Detection of circulating IgG autoantibody to FcεRIα in sera from chronic spontaneous urticaria patients

Ulambayar, Bastsetseg; Chen, Yi-Hsing; Ban, Ga‐Young; Lee, Ji-Ho; Jung, Chang-Gyu; Yang, Eun‐Mi; Park, Hae‐Sim; Ye, Young-Min

doi:10.1016/j.jmii.2017.10.003

Cited by 29 publications

(37 citation statements)

References 33 publications

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“…The first, by Ulambayar et al . , showed 54% higher levels of IgG anti‐FcεRI in patients with CSU than in normal controls, while the second, by Cugno et al . , showed more than 111% higher levels of IgE anti‐TF and anti‐TG in CSU patients than in normal controls.…”

Section: Methodsmentioning

confidence: 93%

Co-occurrence of IgE and IgG autoantibodies in patients with chronic spontaneous urticaria

Asero

Marzano

Ferrucci

et al. 2020

Clinical and Experimental Immunology

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Chronic spontaneous urticaria (CSU) pathogenesis shows a complex and still unclear interplay between immunoglobulin (Ig)G-and IgE-mediated autoimmunity, leading to mast cell and basophil degranulation and wheal formation. The objective of this study was to evaluate at the same time IgE-and IgG-reactivity to well recognized and recently reported autoantigens in CSU patients, and to assess the effects of such reactivity on response to the anti-IgE monoclonal antibody omalizumab. Twenty CSU patients underwent omalizumab treatment. Urticaria activity score 7 (UAS7) was recorded at baseline and at different drug administration time-points for categorizing early-, late-or non-responders. At baseline, sera from the 20 patients and from 20 controls were tested for IgE and IgG autoantibodies to high-and low-affinity IgE receptors (FcεRI and FcεRII), tissue factor (TF) and thyroglobulin (TG) by immunoenzymatic methods. Antibody levels were compared with those of controls and analysed according to response. Eighteen patients were omalizumab responders (11 early and seven late), while two were non-responders. More than 50% of patients had contemporary IgE and IgG to at least to one of the four different autoantigens. Late responders showed higher levels of both anti-TF IgE and IgG than early responders (P = 0·011 and P = 0·035, respectively). Twenty-five per cent of patients had levels of anti-FcεRI IgE, exceeding the upper normal limit, suggesting that it could be a novel auto-allergen in CSU. In CSU, there is an autoimmune milieu characterized by the co-existence of IgE and IgG autoantibodies to the same antigen/allergen, particularly in late responders to omalizumab, possibly explaining the slower response.

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Section: Methodsmentioning

confidence: 93%

Co-occurrence of IgE and IgG autoantibodies in patients with chronic spontaneous urticaria

Asero

Marzano

Ferrucci

et al. 2020

Clinical and Experimental Immunology

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“…The concept that circulating IgG antibodies against IgE and the high-affinity IgE receptor FcεR1 likely contribute to the pathogenesis of CSU has since become widely accepted. Approximately 40% of patients with CSU have circulating antibodies to one of these targets (27) with a higher frequency of positivity in CSU patients who are ASST positive (28). Anti-FcεRI antibodies are thought to be the more common of the two.…”

Section: The Autoimmune Theory Of Mast Cell Activation In Chronic Spomentioning

confidence: 99%

Autoimmune Theories of Chronic Spontaneous Urticaria

2019

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Urticaria (hives) is a highly prevalent skin disorder that can occur with or without associated angioedema. Chronic spontaneous urticaria (CSU) is a condition which persists for more than 6 weeks in duration and occurs in the absence of an identifiable provoking factor. CSU results from pathogenic activation of mast cells and basophils, which gives rise to the release of proinflammatory mediators that support the generation of urticaria. Several theories have been put forth regarding the pathogenesis of CSU with much evidence pointing toward a potential autoimmune etiology in up to 50% of patients with this condition. In this review, we highlight the evidence surrounding the autoimmune pathogenesis of chronic urticaria including recent data which suggests that CSU may involve contributions from both immunoglobin G (IgG)-specific and immunoglobulin E (IgE)-specific autoantibodies against a vast array of antigens that can span beyond those found on the surface of mast cells and basophils.

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“…Blood levels of IgG-anti-FceRI, IgG anti-IGE, total IgE, IgE anti-self and other autoantibodies, and autologous serum skin testing are important [71-74]. There are recent data linking low basophil counts with more rapid resolution in children [75].…”

Section: Laboratory Investigationsmentioning

confidence: 99%

Chronic Urticaria: An Overview of Treatment and Recent Patents

Hon

Leung

et al. 2019

IAD

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Background: Up to 1% of the general population in the USA and Europe suffer from chronic urticaria (CU) at some point in their lifetime. CU has an adverse effect on the quality of life. Objectives: This study aims to provide an update on the epidemiology, pathogenesis, clinical manifestations, diagnosis, aggravating factors, complications, treatment and prognosis of CU. Methods: The search strategy included meta-analyses, randomized controlled trials, clinical trials, reviews and pertinent references. Patents were searched using the key term "chronic urticaria" at the following links: www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com. Results: CU is a clinical diagnosis, based on the episodic appearance of characteristic urticarial lesions that wax and wane rapidly, with or without angioedema, on most days of the week, for a period of six weeks or longer. Triggers such as medications, physical stimuli, and stress can be identified in 10 to 20% of cases. C-reactive protein/erythrocyte sedimentation rate, and complete blood cell count with differential are the screening tests that may be used to rule out an underlying disorder. The mainstay of therapy is reassurance, patient education, avoidance of known triggers, and pharmacotherapy. Secondgeneration H1 antihistamines are the drugs of choice for initial therapy because of their safety and efficacy profile. If satisfactory improvement does not occur after 2 to 4 weeks or earlier if the symptoms are intolerable, the dose of second-generation H1 antihistamines can be increased up to fourfold the manufacturer’s recommended dose (all be it off license). If satisfactory improvement does not occur after 2 to 4 weeks or earlier if the symptoms are intolerable after the fourfold increase in the dosage of second-generation H1 antihistamines, omalizumab should be added. If satisfactory improvement does not occur after 6 months or earlier if the symptoms are intolerable after omalizumab has been added, treatment with cyclosporine and second-generation H1 antihistamines is recommended. Short-term use of systemic corticosteroids may be considered for acute exacerbation of CU and in refractory cases. Recent patents for the management of chronic urticaria are also discussed. Complications of CU may include skin excoriations, adverse effect on quality of life, anxiety, depression, and considerable humanistic and economic impacts. On average, the duration of CU is around two to five years. Disease severity has an association with disease duration. Conclusion: CU is idiopathic in the majority of cases. On average, the duration of CU is around two to five years. Treatment is primarily symptomatic with second generation antihistamines being the first line. Omalizumab has been a remarkable advancement in the management of CU and improves the quality of life beyond symptom control.

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Detection of circulating IgG autoantibody to FcεRIα in sera from chronic spontaneous urticaria patients

Abstract: These findings suggest that circulating IgG autoantibody to FcεRIα in a subset of patients may be involved in the autoimmune mechanism of CSU. Further studies are needed to clarify its clinical significance.

Cited by 29 publications

References 33 publications

Co-occurrence of IgE and IgG autoantibodies in patients with chronic spontaneous urticaria

Co-occurrence of IgE and IgG autoantibodies in patients with chronic spontaneous urticaria

Autoimmune Theories of Chronic Spontaneous Urticaria

Chronic Urticaria: An Overview of Treatment and Recent Patents

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