Food allergy, anaphylaxis, dermatology, and drug allergyActivation of the tissue factor pathway of blood coagulation in patients with chronic urticaria
Section snippets
Patients
Thirty-seven consecutive adult patients (male/female, 8/29; mean age, 45 years; age range, 14-82 years) with CU seen at the allergy department of the Clinica San Carlo (Paderno Dugnano, Italy) were studied. CU was diagnosed on the basis of the appearance of continuous or recurrent hives with or without angioedema for more than 6 weeks.16 Patients with physical urticaria were excluded. Disease activity was estimated according to the number of wheals present at the time when blood samples from
Patients
Disease activity was slight, moderate, or severe in 20, 14, and 3 patients, respectively. Thirty-six of 37 (97%) patients scored strongly positive on the autologous plasma skin test (in the remaining case there was only a slight wheal-and-flare reaction). On the ASST, 10 patients scored negative, 6 showed a slight reactivity, and 15 (48%) showed a marked wheal-and-flare reaction. The only patient showing only slight skin reactivity on the autologous plasma skin test scored negative on ASST.
Prothrombin fragment F1+2
Discussion
There is some evidence that the coagulation cascade might be involved in the pathogenesis of CU. Some studies showed that heparin inhibits both the skin response to autologous serum and histamine release from human cultured basophils in vitro.23, 24 The immediacy of the in vivo effect of heparin suggests that this should be caused by a direct action at a cellular level or by a direct binding of circulating histamine releasing factors and not by an interference with the intracellular system of
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Genetic Variants Leading to Urticaria and Angioedema and Associated Biomarkers
2023, Journal of Allergy and Clinical Immunology: In PracticeAssociation between the severity of chronic spontaneous urticaria and sleep-disordered breathing
2022, Allergology InternationalThe Diagnostic Workup in Chronic Spontaneous Urticaria—What to Test and Why
2021, Journal of Allergy and Clinical Immunology: In PracticeThe Pathogenesis of Chronic Spontaneous Urticaria: The Role of Infiltrating Cells
2021, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :Although other cell types such as endothelial cells130 and peripheral monocytes131 may also show this feature, eosinophils are able to store tissue factor (TF) and to transfer it rapidly to the cell membrane on activation.132 The potentially relevant role played by these cells in the pathogenesis of CSU has been further highlighted by the observation that patients with a severe disease are characterized by an intense activation of the extrinsic pathway of the coagulation cascade.133-135 Immunohistochemical experiments using double staining showed that in CSU skin, TF colocalizes with eosinophil cationic protein, a classic cell marker of eosinophils.136
Evaluation of serum levels of C-reactive protein, D-Dimer and Autologous Serum Skin Test in patients with Chronic Spontaneous Urticaria in a Brazilian tertiary center: a cross-sectional study
2021, Anais Brasileiros de DermatologiaCitation Excerpt :In that study, the authors found high mean D-dimer levels in patients with CU, as opposed to the healthy control group, also demonstrating markers of fibrinolysis activation in their patients.13 It was then proven by the authors that the activation of coagulation and, consequently, the presence of D-dimer, can be correlated with disease severity.13 Similar findings related to plasma D-dimer levels and CSU severity were observed in the present study.
Disclosure of potential conflict of interest: P. Riboldi has received grant support from IRCCS Istituto Auxologico. The rest of the authors have declared that they have no conflict of interest.