Endo Takahiro, Toyoshima Shota, Hayama Koremasa, Tagui Maho, Niwa Yusuke, Ito Mana, Terui Tadashi, Okayama Yoshimichi
Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan.
Center for Allergy, Nihon University School of Medicine, Tokyo, Japan.
Asia Pac Allergy. 2020 Apr 10;10(2):e12. doi: 10.5415/apallergy.2020.10.e12. eCollection 2020 Apr.
About one-half of all patients with chronic spontaneous urticaria have low or less reactivity of the basophils to FcεRI stimulation. However, the differences in the clinical characteristics between patients who show normal and attenuated basophil reactivities to FcεRI stimulation are still unclear. Furthermore, it also remains unknown as to what factors induce the poor reactivity of basophils to FcεRI stimulation.
The aim of the study is to investigate the differences in the clinical characteristics between patients who show normal and attenuated basophil reactivities to FcεRI stimulation.
We compared the clinical characteristics, including the autologous serum skin test-positive rates, serum concentrations of anti-IgE and anti-FcεRIα autoantibodies, and the FcεRI-crosslinking ability of these autoantibodies between patients with a negative basophil activation test (BAT) (≤10% CD203c basophils, n = 9) and positive BAT (>10% CD203c basophils, n = 13). We also monitored the changes in the 7-day urticaria activity scores after treatment with omalizumab, as compared to the score at the baseline, between the BAT-positive and BAT-negative patients.
The BAT-negative patients showed a significantly higher urticaria control test score than the BAT-positive patients ( = 0.01). There were no significant differences in the autologous serum skin test-positive rates, concentrations of anti-IgE and anti-FcεRIα autoantibodies, and the FcεRI-crosslinking ability of these autoantibodies between the 2 groups. After treatment with omalizumab for 35 days, the score decreased to under 15 (corresponding to controlled or mild chronic spontaneous urticaria) in all of the BAT-negative patients, whereas in 6 out of the 13 BAT-positive patients, the scores remained over 16 (corresponding to moderate or severe chronic spontaneous urticaria).
The weak reactivity of basophils to FcεRI stimulation may not be due to the desensitization of basophils by anti-IgE or anti-FcεRIα autoantibodies. The time to response to omalizumab might differ between BAT-negative and BAT-positive patients with chronic spontaneous urticaria.
约一半的慢性自发性荨麻疹患者嗜碱性粒细胞对FcεRI刺激的反应性较低或较弱。然而，嗜碱性粒细胞对FcεRI刺激反应正常和减弱的患者在临床特征上的差异仍不清楚。此外，嗜碱性粒细胞对FcεRI刺激反应性差的诱导因素也尚不明确。
本研究旨在调查嗜碱性粒细胞对FcεRI刺激反应正常和减弱的患者在临床特征上的差异。
我们比较了嗜碱性粒细胞活化试验（BAT）阴性（≤10% CD203c嗜碱性粒细胞，n = 9）和BAT阳性（>10% CD203c嗜碱性粒细胞，n = 13）患者的临床特征，包括自体血清皮肤试验阳性率、抗IgE和抗FcεRIα自身抗体的血清浓度，以及这些自身抗体的FcεRI交联能力。我们还监测了与基线时相比，奥马珠单抗治疗后7天荨麻疹活动评分的变化，比较了BAT阳性和BAT阴性患者。
BAT阴性患者的荨麻疹控制试验评分显著高于BAT阳性患者（P = 0.01）。两组在自体血清皮肤试验阳性率、抗IgE和抗FcεRIα自身抗体浓度以及这些自身抗体的FcεRI交联能力方面无显著差异。奥马珠单抗治疗35天后，所有BAT阴性患者的评分降至15分以下（对应于受控或轻度慢性自发性荨麻疹），而13例BAT阳性患者中有6例评分仍超过16分（对应于中度或重度慢性自发性荨麻疹）。
嗜碱性粒细胞对FcεRI刺激的弱反应性可能不是由于抗IgE或抗FcεRIα自身抗体使嗜碱性粒细胞脱敏所致。慢性自发性荨麻疹的BAT阴性和BAT阳性患者对奥马珠单抗的反应时间可能不同。
