The spectrum of chronic urticaria
The spectrum of chronic urticaria
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DOI：
10.2500/aap.2009.30.3191
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发表时间：
2009-01-01
影响因子：
2.8
通讯作者：
Sheikh, Javed
中科院分区：
文献类型：
--
作者：
Najib, Umer;Sheikh, Javed
慢性荨麻疹是一种常见的异质性条件，可以相当衰弱。荨麻疹有许多潜在的原因，其严重程度和临床模式可能因患者而异。90%的慢性荨麻疹患者没有特定的外部原因，因此被称为“慢性特发性荨麻疹”。然而，我们现在知道，高达30-50%的特发性病例可能是自身免疫性的或与肥大细胞和嗜碱性粒细胞异常有关。有证据表明，IgE高亲和力受体（FcepsilonRI）的自身抗体特异性结合α链（FcepsilonRIalpha），可能具有致病性。此时，检测临床相关的FcepislonRI自身抗体的金标准是功能性体外供体嗜碱性粒细胞组胺释放试验。这些自身抗体的确切患病率和作用仍在调查中。组胺拮抗剂是治疗的主要药物。对于其症状不能单独由抗组胺药控制的患者，有许多辅助治疗选择，但仍需要开发更好的药物治疗这种疾病。
Chronic urticaria is a common heterogenous condition that can be quite debilitating. There are a number of potential causes of urticaria, and the severity and clinical pattern can vary considerably from patient to patient. Eighty of 90% of patients with chronic urticaria have no specific external cause for their disease, which is therefore labeled "chronic idiopathic urticaria." We now know, however, that up to 30-50% of idiopathic cases may be autoimmune or related to mast cell and basophil abnormalities. There is evidence of an autoantibody to the high-affinity receptor for IgE (FcepsilonRI), specifically binding to the alpha-chain (FcepsilonRIalpha), which may be pathogenic. At this point in time, the gold standard for detecting clinically relevant autoantibodies to FcepislonRI is the functional in-vitro donor basophil histamine release assay. The exact prevalence and role of these autoantibodies is still under investigation. Histamine antagonists are the mainstays of therapy. For patients whose symptoms are not controlled by antihistamines alone, there are a number of adjunct therapy options, Wit there is still a need to develop better agents for this disease.