Oxidative Stress in Children with Chronic Spontaneous Urticaria

Abstract

The pathogenesis of chronic spontaneous urticaria (CSU) has not been fully understood; nevertheless, significant progress has been achieved in recent years. The aim of this study was to investigate the possible role of reactive oxygen species (ROS) in the pathogenesis of CSU. Sixty-two children with CSU and 41 healthy control subjects were enrolled in the study. An extensive evaluation of demographic and clinical features was done, and serum oxidative stress was evaluated by plasma total oxidant status (TOS) and total antioxidant status (TAS) measurements. The median value of plasma TOS was found to be 10.49 μmol H2O2 equiv./L (interquartile range, 7.29–17.65) in CSU patients and 7.68 μmol H2O2 equiv./L (5.95–10.39) in the control group. The difference between the groups was statistically significant (p = 0.003). Likewise, the median plasma TAS level in the CSU group was decreased significantly compared to that of the control group (2.64 [2.30–2.74] versus 2.76 [2.65–2.86] mmol Trolox equiv./L, resp., p = 0,001). Our results indicated that plasma oxidative stress is increased in children with CSU when compared to healthy subjects, and plasma oxidative stress markers are positively correlated with disease activity.

Critical appraisal of the oxidative stress pathway in vitiligo: a systematic review and meta‐analysis

“…Enough evidence has been collected to firmly state that decreased CAT, increased MDA, enhanced lipid peroxidation, deregulated SOD and an overall elevated oxidative/antioxidative balance are present in patients with vitiligo. However, very similar findings have been documented in other inflammatory disorders such as psoriasis, atopic dermatitis, lichen planus and urticaria . This indicates that the observed aberrant oxidative phenomena in vitiligo cannot be considered as disease specific, but fit within the expectations of an immune‐mediated skin disorder.…”

“…However, very similar findings have been documented in other inflammatory disorders such as psoriasis, atopic dermatitis, lichen planus and urticaria. 40,[76][77][78] This indicates that the observed aberrant oxidative phenomena in vitiligo cannot be considered as disease specific, but fit within the expectations of an immune-mediated skin disorder. The major capacity of activated immune cells to release ROS at the inflammation site is well known.…”

The Efficacy and Safety of a Fixed Combination of Chinese Herbal Medicine in Chronic Urticaria: A Randomized, Double-Blind, Placebo-Controlled Pilot Study

“…Although the pharmacologic mechanisms on a human were not acknowledged, XFS, which is one of the CHM formulas used in this trial, has the effects of inhibiting histamine release from mast cells, reducing inflammatory response by inhibiting neutrophil function, scavenging free radicals, and decreasing IL-4 and INF-γ in vivo (Akamatsu et al, 1998; Nose et al, 1999; Gao et al, 2005). Furthermore, the ingredients of another CHM formula, QSFFT, were reported to have a strong anti-oxidative stress effect in vivo , and oxidative stress was proven to be one of the crucial factors of chronic urticaria (Sagdic et al, 2011; Dilek et al, 2016; Zhang et al, 2016). These “multiple herbs, multiple target” pharmacologic effects were characteristics of CHM treatments and can be the potential explanation about add-on effects for urticaria.…”

Plasma lipoxin A4 levels in childhood chronic spontaneous urticaria

“…Although elevated levels by themselves cannot explain the entire disease pathogenesis, the increased production of some cytokines, chemokines, or metabolites-including IL-6, vascular endothelial growth factor (VEGF), matrix metallopeptidase 9 (MMP-9), and reactive oxygen species-was reported in previous clinical studies. [46][47][48][49] LXs can inhibit the generation of pro-inflammatory cytokines and chemokines via the inhibition of transcription factors, such as NF-κB and activator protein 1. [50][51][52] In this regard, several in vitro studies and animal models have proven that LXA 4 and its analogues can decrease IL-6 secretion, 6 MMP-9 expression, 53 and VEGF expression 54 and can block ROS generation.…”