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The Fcε receptor I pathway is crucial but not exclusive for basophil activation in patients with autoimmune forms of chronic spontaneous urticaria.

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Quantity increase and functional affinity/avidity decrease of anti-FcεRI and anti-IgE autoantibodies in chronic

L Joerg1, N Mueller-Wirth2, K Kammermann2

  • 1Division of Allergologie and Clinical Immunology, Department of Pulmonary Medicine, Allergology and Clinical Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

European Annals of Allergy and Clinical Immunology
|December 13, 2023
PubMed
Summary

Autoimmune chronic spontaneous urticaria (aiCSU) involves autoantibodies against IgE and FcεRI. While antibody levels increased, their avidity decreased over six months, suggesting basophil activation tests are better for diagnosing aiCSU.

Keywords:
AffinityFcεRI receptorautoantibodiesbasophil activation testchronic spontaneous urticaria

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Area of Science:

  • Immunology
  • Dermatology
  • Allergy

Background:

  • Autoimmune chronic spontaneous urticaria (aiCSU) is characterized by autoantibodies targeting the high-affinity IgE receptor (FcεRI) and IgE.
  • The correlation between autoantibody presence and disease activity in aiCSU is inconsistent, suggesting functional aspects like avidity may be crucial.

Purpose of the Study:

  • This study aimed to investigate the changes in quantity and avidity of autoantibodies against IgE and FcεRI over a six-month period in patients with aiCSU.
  • To explore the relationship between autoantibody avidity, basophil activation, and disease activity in aiCSU.

Main Methods:

  • Serum samples from 49 patients with chronic spontaneous urticaria (CSU) and 30 healthy controls were collected at baseline and after six months.
  • Enzyme-linked immunosorbent assay (ELISA) was used to quantify autoantibodies against IgE and FcεRI and assess their avidity.
  • Basophil activation was measured using the basophil activation test (CU-BAT).

Main Results:

  • Patients with CSU showed a significant increase in the quantity of anti-FcεRI and anti-IgE autoantibodies after six months.
  • Concurrently, the avidity of these autoantibodies significantly decreased over the same period.
  • No significant changes in basophil activation frequency were observed, and autoantibody avidity did not correlate with basophil activation.

Conclusions:

  • Both the quantity and avidity of anti-FcεRI and anti-IgE autoantibodies fluctuate over time in patients with CSU.
  • The basophil activation test (CU-BAT) appears more suitable for diagnosing aiCSU than measuring autoantibody avidity.
  • The lack of correlation between autoantibody avidity and basophil activation suggests other factors contribute to aiCSU pathogenesis.