Division of Immune-mediated skin diseases, Department of Dermatology and Venereology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Allergy. 2018 Apr;73(4):940-948. doi: 10.1111/all.13352. Epub 2017 Dec 7.
Elevated levels of C-reactive protein (CRP), a sensitive marker of inflammation, have been consistently reported in chronic spontaneous urticaria (CSU). Here, we retrospectively analyzed data from 1253 CSU patients from 2 centers to answer the following questions: (i) What is the prevalence of elevated levels of CRP in CSU? (ii) Why do CSU patients show elevated levels of CRP? (iii) Are elevated CRP levels relevant?
Serum levels of CRP were measured by the nephelometric method. We collected information regarding various laboratory tests including ESR, CBC with differential, D-dimer, fibrinogen, C3, C4, IL-6, etc. For most patients, we also collected data on age, gender, duration of CSU, presence of angioedema, activity (UAS at the time of blood sampling and for 7 days), quality of life (CU-Q2oL and/or DLQI), comorbidities and possible causes of CSU, and autologous serum skin test (ASST) response. The efficacy of second-generation antihistamines was evaluated on the day of blood collecting.
One-third of CSU patients had elevated levels of CRP. Higher levels of CRP were associated with ASST positivity (P = .009) and arterial hypertension (P = .005), but not with other possible causes or comorbidities of CSU. C-reactive protein correlated with urticaria activity (P < .001), quality of life impairment (P = .026), and inflammatory and coagulation markers (P < .001). C-reactive protein levels were significantly higher in nonresponders to antihistamines as compared to responders (P < .001).
Elevated levels of CRP are common and relevant in CSU patients. The assessment of CRP levels may help to optimize the management of patients with CSU.
C 反应蛋白（CRP）是炎症的敏感标志物，其水平升高在慢性自发性荨麻疹（CSU）中一直有报道。在这里，我们回顾性分析了来自 2 个中心的 1253 例 CSU 患者的数据，以回答以下问题：（i）CSU 患者 CRP 水平升高的患病率是多少？（ii）CSU 患者为何会出现 CRP 水平升高？（iii）CRP 水平升高是否具有相关性？
采用散射比浊法测定 CRP 血清水平。我们收集了各种实验室检查的信息，包括 ESR、白细胞计数和分类、D-二聚体、纤维蛋白原、C3、C4、IL-6 等。对于大多数患者，我们还收集了年龄、性别、CSU 病程、血管性水肿存在情况、疾病活动度（采血时和采血后 7 天的 UAS）、生活质量（CU-Q2oL 和/或 DLQI）、合并症和 CSU 的可能病因以及自身血清皮肤试验（ASST）反应等数据。在采血当天评估第二代抗组胺药的疗效。
三分之一的 CSU 患者 CRP 水平升高。较高的 CRP 水平与 ASST 阳性（P =.009）和动脉高血压（P =.005）相关，但与 CSU 的其他可能病因或合并症无关。CRP 与荨麻疹活动度（P <.001）、生活质量受损（P =.026）以及炎症和凝血标志物（P <.001）相关。与抗组胺药反应者相比，无反应者的 CRP 水平显著升高（P <.001）。
CSU 患者中 CRP 水平升高较为常见且具有相关性。CRP 水平的评估可能有助于优化 CSU 患者的管理。
