scholarly journals Evaluation of Serum Substance P Level in Chronic Urticaria and Correlation with Disease Severity

2020 ◽  
Author(s):  
Javad Fadaee ◽  
Maryam Khoshkhui ◽  
Maryam Emadzadeh ◽  
Seyed Isaac Hashemy ◽  
Reza Farid Hosseini ◽  
...  
Keyword(s):  
Substance P ◽  
Serum Level ◽  
Chronic Urticaria ◽  
Healthy Subjects ◽  
Background Information ◽  
Autologous Serum ◽  
Control Group ◽  
Autologous Serum Skin Test ◽  
Urticaria Activity Score

Substance P (SP) is a neurotransmitter emitted from neurons that plays a role in the pathogenesis of itching conditions including chronic urticarial (CU). The present research aims to investigate the serum level of S.P among CU patients and compare them with healthy subjects and explore how it correlates with the severity of urticaria. The present research was conducted on 87 CU patients who visited the allergy clinic of Ghaem Hospital, Mashhad, Iran from October 2017 to June 2018. Besides, 86 healthy subjects were recruited as the control group. Background information of patient was collected including age, sex, duration of the disease and the co-occurrence of angioedema. S.P serum level was measured in two groups by ELISA method. In the patients group, the autologous serum skin test (ASST) was performed along with the urticaria evaluation questionnaire include Urticaria Activity Score 7 (UAS7), Urticaria Control Test (UCT) and Chronic Urticaria Quality of Life (CU-Q2OL). Among the patients, the SP serum level showed to be about two times higher than the healthy subjects (p˂0.001). SP showed to be increased as patients’ age grew (p=0.010). In patients with a positive ASST, SP level was higher (p=0.012). No correlation was found between SP and the presence of angioedema among patients. There was no correlation between the SP serum level and the scores obtained from urticaria evaluation questionnaires. SP among CU patients was higher than healthy subjects. SP was also higher among female, older and positive ASST patients. The SP value was not correlated with the severity of urticaria, angioedema. In conclusion, Using SP antagonist drugs could be a potential treatment for chronic urticaria.

Treatment of chronic spontaneous urticaria with high doses of antihistamines

2016 ◽  
Vol 19 (6) ◽  
pp. 340-345
Author(s):  
Olga A. Kosoukhova ◽  
N. G Kochergin ◽  
P. V Kolkhir
Keyword(s):  
Skin Test ◽  
Chronic Urticaria ◽  
Clinical Symptoms ◽  
Individual Performance ◽  
Clinical Severity ◽  
Autologous Serum ◽  
Autologous Serum Skin Test ◽  
High Doses ◽  
Medical University

Urticaria is a group of diseases, the main clinical symptoms of which are transient rashes characterized not only by itch but skin edema, erythema, arising in any area of the skin, andfull resolution up to 24 hours. Urticaria is observed at least once in life of the 15-25% of the population, 25% of this patients have the chronic form of the disease. The aim of our work was the optimization of treatment of chronic urticaria by the second-generation antihistamine levocetirizine in standard and high daily dosages (up to fourfold), the study of clinical, allergo-logical and immunological characteristics of the results. The study involved 60 patients between the ages of 18 to 73 years with confirmed clinical diagnosis of chronic urticaria. The study was conducted in the clinic of skin and venereal diseases of I.M. Sechenov First Moscow State Medical University. Clinical and anamnestic examination, laboratory tests, autologous serum skin test were performed. The study was conducted within 1 month and included diagnostic consultation period and 5 consultations every 7 days. The obtained data were used to generate optimized approaches to the treatment of patients with chronic urticaria with regard to the form and severity level of the disease. Optimally assigned differentiated dosages of antihistamines, based on individual performance autologous serum skin test and severity of the clinical picture of urticaria, equally lead to a reduction of clinical severity and improve quality of life of patients with chronic urticaria.

Interleukin-23/ Interleukin -17 Axis in Chronic Spontaneous Urticaria: A Case- Control Study

2021 ◽  
Vol 30 (1) ◽  
pp. 169-174
Author(s):  
Lobna A. El-Korashi ◽  
Basma M. Elkholy ◽  
Hanaa M. El Maghraby
Keyword(s):  
Disease Severity ◽  
Serum Levels ◽  
Chronic Spontaneous Urticaria ◽  
Autologous Serum ◽  
Control Group ◽  
Interleukin 17 ◽  
Autologous Serum Skin Test ◽  
Interleukin 23 ◽  
Urticaria Activity Score ◽  
Control Study

