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Immunological effects and potential mechanisms of action of autologous serum therapy in chronic spontaneous urticaria
Background Autoimmune processes are considered to play a major role in the pathogenesis of chronic spontaneous urticaria (CSU). Very recently, interleukin 24 (IL‐24) has been identified as an immunoglobulin E (IgE) autoantigen in CSU. Some studies revealed that notably autologous serum skin test (AS...
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Published in: | Journal of the European Academy of Dermatology and Venereology 2019-09, Vol.33 (9), p.1747-1754 |
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Main Authors: | , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Background
Autoimmune processes are considered to play a major role in the pathogenesis of chronic spontaneous urticaria (CSU). Very recently, interleukin 24 (IL‐24) has been identified as an immunoglobulin E (IgE) autoantigen in CSU. Some studies revealed that notably autologous serum skin test (ASST)‐positive CSU patients may benefit from autohemotherapy; however, the mechanisms of action remain unknown. We aimed to investigate the immunological effects of autologous serum injections in ASST‐positive CSU patients.
Methods
Sixty‐six ASST‐positive CSU patients were treated with weekly intramuscular autologous serum injections for 8 weeks and followed up for 12 weeks. Urticaria activity score (UAS7) and Dermatology Life Quality Index (DLQI) were assessed. The ASST was done at baseline, week 9 and week 21. Serum samples (baseline, weeks 9, 13 and/or 21) were analysed for the levels of IgE‐anti‐IL‐24 and immunoglobulin G (IgG)‐anti‐IL‐24 via ELISA and their ability to release histamine in basophils [basophil histamine release assay (BHRA)].
Results
Autologous serum therapy resulted in a substantial improvement in disease activity and quality of life after 8 and 20 weeks. Twenty‐eight percent and 34% of patients turned ASST‐negative in weeks 9 and 21, respectively, but there was no link between their response to treatment and changes of ASST results. Also, no significant or relevant changes in BHRA were observed. In contrast, autologous serum therapy significantly decreased IgE‐anti‐IL‐24 serum levels, but not IgG‐anti‐IL‐24 serum levels, in responders but not in non‐responders.
Conclusions
Our findings suggest that the immunological effects of autologous serum therapy include a reduction in IgE‐anti‐IL24 autoantibodies, which may contribute to the pathogenesis of CSU. |
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ISSN: | 0926-9959 1468-3083 |
DOI: | 10.1111/jdv.15640 |