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