Department of Pediatrics, National Jewish Health, Denver, CO, U.S.A. 80206.
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, South Korea.
Ann Allergy Asthma Immunol. 2014 Jun;112(6):533-538. doi: 10.1016/j.anai.2014.03.016. Epub 2014 Apr 13.
Chronic idiopathic urticaria (CIU) and atopic dermatitis (AD) are common allergic skin diseases associated with severe pruritus. AD skin is characterized by filaggrin deficiency, but it has not been studied in CIU.
To compare the expression of filaggrin in skin from patients with CIU, patients with AD, and normal controls and to investigate whether altered filaggrin expression is associated with CIU severity.
Skin biopsies were obtained from 16 patients with CIU, 11 patients with AD, and 14 normal controls. Filaggrin expression was evaluated using real-time reverse transcriptase polymerase chain reaction and immunostaining. Urticaria activity score, transepidermal water loss, and skin pH were measured.
FLG gene expression was significantly greater in lesional CIU skin compared with lesional AD skin (P < .01). The staining intensity of filaggrin was significantly increased in lesional CIU skin compared with skin from normal controls (P < .01) and lesional AD skin (P < .001). A significant correlation was observed between filaggrin staining intensity and urticaria activity score in patients with CIU (r = 0.538, P < .05). Transepidermal water loss was significantly increased in lesional skin of patients with AD compared with skin from normal controls (P < .01) and lesional skin from patients with CIU (P < .01). Skin pH was significantly decreased in lesional skin from patients with CIU compared with skin from normal controls (P < .01) and patients with AD (P < .001).
Filaggrin is overexpressed in lesional CIU skin, and increased filaggrin expression is positively correlated with urticaria severity in CIU. Altered filaggrin expression has physiologic effects on transepidermal water loss and pH in the skin of patients with CIU, suggesting increased barrier function compared with skin from patients with AD.
慢性特发性荨麻疹（CIU）和特应性皮炎（AD）是常见的过敏性皮肤疾病，与严重瘙痒有关。AD 皮肤的特征是丝聚合蛋白缺乏，但在 CIU 中尚未进行研究。
比较 CIU 患者、AD 患者和正常对照者皮肤中丝聚合蛋白的表达，并探讨丝聚合蛋白表达的改变是否与 CIU 的严重程度有关。
从 16 例 CIU 患者、11 例 AD 患者和 14 例正常对照者中获取皮肤活检标本。采用实时逆转录聚合酶链反应和免疫染色法评估丝聚合蛋白的表达。测量荨麻疹活动评分、经皮水分丢失和皮肤 pH 值。
与 AD 皮损相比，CIU 皮损中的 FLG 基因表达显著增加（P <.01）。CIU 皮损中的丝聚合蛋白染色强度显著高于正常对照者（P <.01）和 AD 皮损（P <.001）。CIU 患者中，丝聚合蛋白染色强度与荨麻疹活动评分呈显著正相关（r = 0.538，P <.05）。AD 皮损中的经皮水分丢失明显高于正常对照者（P <.01）和 CIU 皮损（P <.01）。CIU 皮损中的皮肤 pH 值明显低于正常对照者（P <.01）和 AD 皮损（P <.001）。
丝聚合蛋白在 CIU 皮损中过度表达，CIU 中丝聚合蛋白表达的增加与荨麻疹的严重程度呈正相关。丝聚合蛋白表达的改变对 CIU 患者皮肤的经皮水分丢失和 pH 值具有生理影响，提示与 AD 患者皮肤相比，CIU 患者皮肤的屏障功能增强。
