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Inflammation and coagulation in urticaria and angioedema
Massimo Cugno1, Riccardo Asero, Alberto Tedeschi
1Department of Internal Medicine, University of Milan, Via Pace 9, 20122 Milano, Italy. massimo.cugno@unimi.it
Current Vascular Pharmacology
|January 26, 2012
Summary
Urticaria and angioedema involve inflammation and coagulation pathways. Research shows increased thrombin generation and fibrinolysis markers during flare-ups, suggesting potential therapeutic targets.
Area of Science:
- Dermatology
- Immunology
- Hematology
Background:
- Urticaria presents as itchy wheals, classified as acute (<6 weeks) or chronic (>6 weeks).
- Chronic urticaria is often autoimmune, while acute forms are typically hypersensitivity reactions.
- Angioedema, a deeper swelling, can occur with urticaria or independently, with various causes including C1-inhibitor deficiency.
Purpose of the Study:
- To explore the interplay between inflammation and coagulation in urticaria and angioedema.
- To investigate the role of thrombin and histamine in these conditions.
- To examine the clinical relevance of coagulation markers in urticaria and angioedema.
Main Methods:
- Analysis of plasma markers of thrombin generation, fibrinolysis, and inflammation.
- Observation of marker levels during exacerbations and remissions of urticaria and angioedema.
- Review of existing reports on thrombosis risk and cardiovascular events in relation to urticaria.
Main Results:
- Increased plasma markers of thrombin generation, fibrinolysis, and inflammation observed during urticaria and angioedema exacerbations.
- Marker levels normalized during remission.
- No increased thrombosis risk reported in chronic urticaria/angioedema, despite cardiovascular events in acute urticaria.
Conclusions:
- Inflammation and coagulation are implicated in the pathogenesis of urticaria and angioedema.
- Elevated coagulation markers during flares suggest potential for anticoagulant and antifibrinolytic therapies.
- Further clinical evaluation of these therapies is warranted.
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