Antihistamines do not inhibit the flare induced by the intradermal injection of autologous plasma in chronic urticaria patients

R. Asero, A. Tedeschi, M. Lorini, M. Cugno

Research output: Contribution to journalArticle

Abstract

Background: There is some evidence suggesting that factors other than autoantibodies to FceRI or IgE and histamine released from mast cells may play a role in skin autore-activity that characterizes many patients with chronic urticaria (CU) and, possibly, in the pathogenesis of this disease. Objective: The effect of antihistamine treatment on autologous plasma skin test (APST) in patients with CU was assessed. Methods: 24 patients with CU underwent autologous plasma skin test (APST) as well as SPT with histamine 10 mg/ml while taking antihistamines. In 6 cases the same tests had been carried out also before the start of antihistamine treatment. Plasma levels of D-dimer, prothrombin F1+2 fragment, and vascular endothelial growth factor (VEGF) were measured in 21 patients. Results: 21/24 (87%) patients showed a large flare on APST while taking antihistamines while the skin reaction to histamine 10 mg/ml was abolished or negligible. Little difference in the autologous plasma-induced flare was seen before and after the start of cetirizine therapy in 6 cases, whereas the drug exerted a marked effect on the histamine SPT as well as on the autologous plasma-induced wheal. The APST-induced flare was not associated with patients' response to antihistamine. Plasma levels of VEGF, prothrombin F1+2 fragment, and D-dimer were increased in plasmas from 8, 9, and 2 patients, respectively. Conclusions: Factors other than histamine are probably involved in the flare following APST in CU; such factors might play a pathogenic role particularly in patients not responding to standard antihistamine treatments.

Original languageEnglish
Pages (from-to)181-186
Number of pages6
JournalEuropean Annals of Allergy and Clinical Immunology
Volume41
Issue number6
Publication statusPublished - Dec 2009

Keywords

  • Autoreactivity
  • Chronic urticaria
  • Histamine
  • Skin testing

ASJC Scopus subject areas

  • Immunology and Allergy

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