Chen Qiquan, Wang Wenwen, Yang Xianjie, Li Shifei, Deng Sisi, Wang Huan, Liu Wenying, Ni Bing, Song Zhiqiang
Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, China,
Department of Pathophysiology, Army Medical University, Chongqing, China,
Int Arch Allergy Immunol. 2024;185(12):1248-1253. doi: 10.1159/000540155. Epub 2024 Jul 30.
Atopy is an important and non-negligible clinical phenomenon in chronic spontaneous urticaria (CSU). However, the characteristics and clinical significance of atopy in patients with CSU have not been fully described. This study aimed to analyze the characteristics and clinical significance of atopy in patients with CSU.
A descriptive cross-sectional design was used. The study enrolled 176 patients with CSU. All enrolled patients underwent total IgE, specific IgE, and autologous serum skin tests (ASSTs). The relationships between atopy, the demographic and clinical data of patients with CSU, and the response to ASST were analyzed in detail; the distribution of allergens in atopic CSU was also analyzed.
Atopy was confirmed in 48.9% of patients with CSU. Patients with atopic CSU were more likely than patients with non-atopic CSU to have dermatographism (57.0% vs. 41.1%, p < 0.05), history of urticaria (37.2% and 18.9%, respectively; p < 0.01), angioedema (39.5% and 24.4%, respectively; p < 0.05), and anaphylaxis (7/86 and 1/90, respectively; p < 0.05). Atopy was not associated with ASST response, disease duration, or response to antihistamine treatment in patients with CSU, nor was it associated with the urticaria activity score (UAS7), chronic urticaria quality of life questionnaire (CU-Q2oL), or pruritus visual analog scale (VAS) scores (all p < 0.05). The most common allergen in patients with atopic CSU was dust mites, followed by animal food allergens, tree/grass pollen, and cockroaches.
Although larger prospective studies are needed to confirm these results, our study found atopy occurred in nearly half of patients with CSU, and preliminarily links atopy to CSU, suggesting it as a potential risk factor for angioedema, anaphylaxis, and recurrent urticaria, mirroring allergen patterns in other allergic disease.
特应性是慢性自发性荨麻疹（CSU）中一种重要且不可忽视的临床现象。然而，CSU患者特应性的特征及临床意义尚未得到充分描述。本研究旨在分析CSU患者特应性的特征及临床意义。
采用描述性横断面设计。本研究纳入了176例CSU患者。所有纳入患者均接受了总IgE、特异性IgE及自体血清皮肤试验（ASST）。详细分析了CSU患者的特应性、人口统计学和临床数据以及对ASST反应之间的关系；还分析了特应性CSU患者中过敏原的分布情况。
48.9%的CSU患者确诊为特应性。特应性CSU患者比非特应性CSU患者更易出现皮肤划痕症（57.0%对41.1%，p<0.05）、荨麻疹病史（分别为37.2%和18.9%；p<0.01）、血管性水肿（分别为39.5%和24.4%；p<0.05）及过敏反应（分别为7/86和1/90；p<0.05）。特应性与CSU患者的ASST反应、病程或抗组胺治疗反应无关，也与荨麻疹活动度评分（UAS7）、慢性荨麻疹生活质量问卷（CU-Q2oL）或瘙痒视觉模拟量表（VAS）评分无关（所有p<0.05）。特应性CSU患者中最常见的过敏原是尘螨，其次是动物性食物过敏原、树/草花粉和蟑螂。
尽管需要更大规模的前瞻性研究来证实这些结果，但我们的研究发现近一半的CSU患者存在特应性，并初步将特应性与CSU联系起来，提示其为血管性水肿、过敏反应和复发性荨麻疹的潜在危险因素，这与其他过敏性疾病中的过敏原模式相似。
