Interleukin-23/ Interleukin -17 Axis in Chronic Spontaneous Urticaria: A Case- Control Study

Abstract

Background: Chronic Spontaneous Urticaria (CSU) is a common health problem and its clear etiology is not established yet. Several theories have been tried to illustrate its etiology and pathogenesis. Autoantibodies and inflammatory cytokines like IL-23 and IL17 are hypothesized to take part in CSU pathogenesis and outcome. Objectives: To detect serum levels of IL-23 and IL-17A among CSU patients and to determine its correlation with disease severity and its relation to autoreactivity. Methodology: Serum levels of IL-23 and IL-17A were measured in 23 patients with CSU (CSU group) and 23 healthy controls (control group). In CSU group, Weekly Urticaria Activity Score (UAS7) was recorded to assess disease severity. Autologous Serum Skin Test (ASST) was performed to assess autoreactivity. CSU patients᾿ group was subdivided, based on ASST, into positive ASST (ASST+ ) and negative ASST (ASST- ) subgroups. Correlation of serum IL-23 & IL-17A levels, with UAS7 and ASST response were analyzed. Results: CSU group had higher serum IL-17A and IL-23 levels than control group (P=0.000). ASST+ CSU had higher serum IL-17A and IL-23 levels than ASSTones (P=0.000). Additionally, UAS7 was higher in ASST+ subgroup than ASST- subgroup (32+11.7 versus 16.27+ 9.92; P =0.005). There was significant positive correlation between disease severity and serum levels of both IL-17A and IL-23 among CSU patients (r= 0.626 & P= 0.001 and r=0.515 & P= .012, respectively). Conclusion: Increased serum IL-17A and IL-23 levels may constitute two major determinants of CSU pathogenesis and severity.

Assessment of selected interleukins (IL-6, IL-17A, IL-18, IL-23) and chemokines (RANTES, IP-10) in children with acute and chronic urticaria

“…Our analysis showed significantly lower IL-23 levels in AU and CU patients with respect to CG. Different results were obtained in several papers on CU [ 3 , 4 , 20 ], where additionally a correlation between IL-23 levels and CU severity was shown [ 4 ]. On the other hand, Degirmenci et al reported lower levels of IL-17 and IL-23 in patients with CU, which was explained by the effect of cytokine consumption during the ongoing inflammatory process [ 8 ].…”

“…So far, most reports, like our work have shown higher IL-17 levels in CU patients [ 3 , 9 ] compared to CG. Additionally, this increase was found in patients with CU and a positive autologous serum skin test (ASST) [ 20 ]. Atwa et al reported a correlation between IL-17 levels and urticaria severity [ 21 ], which was not confirmed by Chen et al [ 4 ].…”

Assessment of selected interleukins (IL-6, IL-17A, IL-18, IL-23) and chemokines (RANTES, IP-10) in children with acute and chronic urticaria

“…Our analysis showed signi cantly lower IL-23 levels in AU and CU patients with respect to CG. Different results were obtained in several papers on CU [3,4,20], where additionally a correlation between IL-23 levels and CU severity was shown [4]. On the other hand, Degirmenci et al reported lower levels of IL-17 and IL-23 in patients with CU, which was explained by the effect of cytokine consumption during the ongoing in ammatory process [8].…”

“…So far, most reports, like our work have shown higher IL-17 levels in CU patients [3,9] compared to CG. Additionally, this increase was found in patients with CU and a positive autologous serum skin test (ASST) [20]. Atwa et al reported a correlation between IL-17 levels and urticaria severity [21], which was not con rmed by Chen et al [4].…”