Serum prolactin level in chronic urticaria: Is bromocriptine inducing remission in chronic urticaria?

Soliman, Mohamed H.; Khattab, Fathia M; Ebrahim, Howyda Mohamed; Nasr, Mohamad

doi:10.1080/09546634.2018.1468062

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…The effects of prolactin on CU during pregnancy remain largely unexplored, but Sabry et al (29) reported significantly higher serum prolactin levels in a subset of CU patients (positive autologous serum skin test, ASST) and its association with disease severity. In contrast, Soliman et al (30) did not find any relationship between serum prolactin levels and urticaria activity.…”

Section: Hormonal Changesmentioning

confidence: 84%

Urticaria in Pregnancy and Lactation

et al. 2022

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Chronic urticaria (CU) is a mast cell-driven chronic inflammatory disease with a female predominance. Since CU affects mostly females in reproductive age, pregnancy is an important aspect to consider in the context of this disease. Sex hormones affect mast cell (MC) biology, and the hormonal changes that come with pregnancy can modulate the course of chronic inflammatory conditions, and they often do. Also, pregnancy-associated changes in the immune system, including local adaptation of innate and adaptive immune responses and skewing of adaptive immunity toward a Th2/Treg profile have been linked to changes in the course of inflammatory diseases. As of now, little is known about the effects of pregnancy on CU and the outcomes of pregnancy in CU patients. Also, there are no real-life studies to show the safety of urticaria medications during pregnancy. The recent PREG-CU study provided the first insights on this and showed that CU improves during pregnancy in half of the patients, whereas it worsens in one-third; and two of five CU patients experience flare-ups of their CU during pregnancy. The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for urticaria recommends adopting the same management strategy in pregnant and lactating CU patients; starting treatment with standard doses of second-generation (non-sedative) H1 antihistamines, to increase the dose up to 4-folds in case of no response, and to add omalizumab in antihistamine-refractory patients; but also emphasizes the lack of evidence-based information on the safety and efficacy of urticaria treatments during pregnancy. The PREG-CU study assessed treatments and their outcomes during pregnancy. Here, we review the reported effects of sex hormones and pregnancy-specific immunological changes on urticaria, we discuss the impact of pregnancy on urticaria, and we provide information and guidance on the management of urticaria during pregnancy and lactation.

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Section: Hormonal Changesmentioning

confidence: 84%

Urticaria in Pregnancy and Lactation

et al. 2022

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“…1 Conversely, CU activity and its treatments with medications such as firstgeneration antihistamines, may put burden on pregnant women and their fetuses. 1,[42][43][44] Pregnant women with CU have an impaired quality of life and may suffer from anxiety and depression. [45][46][47] Several skin eruptions in pregnancy must be differentiated from the diagnosis of CSU.…”

Section: Chronic Urticaria and Pregnancymentioning

confidence: 99%

“…59 Finally, the administration of cyclosporine in pregnant women should remain a second choice based on the risk-benefit ratio. 43…”

Section: Cyclosporinementioning

confidence: 99%

Chronic Urticaria in Pregnancy: Physiologic and Hormonal Background for an Immune Skin Disease

Khalili,

Sadeghi

2024

Journal of South Asian Federation of Obstetrics and Gynaecology

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Chronic urticaria (CU) is a cluster of manifestations specified as recurrent pruritic erythematous wheals or angioedema (AE), lasting for more than 6 weeks and complicating 1-2% of the population. Widespread presence of CU is higher in middle-aged women than men (1.3 vs 0.8%). It is proposed that this higher prevalence in women may be linked to female sex hormones, although the precise relationship between sex hormones and immune system function remains to be fully understood. Pregnancy is a condition that impacts CU activity in susceptible individuals. Likewise, CU can have effects on pregnancy, and conversely, pregnancy may alter the presentations of CU. Studies have shown Increased number of mast cells present in skin, and elevated serum levels of autoantibodies such as IgE anti-TPO, IgE anti-dsDNA, and IgE anti-IL-24 in chronic spontaneous urticaria (CSU) patients. The role of autoimmune diseases is crucial in these patients. Based on some evidence, immunologic tolerance is outside of the placenta milieu; and some other inflammatory conditions are alleviated during pregnancy. Chronic urticaria severity, medication before pregnancy, and AE before pregnancy were compromising factors leading to intensified urticaria in pregnancy. Managing CU in pregnant women presents unique challenges. There is little evidence about the safety and efficacy of medications in pregnant women with CU, and the cost/benefit of such treatments should be evaluated. Some studies recommend H1-antihistamines. Firstgeneration H1-antihistamines induce sleepiness and decreased attention by passing blood-brain barrier in CNS. However, second-generation H1-antihistamines have minimal CNS complication with most negligible side effects. Omalizumab, a biological monoclonal antibody against IgE molecules, is recently recommended by the guidelines as one of the therapeutic options in patients with uncontrolled CU. Cyclosporine and systemic corticosteroid are the other reserved options for the treatment of CU in pregnancy. In this review, we focused on the effect of underlying physiologic, hormonal, and immunologic changes during pregnancy over CU. Then assessed the noteworthy changes in the natural course of CU during pregnancy; the therapeutic challenges faced, and the complications associated with of CU and complications of CU during pregnancy.

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Prolactin: A Mammalian Stress Hormone and Its Role in Cutaneous Pathophysiology

Langan

2024

IJMS

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The hormone prolactin (PRL) is best recognised for its indispensable role in mammalian biology, specifically the regulation of lactation. Bearing in mind that the mammary gland is a modified sweat gland, it is perhaps unsurprising to discover that PRL also plays a significant role in cutaneous biology and is implicated in the pathogenesis of a range of skin diseases, often those reportedly triggered and/or exacerbated by psychological stress. Given that PRL has been implicated in over 300 biological processes, spanning reproduction and hair growth and thermo- to immunoregulation, a comprehensive understanding of the relationship between PRL and the skin remains frustratingly elusive. In an historical curiosity, the first hint that PRL could affect skin biology came from the observation of seborrhoea in patients with post-encephalitic Parkinsonism as a result of another global pandemic, encephalitis lethargica, at the beginning of the last century. As PRL is now being postulated as a potential immunomodulator for COVID-19 infection, it is perhaps timeous to re-examine this pluripotent hormone with cytokine-like properties in the cutaneous context, drawing together our understanding of the role of PRL in skin disease to illustrate how targeting PRL-mediated signalling may represent a novel strategy to treat a range of skin diseases and hair disorders.

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Serum prolactin level in chronic urticaria: Is bromocriptine inducing remission in chronic urticaria?

Abstract: Serum PRL levels could not be considered as a marker of the disease activity in CU patients.

Cited by 3 publications

References 21 publications

Urticaria in Pregnancy and Lactation

Urticaria in Pregnancy and Lactation

Chronic Urticaria in Pregnancy: Physiologic and Hormonal Background for an Immune Skin Disease

Prolactin: A Mammalian Stress Hormone and Its Role in Cutaneous Pathophysiology

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