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 ◽  
...  

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.

2021 ◽  
Vol 4 (1) ◽  
pp. 24-29
Author(s):  
Mahvira Chow Liana Herman Adil ◽  
Nopriyati Nopriyati ◽  
Desi Oktariana ◽  
Yuli Kurniawati ◽  
Gita Dwi Prasasty

Several studies regarding the quality of life of chronic spontaneous urticaria patients based on Autologous Serum Skin Test (ASST) results have shown a variety of results. This study aims to determine the correlation between the quality of life and ASST results in chronic spontaneous urticaria patients at Dermatology and Venereology (DV) Outpatient Clinic of Dr. Mohammad Hoesin Hospital Palembang. This analytic observational study with a cross-sectional design used secondary data in the form of medical records. 76 samples met the inclusion criteria from 110 samples of chronic spontaneous urticaria patients at DV outpatient clinic. The distribution of chronic spontaneous urticaria patients was highest in the 17-25 year age group (23.7%) and the female group (64.5%). The majority of chronic spontaneous urticaria patients had negative ASST results (52.6%). The effect of chronic spontaneous urticaria on the decline in quality of life was mostly moderate (35.5%). The bivariate analysis between DLQI score and ASST results with a value of p = 0.307 or p> 0.05 showed no significant correlation between the quality of life and ASST results.


2021 ◽  
Vol 30 (1) ◽  
pp. 169-174
Author(s):  
Lobna A. El-Korashi ◽  
Basma M. Elkholy ◽  
Hanaa M. El Maghraby

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.


2021 ◽  
Vol 12 ◽  
Author(s):  
Bachar Memet ◽  
Eren Vurgun ◽  
Fatma Barlas ◽  
Martin Metz ◽  
Marcus Maurer ◽  
...  

Background: Patients with chronic spontaneous urticaria often exhibit psychiatric comorbidities including depression that contribute to the impairment of their quality of life. How CSU and depression are linked isn't well-understood. Substance P has been shown to be increased in patients with CSU and is held to contribute to the pathogenesis of depression.Methods: We measured disease activity in 30 CSU patients without depression and 30 CSU patients with depression by using the urticaria activity score. The severity of depression was assessed with the Beck Depression Inventory. We measured SP levels in these patients as well as in 30 healthy control subjects. In patients with comorbid depression, we correlated SP levels with CSU disease activity and the severity of depression.Results: In CSU patients, disease activity and the severity of depression were positively linked. UAS7 values were higher in CSU patients with comorbid depression as compared to those without (p &lt; 0.05). SP levels were higher in CSU patients with depression than in those without (p &lt; 0.001), but was similar in all CSU patients compared to healthy controls. SP levels weren't correlated with UAS7 values in CSU patients with depression, whereas they were weakly but significantly correlated with BDI scores (p &lt; 0.05).Conclusion: Our results suggest that, in CSU patients with comorbid depression, CSU disease activity affects the severity of depression. CSU patients with high disease activity should be explored for comorbid depression.


Author(s):  
Javad Fadaee ◽  
Maryam Khoshkhui ◽  
Maryam Emadzadeh ◽  
Seyed Isaac Hashemy ◽  
Reza Farid Hosseini ◽  
...  

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.


2022 ◽  
Vol 1 ◽  
pp. 7-10
Author(s):  
Bela Shah ◽  
Ankita Choudhary ◽  
Neha Jangid ◽  
Deval Mistry ◽  
Shikha Shah ◽  
...  

Objectives: Chronic spontaneous urticaria (CSU) is correlated with a high detrimental effect on the quality of life (QoL). Antihistamines are the first choice drugs in the management of CSU. QoL is important in the evaluation of the efficacy of antihistamines, as these are the most commonly used in CSU. Materials and Methods: In this comparative, three-arm study, patients with CSU were randomized to standard dose of either bilastine, fexofenadine, or levocetirizine for a period of 4 weeks. Patients were assessed for improvement in their QoL based on chronic urticaria QoL questionnaire (CU-Q2oL) questionnaire and urticaria activity score (UAS). Results: Fifty-eight CSU patients were randomized to bilastine (n = 23), fexofenadine (n = 18) and levocetrizine (n = 17) groups. There was significant improvement in CU-Q2oL and UAS score in all the groups during study period. 83%, 72%, and 65% patients reported improvement in CU-Q2oL score in bilastine, fexofenadine, and levocetrizine group, respectively. Bilastine was associated with significant improvement in CU-Q2oL compared to fexofenadine and levocetrizine (P < 0.05). Mean reduction in UAS score was 86%, 77%, and 68% in bilastine, fexofenadine and levocetrizine group respectively. The difference was statistically insignificant between the groups. The CU-Q2oL total score correlated more strongly (r = 0.62; P = 0.001) with the UAS7 in bilastine group than fexofenadine (r = 0.57; P = 0.01) and levocetrizine groups (r = 0.53; P = 0.02). Conclusion: The results of the study proved that, in CSU patients, QoL was improved significantly with bilastine as compared to fexofenadine and levocetirizine.


