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Chronic urticaria: novel clinical and serological aspects
R Asero1, A Tedeschi, M Lorini
1Allergy Unit, Ospedale Caduti Bollatesi, Via Piave 20, I-20021 Bollate (Milan), Italy. r.asero@libero.it
Summary
67% of chronic idiopathic urticaria (CIU) patients have a positive autologous serum skin test. Their sera can trigger histamine release from basophils, suggesting autoantibodies may play a role in CIU pathogenesis.
Area of Science:
- Immunology
- Dermatology
- Allergy Research
Background:
- Chronic idiopathic urticaria (CIU) is autoimmune in 30-50% of cases.
- Autologous serum skin test (ASST) in CIU patients is inhibited by heparin.
- Basophil histamine release induced by CIU sera may be complement-dependent.
Purpose of the Study:
- To conduct a comprehensive clinical and serological study on CIU.
- To investigate the role of autoantibodies and complement in CIU.
- To evaluate the effect of heparin on histamine release in CIU.
Main Methods:
- 306 adult CIU patients underwent autologous serum skin testing.
- Autologous heparinized plasma testing was performed on 57 patients.
- Sera/plasmas from patients were used to induce in vitro histamine release from normal basophils.
Main Results:
- 67% of CIU patients had a positive autologous serum skin test.
- Sera from 16.5% of patients induced significant histamine release from basophils in vitro.
- Heparin dose-dependently inhibited histamine release induced by sera, plasma, and other agonists.
Conclusions:
- Functional autoantibodies are likely present in a subset of CIU patients.
- Complement may be essential for the histamine-releasing activity of CIU sera in some cases.
- Heparin inhibits histamine release from both basophils and mast cells, potentially at a cellular level.