Activation of the tissue factor pathway of blood coagulation in patients with chronic urticaria

Riccardo Asero, Alberto Tedeschi, Raffaella Coppola, Samantha Griffini, Paolo Paparella, Piersandro Riboldi, Angelo V. Marzano, Daniele Fanoni, Massimo Cugno

Research output: Contribution to journalArticle

Abstract

Background: In patients with chronic urticaria (CU), plasma shows signs of thrombin generation and autologous plasma skin tests score positive in as many as 95% of cases. Objective: To evaluate the initiators of blood coagulation that lead to thrombin generation and fibrinolysis in CU. Methods: Activated factor VII, activated factor XII, fragment F1+2, and D-dimer plasma levels were measured in 37 patients with CU and 37 controls. Skin specimens from 10 patients with CU and 10 controls were tested for tissue factor immunohistochemically. Results: Mean F1+2 levels were higher in patients than controls (2.54 [SD 2.57] nmol/L vs 0.87 [0.26] nmol/L; P <.001); disease activity was moderate or severe in 9 of 11 (82%) and 9 of 26 (35%) patients showing high or normal F1+2 levels, respectively (P <.025). Mean D-dimer plasma levels were higher in patients than controls (329 [188] ng/mL vs 236 [81] ng/mL; P <.01); disease activity was moderate or severe in 6 of 8 (75%) and 11 of 29 (38%) showing elevated or normal plasma D-dimer levels (P = NS). Factor VIIa levels were higher in patients than controls (2.86 ng/mL [0.66] vs 1.97 ng/mL [0.65]; P <.001). Activated factor VII and F1+2 levels were correlated (r = 0.529; P = .008). Tissue factor reactivity was observed only in CU skin specimens. Conclusion: The extrinsic pathway of clotting cascade is activated in CU. Disease severity is associated with the activation of the coagulation cascade. Clinical implications: The involvement of the coagulation pathway in CU opens new perspectives for a better understanding of the pathogenesis and, possibly, for the treatment of this disease.

Original languageEnglish
Pages (from-to)705-710
Number of pages6
JournalJournal of Allergy and Clinical Immunology
Volume119
Issue number3
DOIs
Publication statusPublished - Mar 2007

Keywords

  • Chronic urticaria
  • coagulation
  • D-dimer
  • factor VII
  • thrombin

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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