Acute Urticaria with Elevated Circulating Interleukin‐6 Is Resistant to Anti‐Histamine Treatment
Acute Urticaria with Elevated Circulating Interleukin‐6 Is Resistant to Anti‐Histamine Treatment
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循环白细胞介素 6 升高的急性荨麻疹对抗组胺治疗有抵抗力
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
N. Ohgou
中科院分区：
文献类型：
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作者：
K. Fujii;K. Konishi;Y. Kanno;N. Ohgou
从真皮肥大细胞释放的组胺在急性荨麻疹的血管通透性增加中起着重要作用，抗组胺药的给药通常会抑制风团的发展。急性特发性荨麻疹，特别是严重病例，偶尔会出现急性炎症反应，如低热和白细胞增多，并对抗组胺药耐药。考虑到广泛的促炎细胞因子和趋化因子，可以从活化的肥大细胞释放，其中一些可能参与荨麻疹的发病机制。我们测定了16例严重急性荨麻疹患者的血浆白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和肿瘤坏死因子-α（TNF-α）水平。所有患者均未显示血浆IL-8或TNF-α水平升高。16例急性荨麻疹患者中有9例显示循环IL-6升高，同时血清CRP水平升高。所有这些患者均对常规抗组胺治疗耐药，需要全身性类固醇以完全抑制风团的发展。荨麻疹消退后，他们升高的IL-6和CRP水平下降到正常范围。相比之下，除1例患者外，所有未升高循环IL-6的患者均成功接受H1受体拮抗剂西替利嗪治疗。数据表明IL-6参与对抗组胺药耐药的严重急性荨麻疹的发病机制。
Histamine released from dermal mast cells plays a central role in the increased vascular permeability in acute urticaria, and administration of anti‐histamines usually suppresses development of wheals. Acute idiopathic urticaria, particularly a severe case, occasionally presents with acute inflammatory reactions such as low‐grade fever and leukocytosis and is resistant to anti‐histamines. Considering the wide spectrum of proinflammatory cytokines and chemokines that can be released from activated mast cells, some of them might be involved in the pathogenesis of urticaria. We measured plasma levels of interleukin‐6 (IL‐6), interleukin‐8 (IL‐8), and tumor necrosis factor‐α (TNF‐α) in 16 cases of severe acute urticaria. None of them showed elevated plasma levels of IL‐8 or TNF‐α. Nine out of 16 acute urticaria patients showed elevated circulating IL‐6 with concomitant increases in serum CRP levels. All such patients were resistant to conventional anti‐histamine treatment and required systemic steroids for complete suppression of wheal development. After subsidence of the urticaria, their elevated IL‐6 and CRP levels dropped to their normal ranges. In contrast, all but one patient without elevated circulating IL‐6 was successfully treated with a H1 receptor antagonist, cetirizine. The data suggest involvement of IL‐6 in the pathogenesis of severe acute urticaria that is resistant to anti‐histamines.