Autologous Serum Skin Test for Autoantibodies Is Associated with Airway Hyperresponsiveness in Patients with Asthma

Abstract

Background: Autoimmune diseases have been implicated as a cause of intrinsic asthma; however, there is little data on the role of autoimmunity in the pathogenesis of asthma. Objective: The purpose of this study was to investigate circulating functional autoantibodies against the high-affinity IgE receptor FcΕRI or IgE in patients with asthma. Methods: Twenty-eight patients with asthma and 19 control subjects were included. All subjects were skin tested with autologous serum to assess for the potential presence of receptor FcΕRI or IgE autoantibodies. If the serum-induced wheal diameter was 1.5 mm larger than the histamine-induced wheal diameter and that was 3 mm larger than the saline-induced wheal diameter at 30 min, the reaction was defined positive. Results: Of the 47 total subjects (both asthma patients and control subjects), 13 (27.7%) had a positive autologous serum skin test (ASST). Of the 28 asthma patients, 8 (28.6%) were regarded as having autoimmune origin. Autoantibodies against FcΕRI or IgE were found in asthma patients, irrespective of atopic status (atopy+ 3/13 vs. atopy– 5/15). The wheal diameter related to ASST was not related to atopy. Asthma patients with ASST-positive results as compared with patients with ASST-negative results exhibited a significant increased airway hyperresponsiveness (PC₂₀ methacholine, 2.70 ± 1.27 vs. 9.08 ± 2.35; p < 0.026). Conclusion: Our data demonstrate that aberrant autoantibodies against the high-affinity IgE receptor FcΕRI or IgE are related to airway hyperresponsiveness in patients with asthma.

FcɛR1α gene polymorphism shows association with high IgE and anti‐FcɛR1α in Chronic Rhinosinusitis with Nasal Polyposis

“…Early reports analyzing autoimmune background of allergic diseases show the presence of autoantibodies against IgE and/or FcɛR1α in allergic disorders, like chronic idiopathic urticarial and asthma . We also observed significantly high FcɛR1α antibodies in the study group.…”

Markers of autoreactivity, coagulation and angiogenesis in patients with nonallergic asthma

“…First, it was found that patients with nonallergic asthma frequently score positive on the autologous serum skin test (ASST), suggesting the presence of circulating histamine‐releasing factors in this disease (27), a finding that confirms pioneering observations by a Swedish doctor who carried out experiments with the so‐called autoserum test as long as 50 years ago (28). This observation was further analyzed by other researchers who showed that in patients with asthma, a positive ASST is associated with an increase in bronchial hyper‐responsiveness (29). Moreover, bronchial hyper‐responsiveness, which is a hallmark of asthma, is a frequent finding in patients with CU (30).…”

The EAACI/GA2LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update

“…Ogólne doświad czenia, w tym członków panelu, są takie, że u zdro wych osób z grupy kontrolnej i u pacjentów bez objawów PPS wynik ASST nigdy nie jest dodatni, a zatem nie stwierdza się reakcji miejscowej zdefi niowanej jako powstanie zapalnego bąbla o rumie niowym zabarwieniu [48][49][50][51][52][53][54][55][56][57][58][59][60]. W przeciwieństwie do większości wcześniej opublikowanych badań, niektóre prace wykazują relatywnie wysoki odse tek dodatniej reakcji w ASST u chorych z alergicz nymi lub niealergicznymi objawami ze strony ukła du oddechowego, wynoszący 30-50% u dorosłych pacjentów i aż do 80% w populacji dziecięcej [53][54][55][56]61]. W dwóch z tych badań u 40-45% zdrowych osób także uzyskano dodatni wynik ASST, choć jako kryterium wyniku dodatniego zostały przyjęte dane zatwierdzone tylko dla pokrzywki przewle kłej.…”