Evaluation of Autologous Serum Therapy in Patients with Chronic Spontaneous Urticaria
Keywords:
urticaria activity, atopic history, quality of life, autologous serum, chronic spontaneous urticaria.Abstract
Introduction: Autologous serum therapy is an alternative for chronic spontaneous urticaria, which induces tolerance to circulating histamine-releasing factors.
Objective: To evaluate the results of autologous serum therapy in patients with chronic spontaneous urticaria (reactive or not to autologous serum).
Methods: Analytical, longitudinal and prospective study in 53 patients with chronic spontaneous urticaria who consented to participate in the Allergology Service of the Clinical-Surgical Hospital “Hermanos Ameijeiras”, between July 2022 and December 2023. The sample was divided into two groups, according to the result of the skin test with autologous serum, in positive and negative, and therapy with this serum was administered for nine weeks. The information was summarized and statistical tests were applied to detect significant differences before/after the administration of autologous serum, according to variables of interest.
Results: Females (81.1 %), the 19-39 years age group (39.6 %), normopesos (49.1 %) and non-smokers (37.7 %) predominated. Atopic disease accounted for 22.6 % of the sample. Thyroid disease (16.0 %) and hypertensive disease (30.2 %) were the most frequent comorbidities. In both groups, with autologous serum therapy, urticaria activity and quality of life behaved as follows: at baseline, severe/quite affected; at endline, good control/little affected; and three months later, no symptoms/little affected. Six patients reported adverse events, but none severe and with full recovery.
Conclusions: Autologous serum therapy reduces urticaria activity and improves quality of life in patients with chronic spontaneous urticaria.
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References
Hon K, Leung A, Ng W, Loo S. Chronic urticaria: an overview of treatment and recent patents. Recent Pat Inflamm Allergy Drug Discov. 2019 [acceso 18/09/2023];13(1):27-37. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30924425/
O’Farrill P, Álvarez F, Xochihua J. Alteraciones tiroideas en urticaria crónica espontánea. RevAlerg Mex. 2020 [acceso 20/10/2023];66(4):403-8 Disponible en: https://www.scielo.org.mx/pdf/ram/v66n4/2448-9190-ram-66-04-403.pdf
Hurtado M, Martínez M, Vargas M, Castrejón M. Autoinmunidad en urticaria crónica. Perspectiva histórica y actual. RevAlerg Mex. 2022 [acceso 23/10/2023];69(1):s69-s80. Disponible en: https://www.revistaalergia.mx/ojs/index.php/ram/article/view/1037/1526
Aguilera R, Correa H, Díaz C, Marinovic M, Valenzuela F. Guía clínica chilena de urticaria crónica espontánea. RevMéd Chile. 2018 [acceso 24/09/2023];146(11):1334-42. Disponible en: https://scielo.conicyt.cl/scielo.php?pid=S003498872018001101334&script=sci_arttext&tlng=n
Sánchez M, Ansotegui I, Baiardini I, Bernstein J, Walter G, Ebisawa M, et al. The challenges of chronic urticaria part 1: epidemiology, immunopathogenesis, comorbidities, quality of life, and management. World AllergOrgan J. 2021 [acceso 22/10/2023];14(6):100533. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233382/
Elias M, Dozo G, Ferrero P, Muino J. Factor de crecimiento endotelial tipo A en urticaria crónica. ArchAlergInmunol Clin. 2020 [acceso 12/09/2023];51(1):033-8 Disponible en: https://adm.meducatium.com.ar/contenido/articulos/23600330038_1753/pdf/23600330038.pdf
Pratas I, Gonçalo M. Biomarkers in chronic spontaneous urticaria. J Soc Port Dermatol Venereol. 2021 [acceso 15/09/2023];79(2):147-54. Disponible en: https://www.scielo.pt/scielo.php?script=sci_arttext&pid=S2182-23952021000200043&lang=es
Kumar S, Singh S, Brar B, Singh A. Comparative evaluation of the therapeutic efficacy and safety of injected histaglobulin versus autologous serum therapy in chronic urticaria. J Clin Aesthet Dermatol. 2021 [acceso 28/08/2023];14(3):38-41. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33841615/
Pan S, Chia Y, Yee H, Ying A, Anjum C, Kenisi Y, et al. Immunomodulatory potential of anti-idiotypic antibodies for the treatment of autoimmune diseases. Future Sci OA. 2021 [acceso 18/10/2023];7(2):FSO648. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33437514/
