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EAACI taskforce position paper: evidence for autoimmune urticaria and proposal for defining diagnostic criteria.
- Source :
-
Allergy [Allergy] 2013 Jan; Vol. 68 (1), pp. 27-36. Date of Electronic Publication: 2012 Nov 15. - Publication Year :
- 2013
-
Abstract
- An autoimmune subset of chronic spontaneous urticaria is increasingly being recognized internationally, based on laboratory and clinical evidence that has accrued over the last 20 years. This evidence has been reviewed by a taskforce of the Dermatology section of the European Academy of Allergy and Clinical Immunology. Functional autoantibodies in chronic urticaria (CU) patient sera have been demonstrated against IgE and FcεRIα by basophil and mast cell histamine release assays and by basophil activation assays. Antibody specificity has been confirmed by immunoassay, but there is a poor correlation between functionality and immunoreactivity. Approximately 25% of CU patients have a positive basophil histamine release assay and show autoreactivity (a positive autologous serum skin test), whereas 50% are negative regarding both. Functionality of CU sera appears to be complement dependent on mast cells but not exclusively on basophils. Basophil activation by CU sera is predominantly restricted to IgG1 and IgG3 subclasses. Circumstantial evidence for CU being an autoimmune disease comes from an observed association with other autoimmune diseases, a strong association between serum functionality and HLA-DR4 haplotype and the good response of CU patients to immunotherapies. It was proposed that a study should be undertaken to prospectively validate potentially relevant clinical criteria (from the history, examination and routinely available clinical investigations) against a new 'gold standard' for the diagnosis of ACU (positive autoreactivity, functional bioassay and immunoassay) to define preliminary criteria sets for the diagnosis of ACU based on clinical and laboratory features with highest individual sensitivity and specificity.<br /> (© 2012 John Wiley & Sons A/S.)
- Subjects :
- Autoantibodies blood
Autoantibodies immunology
Autoimmune Diseases genetics
Autoimmune Diseases therapy
Basophils immunology
Basophils metabolism
Cell Degranulation immunology
Complement System Proteins
Histamine Release immunology
Humans
Immunoglobulin G blood
Immunoglobulin G immunology
Immunotherapy
Mast Cells immunology
Mast Cells metabolism
Receptors, IgE immunology
Urticaria genetics
Urticaria therapy
Autoimmune Diseases diagnosis
Urticaria diagnosis
Urticaria immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1398-9995
- Volume :
- 68
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Allergy
- Publication Type :
- Academic Journal
- Accession number :
- 23157716
- Full Text :
- https://doi.org/10.1111/all.12056