In chronic spontaneous urticaria, high numbers of dermal endothelial cells, but not mast cells, are linked to recurrent angio-oedema

Terhorst‐Molawi, Dorothea; Koti, I.; Krause, Karoline; Metz, Martin; Maurer, Marcus

doi:10.1111/ced.13254

Cited by 17 publications

(15 citation statements)

References 27 publications

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“…Future research should explore the clinical course of angioedema in CSU—including the most commonly affected areas, the clinical differences compared with hereditary angioedema and evolution of symptoms over time—as well as the distinct management patterns that patients with angioedema in CSU require. Understanding the underlying mechanisms of angioedema in CSU and exploring differences in the general categories of angioedema (ie mast cell–induced and bradykinin‐induced) are also important areas for additional research.…”

Section: Discussionmentioning

confidence: 99%

Angioedema in chronic spontaneous urticaria is underdiagnosed and has a substantial impact: Analyses from ASSURE‐CSU

Sussman

Abuzakouk

Berard

et al. 2018

Allergy

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Background ASSURE‐CSU revealed differences in physician and patient reporting of angioedema. This post hoc analysis was conducted to evaluate the actual rate of angioedema in the study population and explore differences between patients with and without angioedema.MethodsThis international observational study assessed 673 patients with inadequately controlled chronic spontaneous urticaria (CSU). Physicians abstracted angioedema data from medical records, which were compared with patient‐reported data. Patients in the Yes‐angioedema category had angioedema reported in the medical record and a patient‐reported source. For those in the No‐angioedema category, angioedema was reported in neither the medical record nor a patient‐reported source. Those in the Misaligned category had angioedema reported in only one source. Statistical comparisons between Yes‐angioedema and No‐angioedema categories were conducted for measures of CSU activity, health‐related quality of life (HRQoL), productivity and healthcare resource utilization (HCRU). Regression analyses explored the relationship between Dermatology Life Quality Index (DLQI) score and angioedema, adjusting for important covariates.ResultsAmong evaluable patients, 259 (40.3%), 173 (26.9%) and 211 (32.8%) were in the Yes‐angioedema, No‐angioedema and Misaligned category, respectively. CSU activity and impact on HRQoL, productivity, and HCRU was greater for Yes‐angioedema patients than No‐angioedema patients. After covariate adjustment, mean DLQI score was significantly higher (indicating worse HRQoL) for patients with angioedema versus no angioedema (9.88 vs 7.27, P < .001). The Misaligned category had similar results with Yes‐angioedema on all outcomes.ConclusionsAngioedema in CSU seems to be under‐reported but has significant negative impacts on HRQoL, daily activities, HCRU and work compared with no angioedema.

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Section: Discussionmentioning

confidence: 99%

Angioedema in chronic spontaneous urticaria is underdiagnosed and has a substantial impact: Analyses from ASSURE‐CSU

Sussman

Abuzakouk

Berard

et al. 2018

Allergy

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“…Skin MCs express Kit, the receptor for stem cell factor, which is the major driver of MC differentiation, activation, migration, proliferation, and survival [95]. MC numbers are increased in the skin of CSU patients, which may be due to the effects of stem cell factor, which is also a potent activator of MCs [96,97]. Reducing the number of MCs may help patients with CSU.…”

Section: Drugs Inhibiting the Effects Of Signals That Drive MC Activamentioning

confidence: 99%

Urticaria: Collegium Internationale Allergologicum (CIA) Update 2020

Maurer

Eyerich

et al. 2020

Int Arch Allergy Immunol

123

141

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“…Mast cells in urticaria patients, as in healthy individuals, are located in the upper and lower dermis with a prevalent perivascular and periadnexal pattern . Highest numbers are found in superficial dermal skin lesions and the lowest numbers in lower reticular dermis …”

Section: Mast Cell Location and Changes In Number In Chronic Urticariamentioning

confidence: 99%

“…60,61 Highest numbers are found in superficial dermal skin lesions and the lowest numbers in lower reticular dermis. 62,63 Although the disposition of mast cells in the skin of urticaria patients is normal, do their numbers change in chronic urticaria? Reports Increased mast cell numbers in both lesional and non-lesional skin have been reported in several other studies, 64,65 while others report increases in areas of whealing or recent whealing [66][67][68][69][70] or in both lesional and uninvolved skin of patients with prolonged (>10 weeks) disease.…”

Section: Mast Cell Location and Changes In Number In Chronic Urticariamentioning

confidence: 99%

The role and relevance of mast cells in urticaria

Church

Kolkhir

Metz

et al. 2018

Immunological Reviews

184

198

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This review presents evidence that the skin mast cell, in particular the MC subtype, is the primary effector cell in urticaria. Mast cells are located in the upper dermis, the ideal situation for wheal formation and sensory nerve stimulation. Increased numbers of mast cells are found in both lesional and non-lesional skin in CSU and inducible urticaria. Mast cell degranulation in the area of wheals has been demonstrated repeatedly by light and electron microscopy. Histamine, PGD and tryptase are found in the venous blood draining wheal formation. The last 2 are specific for mast cells rather than basophils. Mast cell reactivity is increased in active urticaria by local inflammatory cytokines and neuropeptides. Mast cell cytokines and neuropeptides, particularly nerve growth factor, induce a Th2 type inflammation that is particularly obvious at the sites of whealing. In conclusion, autoimmunity, either of Type 1 viz. IgE antibodies to local autoallergens, or Type 2b, viz. IgG autoantibodies to IgE or its receptor, are considered to be the most frequent causes of CSU. In both cases, the mast cell is likely to be the axial cell in producing the wheals.

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In chronic spontaneous urticaria, high numbers of dermal endothelial cells, but not mast cells, are linked to recurrent angio-oedema

Cited by 17 publications

References 27 publications

Angioedema in chronic spontaneous urticaria is underdiagnosed and has a substantial impact: Analyses from ASSURE‐CSU

Angioedema in chronic spontaneous urticaria is underdiagnosed and has a substantial impact: Analyses from ASSURE‐CSU

Urticaria: Collegium Internationale Allergologicum (CIA) Update 2020

The role and relevance of mast cells in urticaria

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