Chronic spontaneous urticaria: Evidence of systemic microcirculatory changes

IF 4.6 2区医学 Q2 ALLERGY Clinical and Translational Allergy Pub Date : 2024-01-27 DOI:10.1002/clt2.12335

Yora Mostmans, Marcus Maurer, Bertrand Richert, Vanessa Smith, Karin Melsens, Viviane De Maertelaer, Ines Saidi, Francis Corazza, Olivier Michel

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Abstract

Background

Chronic spontaneous urticaria (CSU) is a chronic inflammatory skin disease where activation of endothelial cells (ECs) at sites of skin lesions leads to increased blood flow, leakage of fluid into the skin, cellular infiltration, and vascular remodeling. To understand the disease duration and the sometimes vague systemic symptoms accompanying flares, the objective of this study was to examine if CSU comes with systemic vascular changes at the microcirculatory level.

Methods

We investigated CSU patients (n = 49) and healthy controls (HCs, n = 44) for microcirculatory differences by nailfold videocapillaroscopy (NVC) and for blood levels of the soluble EC biomarkers serum vascular endothelial growth factor (VEGF), soluble E-selectin, and stem cell factor (SCF). Patients were also assessed for clinical characteristics, disease activity, and markers of autoimmune CSU (aiCSU).

Results

CSU patients had significantly lower capillary density, more capillary malformations, and more irregular capillary dilations than HCs on NVC. Serum levels of VEGF, soluble E selectin and SCF were similar in CSU patients and HCs. CSU patients with higher VEGF levels had significantly more abnormal capillaries. Patients with markers of aiCSU, that is, low IgE levels or increased anti-TPO levels, had significantly more capillaries and less capillary dilations than those without.

Conclusion

Our results suggest that CSU comes with systemic microcirculatory changes, which may be driven, in part, by VEGF.

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慢性自发性荨麻疹：全身微循环变化的证据。

背景：慢性自发性荨麻疹（CSU）是一种慢性炎症性皮肤病：慢性自发性荨麻疹（CSU）是一种慢性炎症性皮肤病，皮肤病变部位的内皮细胞（EC）活化会导致血流量增加、液体渗入皮肤、细胞浸润和血管重塑。为了了解疾病的持续时间和有时伴随复发的模糊的全身症状，本研究旨在探讨 CSU 是否会在微循环水平上引起全身血管变化：方法：我们通过甲折摄像显微镜（NVC）和血清血管内皮生长因子（VEGF）、可溶性E-选择素和干细胞因子（SCF）等可溶性EC生物标志物的血液水平，对CSU患者（49人）和健康对照组（44人）的微循环差异进行了调查。此外，还对患者的临床特征、疾病活动性和自身免疫性CSU（aiCSU）标志物进行了评估：结果：CSU 患者的毛细血管密度、毛细血管畸形和不规则毛细血管扩张均明显低于接受 NVC 治疗的 HC 患者。CSU 患者和 HCs 血清中的血管内皮生长因子、可溶性 E 选择素和 SCF 水平相似。血管内皮生长因子水平较高的 CSU 患者异常毛细血管明显增多。具有 aiCSU 标记（即 IgE 水平低或抗-TPO 水平升高）的患者的毛细血管数量和毛细血管扩张程度均明显高于无 aiCSU 标记的患者：我们的研究结果表明，CSU 伴随着全身微循环的变化，而这种变化可能部分是由血管内皮生长因子驱动的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.