The relation of autologous serum and plasma skin test results with urticarial activity score, sex and age in patients with chronic urticaria

Abstract

IntroductionSome previous studies reported autoimmunity as an etiologic factor in chronic urticaria (CU), but the results of some autoimmunity tests in these studies are conflicting.AimTo concretize whether there was any relation of autologous serum skin test (ASST) and autologous plasma skin test (APST) results with sex, age and urticarial activity score (UAS) in patients with CU.Material and methodsFifty patients with CU and twenty healthy subjects admitted to our dermatology clinic were included in the present study. The ASST and APST were applied to all individuals.ResultsThe positiveness rates of ASST and APST were significantly higher in the patient group than controls (p = 0.027, p = 0.001, respectively). Among patients, the APST positiveness rate (72%) was significantly (p < 0.05) higher than ASST (46%). It was seen that 48% of patients with negative ASST results had positive APST. However, no patient with negative APST results had positive ASST. There were significant (p < 0.05) relations of the tests’ positiveness rates with sex and old age but with UAS. The diameter of the erythematous papule was remarkably (p < 0.05) larger in APST than ASST and also significantly (p < 0.05) larger in females compared to males in both tests (p < 0.05). It was positively increased with old age (p < 0.05).ConclusionsWe can suggest that APST is more sensitive than ASST in the assessment of autoimmunity in CU. A high positiveness rate of APST results may be attributed to high numbers of autoantibodies and coagulation factors present in plasma that might probably play a role in etiopathogenesis of CU.

Autoimmune chronic spontaneous urticaria: What we know and what we do not know

“…The ASST is considered to be a screening test for autoimmune CSU because of IgG-anti-IgE AAbs, anti-FcεRI AAbs, or both. 79 Rates of ASST positivity were higher in patients with CSU compared with those in healthy control subjects, 26,[80][81][82] atopic patients, 80,83 and patients with inducible urticaria 80 in some studies but not others. 84,85 A positive ASST result is significantly associated with CSU and female sex.…”

The Role of Platelets in Chronic Urticaria

“…Patients with CU were found to more commonly have a positive result to the autologous plasma skin test (APST) than to ASST [12,13]. As histamine-releasing autoantibodies are equally present in serum and plasma, the higher APST-positive rate observed by some authors [12,13] gave clues to the possible influence of clotting factors on the wheal-and-flare reactions induced by APST.…”

“…Patients with CU were found to more commonly have a positive result to the autologous plasma skin test (APST) than to ASST [12,13]. As histamine-releasing autoantibodies are equally present in serum and plasma, the higher APST-positive rate observed by some authors [12,13] gave clues to the possible influence of clotting factors on the wheal-and-flare reactions induced by APST. Nevertheless, other studies [14,15,16] failed to confirm these results and some authors [17] pointed out that the use of APST for detecting autoreactivity in clinical practice is not superior to the use of ASST and requires further investigation.…”

Thyroid function and thyroid autoantibodies in patients with chronic spontaneous urticaria

“…In about 60% of patients presenting characteristic lesions, the disorder is associated with serological factors. It is related to higher immunoglobulin E (IgE) production and T-cell induced cytokine production, secretion of vasoactive substances such as histamine, prostaglandins, kinins and other proinflammatory substances [ 1 , 2 , 4 , 5 ]. In about 55% of cases of CU (excluding CU with known pathogenesis), the spontaneous type is confirmed, 45% of the patients present an autoimmune type, called chronic autoimmune urticaria.…”