Autologous serum therapy in chronic urticaria: Old wine in a new bottle
Autologous serum therapy in chronic urticaria: Old wine in a new bottle
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DOI：
10.4103/0378-6323.39691
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发表时间：
2008-03-01
影响因子：
2.9
通讯作者：
Dhar, Sandipan
中科院分区：
文献类型：
--
作者：
Bajaj, A. K.;Saraswat, Abir;Dhar, Sandipan
背景：慢性荨麻疹（CU）是皮肤科医生面临的最具挑战性和最令人沮丧的治疗问题之一。最近的一项研究表明，一些CU患者对皮内自体血清注射的1型异常反应导致了一个新的“自身免疫性慢性荨麻疹”亚组的特征。这重新点燃了对自体血液注射作为这些患者理论上合理的治疗选择的古老实践的兴趣。目的：评价反复自体血清注射治疗荨麻疹的疗效。研究方法：前瞻性分析了62例（32例女性）自体血清皮肤试验（ASST）阳性的CU患者（第1组）连续9周每周自体血清注射的疗效，干预后随访12周。另一组13名（7名女性）ASST阴性的CU患者（第2组）也接受了类似治疗。在两组中，记录了疾病严重程度和活动性的六个独立参数。结果：两组的人口统计学和疾病变量相似。组1的平均病程为1.9 ± 0.3年（范围= 3个月至32年），组2为1.5 ± 0.2年（范围= 3个月至10年）。在ASST（+）组中，35.5%的患者在随访结束时完全无症状，而另外24.2%的患者明显改善。在ASST（-）组中，这些数字分别为23%和23%。完全下沉组间差异有统计学意义（P < 0.05）。在两组中，瘙痒和抗组胺药使用评分的降低最明显，其次是风团的大小和频率。结论：自体血清治疗对大部分ASST（+）伴CU患者有效。一个较小的，但仍然相当数量的ASST（-）患者也受益于这种治疗。
Background: Chronic urticaria (CU) is one of the most challenging and frustrating therapeutic problems faced by a dermatologist. A recent demonstration of abnormal type 1 reactions to intradermal autologous serum injections in some CU patients has led to the characterization of a new subgroup of "autoimmune chronic urticaria". This has rekindled interest in the age-old practice of autologous blood injections as a theoretically sound treatment option in these patients. Aims: To evaluate the efficacy of repeated autologous serum injections (ASIs) in patients with recalcitrant chronic urticaria. Methods: A cohort of 62 (32 females) CU patients with a positive autologous serum skin test (ASST) (group 1) was prospectively analyzed for the efficacy of nine consecutive weekly autologous serum injections with a postintervention follow-up of 12 weeks. Another group of 13 (seven females) CU patients with negative ASST (group 2) was also treated similarly. In both groups, six separate parameters of disease severity and activity were recorded. Results: Demographic and disease variables were comparable in both groups. The mean duration of disease was 1.9 0.3 years (range = 3 months to 32 years) in group 1 and 1.5 +/- 0.2 years (range = 3 months to 10 years) in group 2. In the ASST (+) group, 35.5% patients were completely asymptomatic at the end of the follow-up while an additional 24.2% were markedly improved. In the ASST (-) group, these figures were 23 and 23% respectively. The intergroup difference for complete subsidence was statistically significant (P < 0.05). In both groups, the most marked reduction was seen in pruritus and antihistamine use scores followed by the size and frequency of the wheals. Conclusion: Autologous serum therapy is effective in a significant proportion of ASST (+) patients with CU. A smaller but still substantial number of ASST (-) patients also benefited from this treatment.