Department of Allergy, Clinica Universitaria, Universidad de Navarra, Pamplona, Spain.
Allergy Asthma Clin Immunol. 2007 Mar 15;3(1):31-5. doi: 10.1186/1710-1492-3-1-31.
: Chronic urticaria is a skin disorder characterized by transient pruritic weals that recur from day to day for 6 weeks or more. It has a great impact on patients' quality of life. In spite of this prevalence and morbidity, we are only beginning to understand its physiopathology and we do not have a curative treatment. Moreover, a patient with chronic urticaria may undergo extensive laboratory evaluations seeking a cause only to be frustrated when none is found. In recent years there have been significant advances in our understanding of some of the molecular mechanisms responsible for hive formation. The presence and probable role of IgG autoantibodies directed against epitopes expressed on the alpha-chain of the IgE receptor and to lesser extent, to IgE in a subset of patients is generally acknowledged. These autoantibodies activate complement to release C5a, which augments histamine release, and IL4 and leukotriene C4 are released as well. A perivascular cellular infiltrate results without predominance of either Th1 or Th2 lymphocyte subpopulations. Basophils of all chronic urticaria patients (autoimmune or idiopathic) are hyperresponsive to serum, regardless of source, but poorly responsive to anti IgE. In this review we will summarize the recent contributions to this field and try to provide insights to possible future directions for research on this disease.
慢性荨麻疹是一种以皮肤瘙痒性风团为特征的皮肤病，其风团每天或隔天反复发作，持续 6 周或以上。它对患者的生活质量有很大影响。尽管这种疾病如此普遍且发病率高，但我们才刚刚开始了解其病理生理学，而且还没有有效的治疗方法。此外，慢性荨麻疹患者可能会接受广泛的实验室评估，以寻找病因，但当找不到病因时，他们会感到沮丧。近年来，我们对导致荨麻疹形成的一些分子机制有了更深入的了解。一般认为，在某些患者中，针对 IgE 受体α链上表达的表位以及在较小程度上针对 IgE 的 IgG 自身抗体的存在和可能作用。这些自身抗体激活补体释放 C5a，从而增强组胺的释放，并释放白细胞介素 4 和白三烯 C4。结果导致血管周围细胞浸润，没有 Th1 或 Th2 淋巴细胞亚群占优势。所有慢性荨麻疹患者（自身免疫性或特发性）的嗜碱性粒细胞对血清均高度敏感，而与来源无关，但对抗 IgE 反应不佳。在这篇综述中，我们将总结该领域的最新进展，并尝试为该疾病的未来研究提供思路。
