Grattan C E, Francis D M, Slater N G, Barlow R J, Greaves M W
St John's Institute of Dermatology, UMDS, London, UK.
Lancet. 1992 May 2;339(8801):1078-80. doi: 10.1016/0140-6736(92)90666-q.
Histamine-releasing autoantibodies have been identified in chronic idiopathic urticaria. 8 patients with severe disease and histamine-releasing activity in their sera underwent plasmapheresis. Symptoms were abolished for 2 months in 1 patient and for 3 weeks in another, 2 showed almost complete resolution of symptoms, 2 had temporary relief, and the other 2 showed little change. Further investigation in 4 of the patients showed significantly reduced skin-test responses to fresh post-exchange autologous sera after plasmapheresis compared with stored pre-exchange sera, but the response to intradermal histamine remained unchanged. Blood cellular histamine increased as in-vitro serum histamine-releasing activity fell after plasmapheresis. These results favour a pathogenetic role for histamine-releasing autoantibodies in patients with chronic urticaria.
在慢性特发性荨麻疹中已鉴定出组胺释放自身抗体。8例病情严重且血清具有组胺释放活性的患者接受了血浆置换。1例患者症状消失2个月，另1例消失3周，2例症状几乎完全缓解，2例症状暂时缓解，另外2例几乎没有变化。对4例患者的进一步研究表明，与储存的置换前血清相比，血浆置换后对新鲜的置换后自体血清的皮肤试验反应显著降低，但对皮内注射组胺的反应保持不变。血浆置换后，随着体外血清组胺释放活性下降，血细胞组胺增加。这些结果支持组胺释放自身抗体在慢性荨麻疹患者发病机制中的作用。
