Protease inhibitors in plasma of patients with chronic urticaria

Abstract

The hypothesis that deficiencies of plasma protease inhibitors might play a role in the pathogenesis of chronic urticaria was evaluated. Plasma levels were measured in patients with urticaria and a matched control group for alpha1-antitrypsin, alpha2-macroglobulin, total trypsin-inhibiting capacity, kallikrein-inhibiting capacity, and the complement factors C1 esterase inhibitor, C3, and C4. A total of 92 patients with chronic urticaria or more than three months' duration was studied. Patients with acquired cold urticaria had significantly decreased levels of alpha1-antitrypsin and total antitrypsin activity. In patients with acquired angioneurotic edema, alpha1-antitrypsin levels and antichymotrypsin activities were lowered, with less significant decreases in anti-trypsin and antikallikrein activities. Levels of C1 esterase inhibitor , C3, and C4 were normal in all groups. There was no correlation between the increased sensitivity to intracutaneously administered kallikrein injection and deficiencies of of protease inhibitors.

Symptomatic dermographism: Natural history, clinical features, laboratory investigations and response to therapys

“…In contrast to a previous report of normal protease inhibitor levels in symptomatic dermographism (Doeglas & Bleumink, 1975), we found a significant reduction in the level of circulating ai-antitrypsin. This reduction was not the result of a genetic difference between the patient and control groups and may have been in part due to a consumptive phenomenon (Eftekhari et al, 1980).…”

Reactions to aspirin and food additives in patients with chronic urticaria, including the physical urticarias*

“…The group of 131 patients contained 57% of patients with physical urticarias (Table i). This high percentage probably refiects the type of urticaria patient referred to a University Clinic, but is also a result of an active search for physical causes (Doeglas & Bleumink, 1975).…”

Acute-phase response and its biomarkers in acute and chronic urticaria

“…There are some reports suggesting that protease inhibitor deficiency, mainly AT, is responsible for developing urticaria. The study conducted by Doeglas and Bleumink on 92 cases of CU revealed a statistically lower serum concentration of AT in patients with cold urticaria and in urticaria associated with angioedema [ 30 ]. The same authors examined 281 patients and demonstrated that CU is characterized by a lower serum concentration of AT comparing to healthy subjects.…”