Kim Hyuk Soon, Noh Geunwoong
Department of Biomedical Sciences, College of Natural Science and Department of Health Sciences, The Graduate School of Dong-A University, Busan, Korea.
Department of Allergy, Allergy and Clinical Immunology Center, Cheju Halla General Hospital, Doreongno 65, Jeju-si, 63127, Jeju-Si Jeju Special Self-Governing Province, Korea.
Allergy Asthma Clin Immunol. 2021 Nov 12;17(1):116. doi: 10.1186/s13223-021-00612-8.
Symptom control is a major concern in chronic urticaria. Histobulin™ is a histamine/immunoglobulin complex that has been approved for allergic rhinitis, bronchial asthma and chronic urticaria in some countries. Not only has the immunoglobulin/histamine complex been reported to be effective in allergic diseases, including chronic urticaria, but recently, the possibility of remission induction in chronic urticaria by the immunoglobulin/histamine complex has been reported.
Histobulin™ was administered until remission was induced instead of fixing the number of administrations in four cases of chronic urticaria. Two patients showed an early response and finished treatment with 12 injections of Histobulin™, and the other two patients showed a late response and were injected 43 and 46 times. Remission was induced successfully in all four cases.
Histobulin™ is not only effective but also induces remission in CSU. The Histobulin™ therapy protocol in CSU may be better if the treatment is continued until remission is achieved. Based on the responses of the patients, early responders and late responders were present. The progression of the disease during treatment consisted of a slow improvement phase and a rapid improvement phase. Uniquely, the appropriate allergy laboratory results, including blood eosinophil fraction, total IgE and eosinophil cationic protein level, were normal in all 4 cases. Further studies concerning the mechanisms of Histobulin™ may be needed.
症状控制是慢性荨麻疹的主要关注点。组胺球蛋白™是一种组胺/免疫球蛋白复合物，在一些国家已被批准用于过敏性鼻炎、支气管哮喘和慢性荨麻疹。不仅有报道称免疫球蛋白/组胺复合物在包括慢性荨麻疹在内的过敏性疾病中有效，而且最近，也有报道称免疫球蛋白/组胺复合物可能诱导慢性荨麻疹缓解。
在4例慢性荨麻疹患者中，给予组胺球蛋白™直至诱导缓解，而不是固定给药次数。2例患者出现早期反应，接受12次组胺球蛋白™注射后完成治疗，另外2例患者出现晚期反应，分别注射了43次和46次。所有4例均成功诱导缓解。
组胺球蛋白™不仅有效，还可诱导慢性自发性荨麻疹（CSU）缓解。如果持续治疗直至缓解，CSU的组胺球蛋白™治疗方案可能更好。根据患者的反应，存在早期反应者和晚期反应者。治疗期间疾病进展包括缓慢改善期和快速改善期。独特的是，所有4例患者的适当过敏实验室检查结果，包括血液嗜酸性粒细胞比例、总IgE和嗜酸性粒细胞阳离子蛋白水平均正常。可能需要进一步研究组胺球蛋白™的作用机制。
