Department of Dermatology, Hospital del Mar-Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
Department of Dermatology, Hospital del Mar-Institut Mar d'Investigacions Mèdiques, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Department of Immunology, Hospital del Mar-Institut Mar d'Investigacions Mèdiques, Barcelona, Spain.
J Allergy Clin Immunol Pract. 2019 May-Jun;7(5):1619-1626.e1. doi: 10.1016/j.jaip.2019.01.026. Epub 2019 Jan 25.
The high-affinity IgE receptor (FcεRI) expression on effector cells has been poorly characterized in patients with chronic urticaria (CU) to date.
To investigate the FcεRI expression on blood basophils in a large cohort of patients with CU and its potential relationship with relevant features of the disease.
Basophil FcεRI expression was measured by flow cytometry in 287 patients with CU (192 with chronic spontaneous urticaria and 95 with chronic inducible urticaria) at their initial evaluation in our department. A control group of healthy nonatopic individuals was included to provide reference data, and the effect of antihistamine and anti-IgE therapy on the basophil FcεRI expression was also evaluated in a cohort of patients with CU.
The median FcεRI expression was found significantly higher in patients with CU compared with healthy controls (P < .0001). A positive correlation was found between serum IgE levels and basophil FcεRI expression (R = 0.422; P < .001). Significantly higher FcεRI levels on basophils were detected in patients with CU who presented with concomitant atopic features (P = .003), negative autologous serum skin test (P = .002), negative autologous plasma skin test (P = .009), or undetected levels of antithyroid antibodies (P = 0.01). Baseline FcεRI expression was not related to the activity and duration of the disease, and was not significantly modified during antihistamine therapy; however, it correlated with the clinical response to omalizumab (P = .003).
Although further multicenter studies are needed to corroborate these findings, the assessment of basophil FcεRI levels might be relevant in daily clinical practice supporting an autoimmune pathogenesis and predicting response to anti-IgE treatment.
迄今为止，慢性荨麻疹（CU）患者效应细胞上高亲和力 IgE 受体（FcεRI）的表达特征描述甚少。
调查大样本 CU 患者血液嗜碱性粒细胞上的 FcεRI 表达及其与疾病相关特征的潜在关系。
采用流式细胞术检测 287 例 CU 患者（192 例慢性自发性荨麻疹，95 例慢性诱导性荨麻疹）初诊时嗜碱性粒细胞上的 FcεRI 表达，同时纳入健康非过敏个体作为对照组，提供参考数据，并评估 CU 患者抗组胺和抗 IgE 治疗对嗜碱性粒细胞 FcεRI 表达的影响。
与健康对照组相比，CU 患者的 FcεRI 表达中位数明显升高（P <.0001）。血清 IgE 水平与嗜碱性粒细胞 FcεRI 表达呈正相关（R = 0.422；P <.001）。同时伴有特应性特征（P =.003）、自身血清皮肤试验阴性（P =.002）、自身血浆皮肤试验阴性（P =.009）或甲状腺自身抗体水平检测不出（P = 0.01）的 CU 患者，其嗜碱性粒细胞上的 FcεRI 水平明显升高。基线 FcεRI 表达与疾病的活动度和持续时间无关，且在抗组胺治疗期间无明显改变；然而，它与奥马珠单抗的临床反应相关（P =.003）。
尽管需要进一步的多中心研究来证实这些发现，但嗜碱性粒细胞 FcεRI 水平的评估可能在支持自身免疫发病机制和预测抗 IgE 治疗反应的日常临床实践中具有重要意义。
