In chronic spontaneous urticaria, IgE against staphylococcal enterotoxins is common and functional

Altrichter, Sabine; Hawro, Tomasz; Liedtke, Michaela; Holtappels, Gabriële; Bachert, Claus; Ps, Skov; Maurer, Marcus

doi:10.1111/all.13381

Cited by 32 publications

(20 citation statements)

References 44 publications

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“…Recent literature suggests the elevated presence of specific IgE to SEB in AR and CRSwNP patients, which may amplify mucosal inflammation and initiate a type 2 allergic response [18]. As IgE to SE is common in CSU patients [40], if T2 activity was controlled, complications involving SE and IgE to SEB in the pathogenesis of airway inflammation would be reduced, possibly indirectly leading to a reduction in CSU symptoms.…”

Section: Discussionmentioning

confidence: 99%

Presence of positive skin prick tests to inhalant allergens and markers of T2 inflammation in subjects with chronic spontaneous urticaria (CSU): a systematic literature review

Wong

Keith

2020

Allergy Asthma Clin Immunol

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Background: Current guidelines do not recommend performing aeroallergen skin prick testing (SPT) in chronic spontaneous urticaria (CSU). Objective: The objective of this review was to investigate the presence of aeroallergen sensitization and markers of T2 inflammation in subjects with CSU. Methods: Systematic literature reviews to identify all studies that evaluated the presence of T2 markers of allergic inflammation in CSU subjects were performed. Results: In 16 studies that assessed the prevalence of positive SPT to multiple aeroallergens in CSU, 38.5% of CSU subjects had positive SPT. In three controlled studies, 34.2% of CSU subjects had positive SPT to multiple aeroallergens, compared to 13.6% of controls (p = 0.047). In 18 studies that assessed the prevalence of house dust mite (HDM) positive SPT in CSU, 27.5% of CSU subjects had positive SPT. In three controlled studies, 27.5% of CSU subjects had positive SPT to HDM, compared to 2.1% of controls (p = 0.047). Overall, CSU subjects were 3.1 times more likely to be aeroallergen-sensitized (95% CI 1.7-5.8, p = 0.0002) and 6.1 times more likely to be HDM-sensitized (95% CI 3.7-9.9, p < 0.00001) than controls. Mean total serum IgE (tIgE) levels were 238 kU/L and median tIgE levels were 164 kU/L, which was greater than the upper 90 th percentile of normal (< 137 kU/L). Compared to healthy controls, CSU subjects were 6.5 times more likely to have IgG autoantibody against FcεR1α (p = 0.001), 2.4 times more likely to have IgG anti-IgE antibody (p = 0.03) and 5 times more likely to have anti-thyroid peroxidase (anti-TPO) antibody (p = 0.02). When corticosteroids were withheld for ≥ 28 days, mean blood eosinophil percentage was elevated at 5.9% (normal < 4%), but other studies reporting absolute count found the mean was in the normal range, 239 ×10 6 / L (normal < 400 ×10 6 /L). Conclusion: Increased aeroallergen sensitization, tIgE, autoantibodies and blood eosinophil percentage in the CSU subjects indicates the possible importance of T2 inflammation in the pathogenesis of CSU. Further studies may

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Section: Discussionmentioning

confidence: 99%

Presence of positive skin prick tests to inhalant allergens and markers of T2 inflammation in subjects with chronic spontaneous urticaria (CSU): a systematic literature review

Wong

Keith

2020

Allergy Asthma Clin Immunol

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“…Even in up to one third of patients, NSAIDs hypersensitivity can resolve during periods of CSU remission . However, the underlying mechanisms on CSU are not fully understood …”

Section: Natural Evolutionmentioning

confidence: 99%

Progress in understanding hypersensitivity reactions to nonsteroidal anti‐inflammatory drugs

Doña

Pérez‐Sánchez

Eguiluz‐Gracia

et al. 2019

Allergy

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Nonsteroidal anti‐inflammatory drugs (NSAIDs), the medications most commonly used for treating pain and inflammation, are the main triggers of drug hypersensitivity reactions. The latest classification of NSAIDs hypersensitivity by the European Academy of Allergy and Clinical Immunology (EAACI) differentiates between cross‐hypersensitivity reactions (CRs), associated with COX‐1 inhibition, and selective reactions, associated with immunological mechanisms. Three phenotypes fill into the first group: NSAIDs‐exacerbated respiratory disease, NSAIDs‐exacerbated cutaneous disease and NSAIDs‐induced urticaria/angioedema. Two phenotypes fill into the second one: single‐NSAID‐induced urticaria/angioedema/anaphylaxis and single‐NSAID‐induced delayed reactions. Diagnosis of NSAIDs hypersensitivity is hampered by different factors, including the lack of validated in vitro biomarkers and the uselessness of skin tests. The advances achieved over recent years recommend a re‐evaluation of the EAACI classification, as it does not consider other phenotypes such as blended reactions (coexistence of cutaneous and respiratory symptoms) or food‐dependent NSAID‐induced anaphylaxis. In addition, it does not regard the natural evolution of phenotypes and their potential interconversion, the development of tolerance over time or the role of atopy. Here, we address these topics. A state of the art on the underlying mechanisms and on the approaches for biomarkers discovery is also provided, including genetic studies and available information on transcriptomics and metabolomics.

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“…It should be noted, however, that the presence of IgE against autoantigens is also documented in diseases other than CSU, such as atopic dermatitis (reviewed in (Hradetzky, Werfel et al 2015)), and a direct link between autoantibodies and the clinical manifestations of CSU has not yet been demonstrated. Some reports also indicate the presence of IgE against exogenous antigens, such as Staphylococcus aureus enterotoxins, in some CSU patients, which could contribute to the pathogenesis of CSU in a subpopulation of patients (Ye, Hur et al 2008, Altrichter, Hawro et al 2018.…”

Section: Chronic Spontaneous Urticariamentioning

confidence: 99%

Approaches to target IgE antibodies in allergic diseases

Balbino

Conde

Marichal

et al. 2018

Pharmacology & Therapeutics

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IgE is the antibody isotype found at the lowest concentration in the circulation. However IgE can undeniably play an important role in mediating allergic reactions; best exemplified by the clinical benefits of anti-IgE monoclonal antibody (omalizumab) therapy for some allergic diseases. This review will describe our current understanding of the interactions between IgE and its main receptors FcεRI and CD23 (FcεRII). We will review the known and potential functions of IgE in health and disease: in particular, its detrimental roles in allergic diseases and chronic spontaneous urticaria, and its protective functions in host defense against parasites and venoms. Finally, we will present an overview of the drugs that are in clinical development or have therapeutic potential for IgE-mediated allergic diseases.

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In chronic spontaneous urticaria, IgE against staphylococcal enterotoxins is common and functional

Abstract: IgE against SEs may contribute to the pathogenesis of CSU in a subpopulation of patients. Its role and relevance in the pathophysiology of CSU need to be further analysed.

Cited by 32 publications

References 44 publications

Presence of positive skin prick tests to inhalant allergens and markers of T2 inflammation in subjects with chronic spontaneous urticaria (CSU): a systematic literature review

Presence of positive skin prick tests to inhalant allergens and markers of T2 inflammation in subjects with chronic spontaneous urticaria (CSU): a systematic literature review

Progress in understanding hypersensitivity reactions to nonsteroidal anti‐inflammatory drugs

Approaches to target IgE antibodies in allergic diseases

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