KMID : 1143120200100020012
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Asia Pacific Allergy 2020 Volume.10 No. 2 p.12 ~ p.12
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Relationship between changes in the 7-day urticaria activity score after treatment with omalizumab and the responsiveness of basophils to Fc¥åRI stimulation in patients with chronic spontaneous urticaria
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Endo Takahiro
Toyoshima Shota Hayama Koremasa Tagui Maho Niwa Yusuke Ito Mana Terui Tadashi Okayama Yoshimichi
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Abstract
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Background: About one-half of all patients with chronic spontaneous urticaria have low or less reactivity of the basophils to Fc¥åRI stimulation. However, the differences in the clinical characteristics between patients who show normal and attenuated basophil reactivities to Fc¥åRI stimulation are still unclear. Furthermore, it also remains unknown as to what factors induce the poor reactivity of basophils to Fc¥åRI stimulation.
Objective: The aim of the study is to investigate the differences in the clinical characteristics between patients who show normal and attenuated basophil reactivities to Fc¥åRI stimulation.
Methods: We compared the clinical characteristics, including the autologous serum skin test-positive rates, serum concentrations of anti-IgE and anti-Fc¥åRI¥á autoantibodies, and the Fc¥åRI-crosslinking ability of these autoantibodies between patients with a negative basophil activation test (BAT) (¡Â10% CD203chigh basophils, n = 9) and positive BAT (>10% CD203chigh basophils, n = 13). We also monitored the changes in the 7-day urticaria activity scores after treatment with omalizumab, as compared to the score at the baseline, between the BAT-positive and BAT-negative patients.
Results: The BAT-negative patients showed a significantly higher urticaria control test score than the BAT-positive patients (p = 0.01). There were no significant differences in the autologous serum skin test-positive rates, concentrations of anti-IgE and anti-Fc¥åRI¥á autoantibodies, and the Fc¥åRI-crosslinking ability of these autoantibodies between the 2 groups. After treatment with omalizumab for 35 days, the score decreased to under 15 (corresponding to controlled or mild chronic spontaneous urticaria) in all of the BAT-negative patients, whereas in 6 out of the 13 BAT-positive patients, the scores remained over 16 (corresponding to moderate or severe chronic spontaneous urticaria).
Conclusions: The weak reactivity of basophils to Fc¥åRI stimulation may not be due to the desensitization of basophils by anti-IgE or anti-Fc¥åRI¥á autoantibodies. The time to response to omalizumab might differ between BAT-negative and BAT-positive patients with chronic spontaneous urticaria.
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KEYWORD
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Autoantibody, Basophil, Basophil activation test: Fc¥åRI¥á, Immunoglobulin E, Urticaria
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