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变应性鼻炎患者嗜碱性粒细胞检测结果分析 - CORSA 研究结果

What Basophil Testing Tells Us About CSU Patients - Results of the CORSA Study.

机构信息

Immunoallergology Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte E.P.E., Lisbon, Portugal.

Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.

出版信息

Front Immunol. 2021 Sep 28;12:742470. doi: 10.3389/fimmu.2021.742470. eCollection 2021.

Abstract

Basophil testing is the most effective single approach for diagnosing type-IIb autoimmune chronic spontaneous urticaria (TIIbaiCSU). A positive basophil test has been linked to long disease duration, higher disease activity, a poor response to antihistamines and omalizumab, and a better response to cyclosporine and fenebrutinib. As of now it is unclear what other features are connected to a positive basophil test in chronic spontaneous urticaria (CSU). We aimed to identify features of basophil test-positive CSU patients. We performed a cross-sectional study of 85 CSU patients. Basophil testing was done with the basophil activation test (BAT) and the basophil histamine release assay (BHRA). Data were analysed using SPSS: Student's t-test, Chi-square test, Odds Ratio, Spearman's correlation test. Of 85 CSU patients, 44% and 28% tested positive with the BAT and BHRA, respectively. These patients showed higher disease activity and impact, lower levels of disease control and total serum IgE, as well as higher rates of having a positive autologous serum skin test (ASST), angioedema, nocturnal symptoms, symptoms for >5 days/week, and thyroid autoantibodies. The ASST, by itself, was not a good predictor of basophil test results, but it predicted a positive basophil test in up to 100% of cases when combined with angioedema, thyroid autoantibodies or low IgE. In conclusion, a positive basophil test is linked to known features of TIIbaiCSU and novel characteristics including nocturnal symptoms. Further studies on basophil test-positive and -negative CSU patients can help to better understand CSU endotypes and to develop better management approaches.

摘要

嗜碱性粒细胞检测是诊断 IIb 型自身免疫性慢性自发性荨麻疹(TIIbaiCSU)最有效的单一方法。阳性嗜碱性粒细胞检测与疾病持续时间长、疾病活动度高、抗组胺药和奥马珠单抗治疗反应差以及环孢素和 fenebrutinib 治疗反应好有关。到目前为止,尚不清楚慢性自发性荨麻疹(CSU)中还有哪些其他特征与阳性嗜碱性粒细胞检测有关。我们旨在确定阳性嗜碱性粒细胞检测的 CSU 患者的特征。我们对 85 例 CSU 患者进行了横断面研究。嗜碱性粒细胞检测采用嗜碱性粒细胞激活试验(BAT)和嗜碱性粒细胞组胺释放试验(BHRA)进行。使用 SPSS 进行数据分析:学生 t 检验、卡方检验、优势比、斯皮尔曼相关检验。在 85 例 CSU 患者中,分别有 44%和 28%的患者 BAT 和 BHRA 检测阳性。这些患者表现出更高的疾病活动度和影响,更低的疾病控制和总血清 IgE 水平,以及更高的阳性自身血清皮肤试验(ASST)、血管性水肿、夜间症状、每周症状 >5 天和甲状腺自身抗体的发生率。ASST 本身并不能很好地预测嗜碱性粒细胞检测结果,但当与血管性水肿、甲状腺自身抗体或低 IgE 结合时,它可以预测高达 100%的患者的阳性嗜碱性粒细胞检测结果。总之,阳性嗜碱性粒细胞检测与已知的 TIIbaiCSU 特征以及包括夜间症状在内的新特征有关。对阳性和阴性嗜碱性粒细胞检测的 CSU 患者进行进一步研究有助于更好地了解 CSU 表型并开发更好的管理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e31/8507496/8e4fd1773825/fimmu-12-742470-g001.jpg

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