Improvement of chronic idiopathic urticaria with l‐thyroxine: a new TSH role in immune response?

Abstract

The reason of AT is associated to CIU and others allergical and autoimmune diseases is poorly known. The exclusive hormonal therapy reduces the symptoms of CIU and inflammatory response in many chronic diseases associated to AT. We suggest a stimulatory effect of TSH able to produce considerable changes of the immune response and immune tolerance in patients with AT causing target organs damage. The causal mechanism involves immune, nervous and endocrine system, sharing a common set of hormones, cytokines and receptors, in a unique totally integrated loop (the neuro-immuno-endocrine axis).

Avaliação da associação entre doença auto-imune de tireóide e urticária crônica idiopática

“…Em estudos onde foi encontrada maior prevalência de DAT em pacientes com UC, observou-se melhora das lesões de pele em alguns pacientes após tratamento com levotiroxina (8,22,23). Os autores sugerem que existe uma relação de causa e efeito, ou seja, DAT levaria ao desencadeamento da UCI.…”

What the first 10,000 patients with chronic urticaria have taught me: A personal journey

“…Use of sedating antihistamines is viewed as extreme, use of any corticosteroid chronically is deplored, and the efficacy of cyclosporine is underestimated. Although these guidelines do not comment on the use of thyroid hormone as a treatment for subjects with euthyroid whose sera test positive for antithyroid antibodies, articles have appeared suggesting that this might be efficacious, 49 but the studies are uncontrolled and anecdotal, and a more recent guideline does not mention thyroid hormone therapy as an option. 30 Certainly there is little to suggest thyroid disease as a cause of chronic urticaria or, for that matter, urticaria as a cause of thyroid disease.…”

Chronic urticaria and thyroid autoimmunity markers

“…There is some evidence that TSH has many cytokine-like qualities and can regulate the immune response, mainly by a direct T cell, B cell and dendritic cell activation. Aversano et al [30] hypothesized that inflammatory status inflicted by TSH lead to flares of urticaria and also production of antithyroid antibodies. Unlike some investigators [19][20][21], we did not find a significant correlation between elevated TPO and positive ASST or CD63 expression.…”