Relationship between changes in the 7-day urticaria activity score after treatment with omalizumab and the responsiveness of basophils to FcεRI stimulation in patients with chronic spontaneous urticaria
Relationship between changes in the 7-day urticaria activity score after treatment with omalizumab and the responsiveness of basophils to FcεRI stimulation in patients with chronic spontaneous urticaria
复制标题
DOI：
10.5415/apallergy.2020.10.e12
复制
发表时间：
2020-04-01
影响因子：
1.7
通讯作者：
Okayama, Yoshimichi
中科院分区：
文献类型：
--
作者：
Endo, Takahiro;Toyoshima, Shota;Okayama, Yoshimichi
背景：大约一半的慢性自发性荨麻疹患者的嗜碱性粒细胞对Fce.RI刺激的反应性较低或更低。然而，对FcERI刺激表现出正常和减弱的嗜碱性粒细胞反应性的患者之间的临床特征差异仍不清楚。此外，什么因素导致嗜碱性粒细胞对FccRI刺激的反应性差仍是未知数。目的：本研究的目的是调查对FccRI刺激显示正常和减弱的嗜碱性粒细胞反应性的患者之间的临床特征的差异。比较两组患者的临床特征，包括自体血清皮肤试验阳性率，抗IgE和抗FccRI α自身抗体的血清浓度，以及这些自身抗体在嗜碱性粒细胞活化试验（BAT）阴性患者（100/0 CD 203 c（高）嗜碱性粒细胞，n = 13）之间的FccRI交联能力。我们还监测了与基线评分相比，BAT阳性和BAT阴性患者在奥马珠单抗治疗后7天荨麻疹活动性评分的变化。结果：BAT阴性患者的荨麻疹控制测试评分显著高于BAT阳性患者（p= 0.01）。两组之间的自体血清皮肤试验阳性率、抗IgE和抗FccRIa自身抗体浓度以及这些自身抗体的FcERI交联能力无显著差异。奥马珠单抗治疗35天后，评分降至15分以下在所有BAT阴性患者中，这些评分（对应于控制或轻度慢性自发性荨麻疹），而在13名BAT阳性患者中，6名评分保持在16分以上（相当于中度或重度慢性自发性荨麻疹）。嗜碱性粒细胞对FcgRI刺激的弱反应性可能不是由于抗IgE或抗FccRIa自身抗体使嗜碱性粒细胞脱敏。BAT阴性和BAT阳性慢性自发性荨麻疹患者的奥马珠单抗缓解时间可能不同。
Background: About one-half of all patients with chronic spontaneous urticaria have low or less reactivity of the basophils to Fce.RI stimulation. However, the differences in the clinical characteristics between patients who show normal and attenuated basophil reactivities to FcERI stimulation are still unclear. Furthermore, it also remains unknown as to what factors induce the poor reactivity of basophils to FccRI stimulation.Objective: The aim of the study is to investigate the differences in the clinical characteristics between patients who show normal and attenuated basophil reactivities to FccRI stimulation.Methods: We compared the clinical characteristics, including the autologous serum skin test -positive rates, serum concentrations of anti-IgE and anti-Fc epsilon RI alpha autoantibodies, and the FccRI-crosslinking ability of these autoantibodies between patients with a negative basophil activation test (BAT) (100/0 CD203c(high) basophils, n = 13). We also monitored the changes in the 7-day urticaria activity scores after treatment with omalizumab, as compared to the score at the baseline, between the BATpositive and BAT-negative patients.Resufts: The BAT-negative patients showed a significantly higher urticaria control test score than the BAT-positive patients (p= 0.01). There were no significant differences in the autologous serum skin test-positive rates, concentrations of anti-IgE and anti-FccRIa autoantibodies, and the FcERI-crosslinking ability of these autoantibodies between the 2 groups. After treatment with omalizumab for 35 days, the score decreased to under 15 (corresponding to controlled or mild chronic spontaneous urticaria) in all of the BATnegative patients, whereas in 6 out of the 13 BAT-positive patients, the scores remained over 16 (corresponding to moderate or severe chronic spontaneous urticaria).Conclusions: The weak reactivity of basophils to FcgRI stimulation may not be due to the desensitization of basophils by anti-IgE or anti-FccRIa autoantibodies. The time to response to omalizumab might differ between BAT-negative and BAT-positive patients with chronic spontaneous urticaria.