Sánchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A, González-Aveledo L, Maurer M
Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela.
Allergy Service, Clínica El Avila, Caracas, Venezuela.
J Eur Acad Dermatol Venereol. 2017 Jun;31(6):964-971. doi: 10.1111/jdv.14221. Epub 2017 Apr 4.
Biomarkers useful for the evaluation and management of patients with chronic spontaneous urticaria (CSU) are not currently available. A review of various clinical and laboratory markers that have been studied to assess their value for determining the severity or predicting the evolution of disease in adult patients with CSU was carried out. A search of the medical literature on PubMed and MEDLINE including the terms urticaria, chronic urticaria, chronic idiopathic urticaria, CSU, severity, prognosis and treatment was performed. Based on our review of the literature, among the clinical markers studied, higher age at onset, being female, long disease duration and aspirin/NSAID hypersensitivity may be linked to both severe CSU and a long time to spontaneous remission. In addition, a positive autologous serum skin test (ASST) may be associated with severe CSU, and comorbidity of inducible urticaria and concomitant recurrent angio-oedema may be linked to longer CSU duration. Potential biomarkers of CSU severity and/or duration include basophil numbers and susceptibility to activation, inflammatory markers, markers of activation of the extrinsic coagulation pathway, immunoglobulin E and vitamin D. Although the described markers are promising, further studies on representative and well-characterized patient populations are needed to determine the value of these clinical and biological markers for predicting the severity and course of disease in patients with CSU.
目前尚无用于评估和管理慢性自发性荨麻疹（CSU）患者的生物标志物。我们对各种临床和实验室标志物进行了综述，这些标志物已被研究以评估其在确定成年CSU患者疾病严重程度或预测疾病进展方面的价值。我们在PubMed和MEDLINE上搜索了医学文献，搜索词包括荨麻疹、慢性荨麻疹、慢性特发性荨麻疹、CSU、严重程度、预后和治疗。基于我们对文献的综述，在所研究的临床标志物中，发病年龄较大、女性、病程长以及阿司匹林/非甾体抗炎药超敏反应可能与严重CSU和自发缓解时间长有关。此外，自体血清皮肤试验（ASST）阳性可能与严重CSU相关，诱导性荨麻疹合并复发性血管性水肿可能与CSU病程较长有关。CSU严重程度和/或病程的潜在生物标志物包括嗜碱性粒细胞数量及其活化敏感性、炎症标志物、外源性凝血途径活化标志物、免疫球蛋白E和维生素D。尽管所描述标志物很有前景，但仍需要对具有代表性且特征明确的患者群体进行进一步研究，以确定这些临床和生物学标志物在预测CSU患者疾病严重程度和病程方面的价值。
