Platzer M H, Grattan C E H, Poulsen L K, Skov P S
National University Hospital, Allergy Clinic, Laboratory of Medical Allergology, Copenhagen, Denmark.
Allergy. 2005 Sep;60(9):1152-6. doi: 10.1111/j.1398-9995.2005.00841.x.
Endogenous histamine-releasing factors (HRFs) are involved in 30-60% of patients with chronic urticaria (CU). Evidence for their existence comes from in vivo studies of autoreactivity with the autologous serum skin test (ASST), in vitro immunoassays demonstrating autoantibodies against the immunoglobulin E (IgE) or the high affinity IgE receptor (FcepsilonRI) and serum-induced histamine release (HR) from basophils and mast cells. We have examined the correlation between the ASST and a new basophil histamine-releasing assay (the HR-Urtikaria test) in a group of well-characterized CU patients and subsequently determined the frequency of HR-Urticaria-positive sera from a larger population of CU patients.
Group 1 consisted of 28 patients with CU (16 were ASST-positive) 20 patients with atopic dermatitis, 24 patients with allergy to birch and nine healthy controls. Group 2 consisted of 873 unselected CU patients.
White blood cells containing 1-2% basophils from a healthy nonatopic donor were incubated with patients sera in the presence of interleukin (IL)-3. Histamine was measured by the glass fibre method.
Using the ASST as the true outcome, the HR-Urticaria test showed a sensitivity and specificity of 75% in group 1 using a cut-off value for HR of >16.5%. None of the controls was positive in the HR-Urticaria test. In group 2, we found no difference in the frequency of positives between male (34.6%, n = 254) and female adults (35.1%, n = 576) but twice as many females as males were tested.
Our studies have shown that the HR-Urticaria test has a good sensitivity and specificity for endogenous HRFs demonstrated by the ASST in patients with CU and that about one-third of unselected patients with CU have a positive result.
内源性组胺释放因子（HRFs）与30%至60%的慢性荨麻疹（CU）患者发病有关。其存在的证据来自自体血清皮肤试验（ASST）的自身反应性体内研究、证明针对免疫球蛋白E（IgE）或高亲和力IgE受体（FcepsilonRI）的自身抗体的体外免疫测定以及血清诱导的嗜碱性粒细胞和肥大细胞组胺释放（HR）。我们在一组特征明确的CU患者中研究了ASST与一种新的嗜碱性粒细胞组胺释放试验（HR - 荨麻疹试验）之间的相关性，随后在更大规模的CU患者群体中确定了HR - 荨麻疹阳性血清的频率。
第一组包括28例CU患者（16例ASST阳性）、20例特应性皮炎患者、24例桦树过敏患者和9名健康对照者。第二组包括873例未经选择的CU患者。
将含有1%至2%嗜碱性粒细胞的健康非特应性供体的白细胞与患者血清在白细胞介素（IL）-3存在下孵育。采用玻璃纤维法测定组胺。
以ASST作为真实结果，在第一组中，HR - 荨麻疹试验在HR临界值>16.5%时显示出75%的敏感性和特异性。对照组在HR - 荨麻疹试验中均为阴性。在第二组中，我们发现成年男性（34.6%，n = 254）和成年女性（35.1%，n = 576）的阳性频率无差异，但接受检测的女性人数是男性的两倍。
我们的研究表明，HR - 荨麻疹试验对CU患者中由ASST证实的内源性HRFs具有良好的敏感性和特异性，并且约三分之一未经选择的CU患者结果呈阳性。
