Prevalence of Chronic Inducible Urticaria in Elderly Patients

Napolitano, Maddalena; Fabbrocini, Gabriella; Stingeni, Luca; Patruno, Cataldo

doi:10.3390/jcm10020247

Cited by 6 publications

(10 citation statements)

References 22 publications

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“…Even pediatric population shows an estimated CIndU prevalence around 6%, 3% and some studies describe a 17% (26/153) of elderly CU patients that develop an active CIndU. 17 The prevalence of CIndUs has increased over time 18 and they have a considerable impact on quality of life. 19 Overall, the pathophysiology of CU involves activation and degranulation of effector cells, mainly skin mast cells, among others.…”

Section: Introductionmentioning

confidence: 99%

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IgE and high‐affinity IgE receptor in chronic inducible urticaria, pathogenic, and management relevance

Giménez‐Arnau

Ribas‐Llauradó

Mohammad‐Porras

et al. 2022

Clinical & Translational All

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Background: IgE and high-affinity IgE receptor (FcεRI) expression on basophils have been scarcely explored in patients with chronic inducible urticaria (CIndU). Objectives: To investigate baseline serum IgE and FcεRI expression on blood basophils in a large cohort of CIndU patients and its relationship to treatment response. Methods: Baseline total serum IgE and basophil FcεRI expression measured by flow cytometry in 165 patients with CIndU was studied. The relationship of both parameters with the response to antihistamine and anti-IgE (omalizumab) treatment was considered in a subsample of CIndU patients. FcεRI expression in basophils was assessed by mean fluorescence intensity (MFI) and basophil FcεRI standardized density (receptors/cell). Results:The median FcεRI expression standardized per density in blood basophils was found significantly higher in patients with CIndU compared to HCs. A positive correlation was found between IgE serum levels and basophil FcεRI expression.Basal FcεRI expression was not related to antihistamine treatment response.However, it was related to omalizumab, and patients responding to omalizumab showed higher basal basophil expression of FcεRI levels. Non-responders to the antihistamine showed significantly higher IgE serum levels.Conclusions: FcεRI receptor overexpression in patients with CIndU shows almost the same pattern than chronic spontaneous urticaria. It seems to be independent of CIndU subtypes. Although additional studies would be welcome, our work highlights the relevance of FcεRI receptor regulation in CIndU supporting autoimmune basophil and mast cell activation and may be a biomarker for response to anti-IgE therapy.

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Section: Introductionmentioning

confidence: 99%

“…The worldwide prevalence of CIndU is not negligible. Even pediatric population shows an estimated CIndU prevalence around 6%, 3% and some studies describe a 17% (26/153) of elderly CU patients that develop an active CIndU 17 . The prevalence of CIndUs has increased over time 18 and they have a considerable impact on quality of life 19 …”

Section: Introductionmentioning

confidence: 99%

IgE and high‐affinity IgE receptor in chronic inducible urticaria, pathogenic, and management relevance

Giménez‐Arnau

Ribas‐Llauradó

Mohammad‐Porras

et al. 2022

Clinical & Translational All

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“…Positive D-dimer was found in 50.0% of elderly CU patients, and elevated prothrombin fragment was found in 75.0%. 86 Antinuclear antibody (ANA) was reported in 13 studies 10 , 45 , 51 , 56 , 58 , 63 , 65 , 69 , 79 , 82 , 83 , 85 , 87 with an average positivity rate of 16.0% among those studies. Anti-FcεRI antibody was reported in one study (66.7% positive).…”

Section: Resultsmentioning

confidence: 99%

“… ? + + + + Goldsobel et al, 1986 68 + + + + + + B. Non-randomized controlled trials Study, year Ref Criteria Additional criteria in the case of comparative study A stated aim of the study Inclusion of consecutive patients Prospective collection of data End point appropriate to the study aim Unbiased evaluation of end points Follow-up period appropriate Loss to follow-up not exceeding 5% Prospective calculation of the study size A control group having the criterion standard intervention Contemporary groups Baseline equivalence of groups Prospective calculation of the sample size Statistical analyses adapted to the study design Total Martina et al, 2021 90 2 2 2 2 0 2 0 0 - - - - - 10 Napolitano et al, 2021 45 2 2 2 2 0 2 0 0 - - …”

Section: Discussionmentioning

confidence: 99%

Prevalence, Clinical Manifestations, Treatment, and Clinical Course of Chronic Urticaria in Elderly: A Systematic Review