Author(s):  
Thi Bich Tra Cao ◽  
Hyun-Young Cha ◽  
Eun-Mi Yang ◽  
Bo-Youn Choi ◽  
Hae-Sim Park ◽  
...  

<b><i>Introduction:</i></b> Chronic spontaneous urticaria (CSU) is a common cutaneous disease caused by mast-cell degranulation. Human β-defensin 2 (HBD2) is a well-known antimicrobial peptide that is also a pruritogen inducing vascular permeability via non-IgE-mediated mast-cell degranulation. <b><i>Objective:</i></b> We investigated the associations between serum HBD2 levels and the clinical characteristics of CSU patients. <b><i>Methods:</i></b> Serum samples from 124 CSU patients and 56 healthy controls were screened for the levels of HBD2 and translationally controlled tumor protein (TCTP)_ by using ELISA. The urticaria activity score over 7 days (UAS7) was used to measure disease activity in CSU patients. Accompanying angioedema was self-reported. <b><i>Results:</i></b> Serum HBD2 levels were higher in the CSU group than in healthy subjects (median [interquartile range], 84.1 [43.5, 142.5] vs. 59.5 [26.7, 121.5], <i>p</i> = 0.034). In CSU patients, serum HBD2 level was negatively correlated with the peripheral basophil percentages (Spearman’s rho = −0.229, <i>p</i> = 0.01) and vitamin D levels (−0.262, <i>p</i> = 0.02), but positively correlated with TCTP levels (0.252, <i>p</i> = 0.006). In CSU patients, HBD2 level was higher in those with than without angioedema (101.7 [50.9, 184.2] vs. 66.7 [37.9, 132.0], <i>p</i> = 0.019). It did not differ by aspirin hypersensitivity or atopy status, or autologous serum skin test positivity. <b><i>Conclusion:</i></b> A known mast-cell degranulator, HBD2 was elevated in the sera from CSU patients compared to healthy controls and may be involved in the pathogenesis of accompanying angioedema.


Author(s):  
Marina Sabate-Bresco ◽  
Nuria Rodríguez-Garijo ◽  
JULIÁN AZOFRA ◽  
María L. Baeza ◽  
Carmen Diaz Donado ◽  
...  

Background: Chronic histaminergic angioedema (CHA) is defined as recurrent episodes of isolated angioedema (without hives) of unknown cause that respond to the same treatment as chronic spontaneous urticaria (CSU). Quality of life (QoL) studies have not been performed for CHA, except those carried out in the context of CSU associated with angioedema attacks (CSU-AE). Moreover, biomarkers for monitoring disease activity in CHA have not been identified. We aim to describe the burden of CHA and impact on patient QoL, compare the findings to those in CSU-AE patients, and investigate biomarker associations with disease severity and QoL parameters. Methods: We performed a prospective multicenter study that included 68 patients with CHA and 63 patients with CSU-AE. Demographic and clinical variables were collected. Validated patient-reported questionnaires were employed to analyze the quality of life and disease activity. Blood and serological parameters, including blood cell count, C-reactive protein, D-dimer and total IgE, were also analyzed. Results: Angioedema disease activity was significantly higher in CSU-AE patients (median AAS7, IQR: 1, [0–1]) than CHA patients (0, [0–1]; p= 0.022). A considerable impact on QoL was found in both groups, although significantly worse values were found for CSU-AE (median AEQoL, IQR: 37, [10–65]; p=0.005). CHA patients were older than CSU-AE patients, and female predominance was not observed. Conclusions: Angioedema severity and QoL impacts are significantly worse in CSU than in chronic histaminergic angioedema. Angioedema should be included in severity urticaria scores (UAS) as well as in specific quality of life urticaria scales.


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