Background: Chronic Spontaneous Urticaria (CSU) is a common health problem and its clear etiology is not established yet. Several theories have been tried to illustrate its etiology and pathogenesis. Autoantibodies and inflammatory cytokines like IL-23 and IL17 are hypothesized to take part in CSU pathogenesis and outcome. Objectives: To detect serum levels of IL-23 and IL-17A among CSU patients and to determine its correlation with disease severity and its relation to autoreactivity. Methodology: Serum levels of IL-23 and IL-17A were measured in 23 patients with CSU (CSU group) and 23 healthy controls (control group). In CSU group, Weekly Urticaria Activity Score (UAS7) was recorded to assess disease severity. Autologous Serum Skin Test (ASST) was performed to assess autoreactivity. CSU patients᾿ group was subdivided, based on ASST, into positive ASST (ASST+ ) and negative ASST (ASST- ) subgroups. Correlation of serum IL-23 & IL-17A levels, with UAS7 and ASST response were analyzed. Results: CSU group had higher serum IL-17A and IL-23 levels than control group (P=0.000). ASST+ CSU had higher serum IL-17A and IL-23 levels than ASSTones (P=0.000). Additionally, UAS7 was higher in ASST+ subgroup than ASST- subgroup (32+11.7 versus 16.27+ 9.92; P =0.005). There was significant positive correlation between disease severity and serum levels of both IL-17A and IL-23 among CSU patients (r= 0.626 & P= 0.001 and r=0.515 & P= .012, respectively). Conclusion: Increased serum IL-17A and IL-23 levels may constitute two major determinants of CSU pathogenesis and severity.

scholarly journals Autologous Serum Skin Test in Chronic Idiopathic Urticaria

2016 ◽  
Vol 12 (2) ◽  
pp. 6-10 ◽  
Author(s):  
Kumar Pokhrel ◽  
S. Subedi ◽  
S. Acharya
Keyword(s):  
Skin Test ◽  
Chronic Urticaria ◽  
Cost Effective ◽  
Activity Score ◽  
Autologous Serum ◽  
Cross Sectional ◽  
Dermatology Department ◽  
Autologous Serum Skin Test ◽  
Autoimmune Urticaria ◽  
Urticaria Activity Score

Background: Urticaria is a short-lived swelling of skin and mucosa due to plasma leakage by immune and non immune mediated activation and released of mediators from mast cell and basophil. Autoimmune urticaria tends to have a high itch and wheal score than other type of urticaria. Its diagnosis is practically relied upon clinical suspicion and autologous serum skin test. Autologous serum skin test (ASST) is the simple and cost effective test to differentiate autoimmune urticaria from the bulk of chronic urticaria patients. Objective: To compare the features of chronic urticaria in patients having positive versus negative autologous serum skin test (ASST).Materials and methods: Cross-sectional hospital based study was conducted among 90 chronic urticaria patients (CIU) attending the outpatient dermatology department of Nepalgunj Medical College, Nepalgunj, during one year period. The study was conducted after ethical approval from the institutional committee. The patients were diagnosed on the basis of the appearance of continuous or recurrent hives with or without angioedema for more than 6 weeks. Patients who suffered from either acute urticaria or urticarial vasculitis or physical urticaria or other systemic diseases known to cause urticaria were excluded. Standard tools and techniques were used to prepare antilogous serum and injection of the serum and interpretation of the result. The test result was Interpreted as positive and negative autologous serum skin test.Results: ASST was positive in 42% of the patients and negative in 58% of the patients. The ASST-positive patients had a higher mean urticaria activity score and median duration of wheals in comparison with the ASST-negative patients. Wheals lasted for significantly longer duration in patients with positive ASST. Patients with positive ASST had more frequent attacks which was statistically significant compared to the ASST-negative group. The mean urticaria activity score was significantly higher in the ASST-positive patients than that in the ASST-negative patients.Conclusions: Autologous serum skin test may be a useful screening test for autoimmune urticaria and may be used as a simple and cost-effective test for the classification of chronic urticaria.JNGMC Vol. 12 No. 2 December 2014, page: 6-10

scholarly journals Oral mini-pulse steroid therapy in severe chronic urticaria

2021 ◽  
Vol 12 (e) ◽  
pp. e83-e83
Author(s):  
Mohammad Abid Keen ◽  
Faizan Younus Shah
Keyword(s):  
Chronic Urticaria ◽  
Maximum Dose ◽  
Autologous Serum ◽  
Once Daily ◽  
Autologous Serum Skin Test ◽  
Pulse Steroid Therapy ◽  
End Of Treatment ◽  
Urticaria Activity Score ◽  
Pulse Steroid