Kulthanan¹,

Rujitharanawong²,

Munprom³

et al. 2022

JAA

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Purpose Data specific to the epidemiology, clinical features, and management of chronic urticaria (CU) in the geriatric population remain limited and not well understood. We aim to systematically review the prevalence, clinical manifestations, treatment, and clinical course of elderly patients with CU. Patients and methods Original articles that included data of elderly (aged >60 years) with CU that were published until February 2021 were searched in PubMed, Scopus, and Embase using predfefined search terms. Related articles were evaluated according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Results Among the included 85 studies and 1,112,066 elderly CU patients, most (57.4%) were women. The prevalence of elderly CU in the general population ranged from 0.2–2.8%, and from 0.7–33.3% among all CU patients. Compared to adult CU, elderly CU patients had a higher percentage of wheal alone (73.9%), and lower rate of positive autologous serum skin test and atopy. Gastrointestinal diseases were the most common comorbidity (71.9%), and there was a high rate of malignancies and autoimmune diseases. Second generation H 1 -antihistamines were commonly used, and achievement of complete control was most often reported. Omalizumab was prescribed in 59 refractory patients, and a significant response to treatment was reported in most patients. The treatment of comorbidities also yielded significant improvement in CU. Conclusion Elderly CU was found to be different from adult CU in both clinical and laboratory aspects. H 1 - antihistamines are effective as first-line therapy with minimal side-effects at licensed doses. Treatment of secondary causes is important since the elderly usually have age-related comorbidities.

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“…Epinastine は NK-4 よりかなり弱いものの濃度依存的な抑制作用を示した(IC 50 ＝ 24.5 mM) ．さらには TRPV2 アンタゴニストとして作用する Tranilast もアレルギー治療薬として汎用されているが，腹腔から調製した肥満細胞の FceRI の架橋や compound 48/80 刺激による脱顆粒反応を抑制することが報告されている． 26,27) Epinastine のみならず，TRPV2 アンタゴニストとして報告のある RR や Tranilast が FceRI の架橋による脱顆粒反応を抑制するという結果は， TRPV2 を介した Ca 2＋の細胞内流入が，FceRI の抗体による FceRI の架橋を介した急性のアレルギー疾患とは異なり，物理性蕁麻疹では TRPV2 の関与が示唆されている． 12) イタリアの研究チームによる疫学調査のデータによれば，2008 年 1 月から 2020 年 9 月までに慢性蕁麻疹と診断された患者は 1970 人であった．このうち 153 人が 65 歳以上の高齢者で，隆起性皮膚描記症を含む物理性蕁麻疹と診断された高齢者は 25 人(16.3％)であったと報告されている．29) …”

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Inhibition of TRPV2 Channel Activation by NK-4, a Cryptocyanine Dye

et al. 2022

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Transient receptor potential vanilloid 2 (TRPV2) channels are expressed and play functional roles in various immune cells. Physical stimuli leading to TRPV2 activation causes mast cell degranulation. Besides their roles in immune cells, it has been shown that TRPV2 channels are pathophysiologically relevant to degenerative muscular diseases such as dilated cardiomyopathy and muscular dystrophy. Hence, development of drug candidates that inhibit human TRPV2 activation is an urgent matter. NK-4, a cryptocyanine dye, inhibited agonist-induced TRPV2 activity in mouse TRPV2transfected HEK293 cells. However, it remains unclear whether NK-4 exerts regulatory eŠects on the activation of human TRPV2 channels. In this study, we show that NK-4 inhibits intracellular Ca 2＋ increase in human TRPV2-transfected HEK293 cells preactivated with a TRPV2 agonist. The inhibitory eŠect of NK-4 (IC 50 ＝ 0.27 mM) on human TRPV2 activation was 74-fold stronger than that on mouse TRPV2 activation (IC 50 ＝ 20 mM). NK-4 also inhibited the agonistinduced TRPV2 expression at the plasma membrane, when the human TRPV2-expressing cells were stimulated with the agonist in the presence of NK-4. These results suggest that NK-4 abrogates the agonist-induced signaling events leading to human TRPV2 activation. Furthermore, TRPV2 agonist caused degranulation of RBL-2H3 cells, which represents a phenomenon related to physical urticarias. NK-4 suppressed the release of b-hexosaminidases upon degradation with IC 50 of 1.9 mM, 35-fold lower than that determined with an anti-allergic drug, Epinastine. Our results suggest that NK-4 would be a potential therapeutic strategy to resolve dilated cardiomyopathy and its associated heart failure as well as physical urticarias.

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Prevalence of Chronic Inducible Urticaria in Elderly Patients

Cited by 6 publications

References 22 publications

IgE and high‐affinity IgE receptor in chronic inducible urticaria, pathogenic, and management relevance

IgE and high‐affinity IgE receptor in chronic inducible urticaria, pathogenic, and management relevance

Prevalence, Clinical Manifestations, Treatment, and Clinical Course of Chronic Urticaria in Elderly: A Systematic Review

Inhibition of TRPV2 Channel Activation by NK-4, a Cryptocyanine Dye

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