Predictors of treatment response in chronic spontaneous urticaria

Fok, Jie Shen; Kolkhir, Pavel; Church, Martin K.; Maurer, Marcus

doi:10.1111/all.14757

Cited by 103 publications

(86 citation statements)

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“…A recent review on the predictors of treatment response in CSU show a strong level of evidence for no association of sex as a possible markers of non-response to OmAb. 23 In their recent work, Yu et al 24 observed that gender is not linked to the speed of achieving complete control with OmAb treatment.…”

Section: Discussionmentioning

confidence: 98%

Sex differences in the efficacy of omalizumab in the treatment of chronic spontaneous urticaria

Sirufo

Bassino

Pietro

et al. 2021

Int J Immunopathol Pharmacol

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Background Omalizumab is shown to be effective in the treatment of chronic spontaneous urticaria (CSU), a disease with high personal and social impact. Sex differences in CSU are recognized with women more frequently affected. Scarce is the knowledge about response to omalizumab between sex groups. We sought to identify any differences based on the sex of patients receiving omalizumab. Methods We evaluated data of patients diagnosed with CSU refractory to high-dose second-generation H1 antihistamines and treated with 300 mg omalizumab every 4 weeks for 6 months and then at relapse. Results Discussion: All patients, regardless of sex, age, or any other factor, achieved the clinical remission of the disease after the first 3 doses with a reduction of the disease activity indices and impact on the quality of life. Recurrences predominate in men, two months after the suspension of the drug. Respect to sex and recurrence we did not find any correlation with age, body mass index, peripheral eosinophil counts, total IgE levels, D-dimer, plasma prothrombine level or C-reactive protein. We found no sex differences in tolerability and safety. CSU in girls may persist longer and have worse prognosis, but no one has so far noted sex differences in response to omalizumab. Conclusions Although there are no certainties on the mechanism of action of omalizumab in CSU, the noticeable difference in response between males and females lead us to suppose a role of the hormonal balance both on the pathogenesis of the CSU and on the efficacy of OmAb.

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Section: Discussionmentioning

confidence: 98%

Sex differences in the efficacy of omalizumab in the treatment of chronic spontaneous urticaria

Sirufo

Bassino

Pietro

et al. 2021

Int J Immunopathol Pharmacol

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“…Basophil histamine release assay (BHRA) and basophil activation test (BAT) aid identification of autoimmune CSU (32). It has been reported that positive BHRA results and low levels of total IgE are predictors of a good response to cyclosporine for CSU (33). However, one of the main pharmacodynamic mechanisms responsible for CSU patients' clinical response to omalizumab is to rapidly correct the basopenia in CSU patients and downregulate the expression of FcϵRI on basophils (34).…”

Section: Discussionmentioning

confidence: 99%

Genome-Wide DNA Methylation Profile in Whole Blood of Patients With Chronic Spontaneous Urticaria

Zhang²,

Yang³

et al. 2021

Front. Immunol.

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BackgroundChronic spontaneous urticaria (CSU) is a common autoimmune skin disease. Little is known about the role of epigenetics in the pathogenesis of CSU. This study aimed to investigate genome-wide DNA methylation profile in whole blood of patients with CSU.Patients and MethodsGenome-wide DNA methylation levels in whole blood samples of 95 Chinese Han ethnicity adult CSU patients and 95 ethnicity-, age- and sex-matched healthy controls were analyzed using Illumina 850K methylation chip. The differentially methylated genes (DMGs) were screened out and then functionally annotated by the gene ontology and the Kyoto encyclopedia of genes and genomes databases.ResultsA total of 439 differentially methylated positions (DMPs) (p < 0.01 and |Δβ| ≥ 0.06) were identified with 380 hypomethylated and 59 hypermethylated. The average global DNA methylation levels of the 439 DMPs in the CSU patients were significantly lower than those in the healthy controls (p < 0.001). The distribution of the 439 DMPs was wide on chromosome 1 to 22 and chromosome X. Chromosome 6 embodied the largest number of DMPs (n = 51) and their annotated genes were predominantly related to autoimmunity. The 304 annotated DMGs were mainly enriched in autoimmune disease- and immune-related pathways. A total of 41 DMPs annotated to 28 DMGs were identified when p < 0.01 and |Δβ| ≥ 0.1. Of the 28 DMGs, HLA-DPB2, HLA-DRB1, PPP2R5C, and LTF were associated with autoimmunity. CSU cases with elevated total IgE, positive anti-thyroid peroxidase IgG autoantibodies, positive anti-thyroglobulin IgG autoantibodies, angioedema, UASday > 4, or recurrent CSU showed phenotype-specific DMPs as compared with cases with normal total IgE, negative anti-thyroid peroxidase IgG autoantibodies, negative anti-thyroglobulin IgG autoantibodies, no angioedema, UASday ≤ 4, or non-recurrent CSU respectively.ConclusionThis study shows a distinct genome-wide DNA methylation profile in Chinese Han ethnicity adult CSU patients and indicates a role of epigenetics in the pathogenesis of CSU. The predominant enrichment of the CSU-associated DMGs in immunological pathways provides supportive evidence for the immunopathogenesis of CSU. Future research on the CSU-associated DMPs and DMGs will help discover potential therapeutic targets for CSU.

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“…Currently, there are potential biomarkers of CSU activity and response to treatment (6). Still, a definitive blood biomarker to predict CSU duration or prognosis is lacking, and anti-thyroid antibodies have been studied for this purpose.…”

Section: Introductionmentioning

confidence: 99%