Correlations between disease activity, autoimmunity and biological parameters in patients with chronic spontaneous urticaria

L. de Montjoye^1,2 laurence.demontjoye@uclouvain.be, A-S. Darrigade¹, A. Giménez-Arnau³, A. Herman^1,2, L. Dumoutier⁴, M. Baeck^1,2
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Doi:
http://doi.org/10.23822/EurAnnACI.1764-1489.132

Summary
Background. Biomarkers of disease activity/severity and criteria of autoimmune chronic spontaneous urticaria (CSU) are still a matter of debate. Objective. To investigate possible correlations between clinical and biological markers and their associations with: (i) disease activity; (ii) resistance to H1-antihistamines; (iii) autoimmunity; and (iiii) autologous serum skin test (ASST) in patients with CSU. To also analyze biological parameter modifications in patients with CSU treated with omalizumab. Materials and methods. Disease activity, H1-antihistamines response and presence of concomitant autoimmune disease were prospectively recorded in 95 patients with CSU. For 60 of them, ASST was performed. Broad biological analysis were performed. Results. C-reactive protein (CRP) serum levels were higher in H1-antihistamines unresponders (p<0.0001) and in more active diseases (p=0.033). D-dimer plasma levels were higher in H1-antihistamines unresponders (p=0.008) and in patients with autoimmune status (concomitant autoimmune disease and/or with autoantibodies) (p=0.016). Total immunoglobuline E (IgE) serum level was lower in patients with positive ASST. Blood basophil counts were lower in patients with CSU and especially in H1-antihistamines unresponders (p=0.023), in patients with more active disease (p=0.023), with positive ASST (p=0.001), and with autoimmune status (p=0.057). Conversely, under omalizumab, a decrease of CRP (p=0.0038) and D-dimer serum/plasma levels (p=0.0002) and an increase of blood basophil counts (p=0.0023) and total IgE serum levels (p=0.0007) were observed. Conclusions. This study brings additional evidences of interest to investigate IgE, D-dimer serum/plasma levels and basophil blood counts in patients with CSU as they could be correlated to disease activity, response to treatment and/or autoimmunity.

Key words
Chronic spontaneous urticaria; blood basophil count; IgE; autoimmunity; autologous serum skin test
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