Clinical Characterization of Patients with Chronic Spontaneous Urticaria according to Anti-TPO IgE Levels
Clinical Characterization of Patients with Chronic Spontaneous Urticaria according to Anti-TPO IgE Levels
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DOI：
10.1155/2019/4202145
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发表时间：
2019-12-07
影响因子：
4.1
通讯作者：
Cardona, Ricardo
中科院分区：
文献类型：
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作者：
Sanchez, Jorge;Sanchez, Andres;Cardona, Ricardo
背景资料。慢性自发性荨麻疹(CSU)是一种异质性疾病，常合并自身免疫性疾病、药物反应、诱发性荨麻疹等。抗甲状腺过氧化物酶的IgE抗体(抗TPO-IgE)可能与这些临床特征有关。目标。根据血清抗TPO-IgE抗体的存在情况，探讨CSU患者的临床特点。方法：研究方法。检测100例CSU患者临床控制期(荨麻疹活动期0分)和急性加重期(>；=3分)抗TPO IgE水平。自我报告因食物、非类固醇抗炎药(NSAIDs)和物理诱因导致皮肤受累加重的患者接受了受控激发试验。结果。我们确定了两组患者：(1)在临床控制期或病情加重期间有抗TPO IgE的患者，他们有较高的特应性、哮喘和NSAIDs激发试验阳性的频率；(2)在任何时期无抗TPO IgE的患者，诱导性荨麻疹激发试验阳性的频率较高。在第一组(任意时间点抗TPO IgE)中，我们确定了3个亚组：在临床控制期抗TPO IgE的患者(n=12)；在临床控制期抗TPO IgE并在荨麻疹加重期间显著升高的患者(n=18)；以及仅在急性发作期间抗TPO IgE的患者(n=13)。自我报告食物反应的患者没有一例挑战测试结果呈阳性。结论。抗TPO-IgE抗体是鉴别CSU患者临床表型的有用生物标志物。急性发作期的抗TPO IgE升高支持这种自身抗体与荨麻疹发病机制之间的联系。
Background. Chronic spontaneous urticaria (CSU) is a heterogeneous disease with some frequent comorbidities like autoimmune diseases, drug reactions, and inducible urticaria. IgE antibodies against thyroid peroxidase (anti-TPO IgE) could be associated with some of these clinical characteristics. Objective. To explore the clinical characteristics of CSU patients, according to the presence of anti-TPO IgE in serum. Methods. Anti-TPO IgE levels were measured during the clinical control period (Urticaria Activity Score, 0 point) and exacerbation period (>= 3 points) in 100 CSU patients. Patients with self-reported exacerbation of skin involvement by foods, nonsteroidal anti-inflammatory drugs (NSAIDs), and physical triggers underwent controlled challenge tests. Results. We identified 2 groups of patients: (1) patients with anti-TPO IgE during the clinical control period or during an exacerbation, who had a higher frequency of atopy, asthma, and positive challenge test results with NSAIDs and (2) patients without anti-TPO IgE during any period, who had a higher frequency of positive challenge test results for inducible urticaria. Among the first group (anti-TPO IgE at any point), we identified 3 subgroups: patients with anti-TPO IgE during the clinical control period (n=12); patients with anti-TPO IgE during the clinical control period and significantly increased levels during an urticaria exacerbation (n=18); and patients with anti-TPO IgE only during an exacerbation (n=13). None of the patients with self-reported food reactions had a positive challenge test result. Conclusion. Anti-TPO IgE is a useful biomarker for differentiating between clinical phenotypes of patients with CSU. Elevation of anti-TPO IgE during exacerbation periods supports an association between this autoantibody and the pathogenesis of urticaria.