Background: Treatment of chronic urticaria can be difficult at times. The present study aimed to evaluate the efficacy of oral mini-pulse (OMP) therapy with methylprednisolone in management of severe chronic urticaria (CU). Methods and material: 100 patients with severe chronic urticaria, not controlled with maximum dose of a second generation antihistamine, were enrolled in the study after an informed written consent. All patients were treated with methylprednisolone 16 mg tablet on two consecutive days of a week for 2 months along with levocetirizine 5 mg tablet once daily. All patients were reviewed at 0, 2, 4, and 8 weeks with urticaria activity score (UAS). Results: The study comprised of 100 patients (33 males and 67 females) with severe chronic urticaria. 29 patients (29%) had raised TSH levels while Autologous Serum Skin Test was positive in 37 patients. Mean UAS in patients treated with OMP was 5.76 at baseline which reduced to 0.6 at the end of treatment period. Conclusion: Mean UAS showed a significant decline following OMP therapy with methylprednisolone. Most of the patients maintained the benefits of therapy at the end of follow up period of 4 months.

scholarly journals Interleukin 17 Receptor a Haplotype Analysis in Chronic Spontaneous Urticaria

2020 ◽  
Author(s):  
Hesham Nada ◽  
Ranya Hassan ◽  
Rasha Abd El-Hamed Ibrahim ◽  
Omnia Emad Abdelsalam ◽  
Amal Fathy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Haplotype Analysis ◽  
Complex Trait ◽  
Chronic Spontaneous Urticaria ◽  
Autologous Serum ◽  
Interleukin 17 ◽  
Allelic Discrimination ◽  
Autologous Serum Skin Test ◽  
Urticaria Activity Score

Abstract Background: Chronic spontaneous urticaria (CSU) is a distressing skin disease. Family clustering and heterogeneity in the onset and progression indicate that susceptibility to CSU is a complex trait. In this study, we performed haplotype analysis for one of the key player gene, IL17RA, for CSU to test the association with disease susceptibility and severity.MethodsThe study included 70 CSU patients and 30 healthy controls. The severity of the disease was evaluated by autologous serum skin test (ASST) and urticaria activity score (UAS). ASST test was done and quality of life was assessed using a questionnaire. Allelic discrimination analysis for rs4819554 and rs879577 was performed using Real-Time Polymerase Chain Reaction technology.Results: Carriers of rs4819554*G were more prone to develop CSU than its counterpart (p = 0.039), while rs4819554*A allele displayed more severe phenotype in the form of more prolonged disease duration (p = 0.040), concurrent angioedema (p < 0.001), higher level of treatment (p < 0.001), and higher score of quality of life (p < 0.001). Additionally, homozygote patients with rs879577*CC were associated with angioedema (p < 0.001). Haplotype analysis revealed that cohorts with both rs4819554*A and rs879577*T conferred protection against developing CSU (OR = 0.07, 95%CI = 0.01 - 0.32, p = 0.001).Conclusions: Our results showed that IL17RA gene polymorphisms might contribute to the increased susceptibility to CSU.

scholarly journals Efficacy of Injection Histaglobulin in Treatment of Chronic Urticaria

2021 ◽  
Author(s):  
Usha Naraindas Khemani ◽  
Avinash Aba Sajgane
Keyword(s):  
Chronic Urticaria ◽  
Treatment Options ◽  
Poor Response ◽  
Treatment Modalities ◽  
Autologous Serum ◽  
Prospective Clinical Study ◽  
Weekly Dose ◽  
Autologous Serum Skin Test ◽  
Secondary Objective ◽  
Urticaria Activity Score

Introduction: Patients of Chronic Urticaria (CU) suffer from the morbidity that arise from irritable itch and wheals and it also shows a poor response to drug treatment. Treatment options which increase the duration of remission and those which address the key factors involved in the disease pathogenesis are the need of the hour. Aim: To assess the efficacy of injection histaglobulin a complex of histamine and human immunoglobulin in producing relief in patients with CU. Secondary objective was to compare effect of histaglobulin in between Autologous Serum Skin Test (ASST) positive and ASST negative group of CU patients. Materials and Methods: The present study was a prospective clinical study in which 40 patients with CU were enrolled. Patients were administered injection histaglobulin as a weekly dose of 1 mL subcutaneously for eight consecutive weeks. Patients were permitted to take Tab Levocetirizine 5 mg as and when required not exceeding the recommended permitted dose. The efficacy of the drug was assessed using Urticaria Activity Score (UAS 7) a unified, validated and simple scoring system. The assessment was done at every weekly visit and the final assessment was done after 24 weeks. Results: Out of 40 patients enrolled, 32 patients had completed the entire schedule of dosage of eight weeks and final follow-up at 24th week. The mean basal UAS 7 was 12.6 at the time of enrolment to the study and it reduced to 2.57 at the end of 8th week which marginally increased to 2.8 at the end of 24 weeks, the antihistamine pill burden also reduced. No adverse effects were observed in the study group. Conclusion: Histaglobulin was found to be effective in producing long term remission and it reduced the antihistamine need as well. Thus, it can be an effective alternative to existing treatment modalities.

