Increased Level of Basophil CD203c Expression Predicts Severe Chronic Urticaria

Abstract

Increased FcεR1α expression with upregulated CD203c expression on peripheral basophils is seen in patients with chronic urticaria (CU). However, there has been no published report on the association between CD203c expression level and clinical disease activity in CU patients. To investigate whether the increase of basophil activation is associated with the disease activity of CU, we measured basophil CD203c expression using a tricolor flow cytometric method in 82 CU patients and 21 normal controls. The relationship between the percentage of CD203c-expressing basophils and clinical parameters was analyzed. The mean basophil CD203c expression was significantly higher in CU patients than in healthy controls (57.5% vs 11.6%, P < 0.001). The basophil CD203c expression in severe CU patients was significantly higher than in non-severe CU (66.5% ± 23.3% vs 54.0% ± 23.3%, P = 0.033). Multiple logistic regression analysis indicated that both ≥ 72% basophil CD203c expression and urticaria activity score (UAS)≥ 13 were significant predictors of severe CU (P = 0.005 and P = 0.032, respectively). These findings suggest that the quantification of basophil activation with CD203c at baseline may be used as a potential predictor of severe CU requiring another treatment option beyond antihistamines.

Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria

“…The expression of CD203c on basophils is a well‐known activation marker that can be used as a potential marker of severe urticaria as it is increased when compared with non‐severe urticaria and normal controls. In one study, the mean basophil CD203c expression was significantly higher in patients with severe urticaria . In CSU subjects who enter into remission basophils shift towards normalization of basophil IgE‐receptor‐mediated histamine release and correction of basopenia .…”

“…In one study, the mean basophil CD203c expression was significantly higher in patients with severe urticaria. 60 In CSU subjects who enter into remission basophils shift towards normalization of basophil IgE-receptormediated histamine release and correction of basopenia. 56,61 Taking together the mentioned observations, basophil numbers and functions should be further explored for their link to defining features of severe CSU as well as long disease duration.…”

Treatment of chronic spontaneous urticaria with an inadequate response to H1-antihistamine

“…Plasma levels of D-Dimer (a marker of fibrinolysis, which may be increased as a result of eosinophil activation in CU) have been proposed as a candidate prognostic marker [46]. Other candidate biomarkers include substance P, interleukin-6, C-reactive protein, metalloproteinase-9, and basophil CD203c [47,48]. However, these have yet to be validated as biomarkers for CU and their predictive capacity is not yet defined [36,[47][48][49].…”

Treatment of chronic spontaneous urticaria with an inadequate response to H1-antihistamines: an expert opinion

“…Plasma levels of D-Dimer (a marker of fibrinolysis, which may be increased as a result of eosinophil activation in CU) have been proposed as a candidate prognostic marker [46]. Other candidate biomarkers include substance P, interleukin-6, Creactive protein, metalloproteinase-9, and basophil CD203c [47,48]. However, these have yet to be validated as biomarkers for CU and their predictive capacity is not yet defined [36,[47][48][49].…”