Du Yuteng, Yang Boyun, Yao Wo, Ge Liuya, Fan Qingqiu, Wang Huiying
Department of Allergy and Clinical Immunology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
Department of Emergency Medicine, Hangzhou Third People's Hospital, Hangzhou, China.
Int Arch Allergy Immunol. 2025;186(2):133-141. doi: 10.1159/000540684. Epub 2024 Sep 3.
Asthma and chronic urticaria (CU) are two high prevalent diseases and often coexist. The underlying relationship and potential immunological mechanism between the two diseases are still unclear. The objective of this study was to investigate the clinical and immunological feature of asthma comorbid with CU.
A retrospective study was conducted. Fifty patients with asthma comorbid CU, 50 patients with asthma, and 50 patients with CU alone were included. Age and sex of the patients enrolled were matched. Data of demographic characteristics, clinical manifestations including disease severity (frequency of symptoms, age of onset, disease duration, symptom score, complication with allergic rhinitis) as well as serum immunological index including total IgE (tIgE), allergen-specific IgE (sIgE), and food-specific IgG4 (FS-IgG4), were collected and analyzed.
No significant differences in the frequency of symptoms, age of onset, and disease duration were found among the three groups. The score of asthma control test (ACT) in patients with asthma comorbid CU was significantly lower than that of asthma (p = 0.005); however, compared with patients with CU, the 7-day urticaria activity score (UAS7) of patients with asthma comorbid CU did not show obvious differences. Immunological index showed that the positive rates of tIgE, house dust mite (HDM)-sIgE, and FS-IgG4 were different among the three groups (p < 0.05). Patients with asthma comorbid CU had the highest rate of positive tIgE, moderate and severe positive sIgE to HDM. Egg-specific IgG4 (egg-sIgG4) had the highest positive rate in all groups. Patients of asthma comorbid CU obtained the highest rate of severe positive of egg-sIgG4.
Our results demonstrated that patients with asthma comorbid CU have lower control level of asthma symptoms, higher tIgE and HDM-sIgE level, and highest rate of severe positive egg-sIgG4. These results indicate that comorbidity of CU in asthma obviously increases the severity of allergens.
哮喘和慢性荨麻疹（CU）是两种高发性疾病，且常并存。这两种疾病之间潜在的关系和免疫机制仍不清楚。本研究的目的是调查合并CU的哮喘的临床和免疫学特征。
进行一项回顾性研究。纳入50例合并CU的哮喘患者、50例哮喘患者和50例单纯CU患者。纳入患者的年龄和性别相匹配。收集并分析人口统计学特征数据、临床表现（包括疾病严重程度：症状频率、发病年龄、病程、症状评分、合并过敏性鼻炎情况）以及血清免疫学指标（包括总IgE（tIgE）、变应原特异性IgE（sIgE）和食物特异性IgG4（FS-IgG4））。
三组在症状频率、发病年龄和病程方面未发现显著差异。合并CU的哮喘患者的哮喘控制测试（ACT）评分显著低于哮喘患者（p = 0.005）；然而，与CU患者相比，合并CU的哮喘患者的7天荨麻疹活动评分（UAS7）没有明显差异。免疫学指标显示，三组的tIgE、屋尘螨（HDM）-sIgE和FS-IgG4阳性率不同（p < 0.05）。合并CU的哮喘患者的tIgE阳性率最高，HDM的sIgE中度和重度阳性率最高。卵特异性IgG4（卵-sIgG4）在所有组中的阳性率最高。合并CU的哮喘患者的卵-sIgG4重度阳性率最高。
我们的结果表明，合并CU的哮喘患者的哮喘症状控制水平较低，tIgE和HDM-sIgE水平较高，卵-sIgG4重度阳性率最高。这些结果表明，哮喘合并CU明显增加了过敏原的严重程度。