scholarly journals Perception of quality of life and social adjustment of patients with recurrent depression

2006 ◽  
Vol 134 (9-10) ◽  
pp. 369-374 ◽  
Author(s):  
Zana Stankovic ◽  
Gordana Nikolic-Balkoski ◽  
Ljubica Leposavic ◽  
Ljiljana Popovic
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Social Adjustment ◽  
Healthy Subjects ◽  
Inverse Correlation ◽  
Control Group ◽  
Recurrent Depression ◽  
Patients With Diabetes ◽  
Perception Of Quality

Introduction: Depression is the most commonly present psychiatric entity in clinical practice, accompanied by significant impairment of both social and professional functioning. In addition, depression frequently develops as complication of other psychiatric disorders and various somatic diseases. Objective: To investigate subjective perception of quality of life and social adjustment, severity of depressive symptoms as well as level of correlation of severity of depressive symptoms and quality of life and social adjustment of patients with recurrent depression in comparison to the group of patients with diabetes and healthy subjects. Method: The study included 45 subjects of both sexes, ranging from 18 to 60 years of age, divided in three groups of 15 subjects each. The experimental group comprised the patients diagnosed with recurrent depression in remission (DSM-IV), one control group was consisted of patients diagnosed with Type 2 Diabetes mellitus and another one comprised healthy subjects. The instruments of assessment were: The Beck Depression Inventory- BDI, The Social Adaptation Self -evaluation scale - SASS, The Psychological General Well-Being Scale - WBQ. Results: Significant difference of both BDI and WBQ scales was found between the experimental and the control group of healthy subjects (ANOVA, Mann Whitney; p?0.01), as well as between two control groups (p?0.02). The level of inverse correlation of mean score values of BDI and SASS scales was significant in the control group of patients with diabetes while such levels of BDI and WBQ scales (Spearman correlation coefficient, p<0.01) were found in all groups of our study. Conclusion: In the group of patients with recurrent depression, significant decline of quality of life and significantly higher severity of depressive symptoms were present in comparison to the group of healthy subjects as well as significant level of inverse correlation of severity of depressive symptoms and quality of life.

scholarly journals Accident-related neurogenic fecal incontinence: a retrospective study

2019 ◽  
Author(s):  
Jie Liu ◽  
Ruiling Wei ◽  
Dewei Wu ◽  
Hulin Chen ◽  
Juan Dong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Retrospective Study ◽  
Fecal Incontinence ◽  
Psychological Health ◽  
Healthy Subjects ◽  
Control Group ◽  
Squeeze Pressure ◽  
Anorectal Motility ◽  
Neurogenic Fecal Incontinence

Abstract Abstract Background To evaluate the anorectal motility characteristics, the quality of life and psychological health of accident-related neurogenic fecal incontinence(ArNFI) patients. Methods A retrospective study was conducted on 26 patients with ArNFI visiting the gastrointestinal motility center of affiliated provincial hospital of Anhui medical university were collected as research objects from January 2016 to August 2019. The anorectal motility characteristics of these patients were recorded and analysed by high resolution manometry (HRM), 10 healthy subjects for the same period were recruited as the control group. The psychological characteristics of these patients and healthy subjects were compared by HAMA and HAMD scores,and their quality of life was investigated by SF36. Results Anal sphincter resting pressure in the ArNFI group was more lowwer than that of the control group (21.18± 4.68vs34.83± 14.13, P<0.05). Anorectal compliance in the ArNFI group was more lowwer than that of the control (1.41± 0.32vs4.03± 1.06, P<0.05). Maximal squeeze pressure were in the ArNFI group was also lowwer than that of the control(53.66±14.59 vs 143.95±19.82, P<0.05).HAMA ,HAMD scores of the ArNFI group in the ArNFI group were all higher than that of the control ( 21.29±2.06 vs 7.63±1.41 ;22.00±3.70 vs 8.75±1.91, respectively.all P<0.01). There were significant differences between SF36 scores of ArNFI group and the control group in the 8 dimensions of PF,RP,GH,VT,SF,RE and MH.(P<0.01) . Conclusion In patients with ArNFI,there were significantly reduced anorectal motility characteristics, increased HAMA.HAMD scores,and their life quality was obviously declined.

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