Debbarman P, Sil A, Datta P, Bandyopadhyay D, Das N. Autologous serum therapy in chronic urticaria: a promising complement to antihistamines. Indian J Dermatol. 2014 [acceso 16/09/2023];59(4):375-82. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25071258/
Majid I, Shah Sh, Hassan A, Aleem S, Aziz K. How effective is autologous serum therapy in chronic autoimmune urticaria. Indian J Dermatol. 2015 [acceso 18/09/2023];60(1):102. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25657418/
Herrera D, Álvarez F, O´Farrill P. Actividad de la urticaria crónica espontánea en pacientes eutiroideos versus hipotiroideos. RevAlerg Mex. 2020 [acceso 12/09/2023];67(2):112-8. Disponible en: https://www.revistaalergia.mx
Valero A, Herdman M, Bartra J, Ferrer M, Jáuregui I, Dávila I, et al. Adaptation and validation of the spanish version of the chronic urticaria quality of life questionnaire (CU-Q2oL). J InvestigAllergol Clin Immunol. 2008 [acceso 28/10/2023];18(6):426-32. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S244891902018000300170
Declaración de Helsinki de la Asociación Médica Mundial. Recomendaciones para orientar a los médicos en la investigación biomédica con sujetos humanos. JAMA. 1997;277(11):925-6. DOI: https://doi.org/10.1001/jama.03540350075038
Bagadagni P, Thammineedi S, Rirudala R. Chronic urticaria: a clinico-etiological study and autologous serum skin test role in chronic idiopathic urticaria. Int J Res Dermatol. 2021 [acceso 18/10/2023];7(4):552-7. Disponible en: https://d1wqtxts1xzle7.cloudfront.net/68178488/Urticaria_publication-with-coverpagev2.pdf?Expires=1670262763&Signature=UcZiCibePMajnKjf3AirtZbcBEeXeQllBArKOemOfQLCXtJtLJs0NTfEs5C-ebPw6FJLSP12MH-7QX7m19NkDYYJrCqsHT84V6zZ7hEfjeSyvbCp5fUZ59D2UUitnvkekXtM-utmwnzAXiETRaeKZ9ODSr~K3kRRj9nz2dqqlJCp8EfMyqB7ypycXf~5tA7FxQdosdjA~gxR4v4GAERu9OLlkUhpmDm0bgXSH-s2AteB~wRe4xBEzmEk-GCTidEW2jBzgE~LRFmtYvXcdkw8VhgS2KbRbdbG0gYpBpT7n~rhiHDKl31s1oS2ooHS2SeYs~NOCqLO17m4iWWLULkGg__&KeyPairId=APKAJLOHF5GGSLRBV4ZA
Alen I, Regateiro F, Fernandes R, Pita J, Gomes R, Coelho C, et al. Refractory chronic urticaria in adults: clinical characterization and predictors of severity. Allergy Asthma Clin Immunol. 2020 [acceso 18/10/2023];16(1):97. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33292453/
Arias A, González S, Macías A, Ibarra J, Sánchez D, Leal L, et al. Calidad de vida en urticaria crónica y su relación con el impacto económico y control de la enfermedad en pacientes atendidos en el Hospital Universitario de Monterrey, México. RevAlerg Mex. 2018 [acceso 18/10/2023];65(3):250-8. Disponible en: https://www.scielo.org.mx/scielo.php?pid=S2448-91902018000300170&script=sci_arttext
Saha P, Ranjan R, Kundu S, Bhunia D, Datta P. Autologous serum skin test as an indicator of chronic urticaria in comparison with serum IgE level at a tertiary care center in north-eastern India. J Current Research Scientific Med. 2020 [acceso 18/10/2023];6:28-33. Disponible en: https://www.jcrsmed.org/text.asp?2020/6/1/28/290244
Attada S, Venkateswara G, Rajesh K, Nukala K. Comparison of chronic idiopathic urticaria patients with positive and negative autologous serum skin test. Int J Res Dermatol. 2022 [acceso 20/10/2023];8(3):301-7. Disponible en: https://scholar.google.com/scholar?hl=es&as_sdt=0%2C5&q=Comparison+of+chronic+idiopathic+urticaria+patients+with+positive+and+negative+autologous+serum+skin+test.&btnG=
Gyeong-Hun P, Jeong-Hee Ch, Sunmi K, Youin B. The Relation of Autologous Serum Skin Test and Autologous Plasma Skin Test Result with Various Clinical and Laboratory Findings in Patients with Chronic Spontaneous Urticaria. Ann Dermatol. 2020;32(4):280-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33911755/
Fachini R, Games C, Criado P, Teixeira M, Alessi B, Machado C. Evaluation of serum levels of C-reactive protein, D-Dimer and Autologous Serum Skin Test in patients with Chronic Spontaneous Urticaria in a Brazilian tertiary center: a cross-sectional study. AnBrasDermatol. 2021;96(2):148-54. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007487/
El-Sharkawy R, Abd-Elmaged W, Ahmed D, Abdel-Wahed S. Pattern of chronic urticaria and value of autologous serum skin test in Sohag province, Upper Egypt. Electron Physician. 2018 [acceso 29/09/2023];10(5):6781-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29997762/
Mohammed J. Autologous serum therapy reduces the symptoms and antihistamine burden in patients with chronic urticaria. Adv Dermatol Allergol. 2023;XL(3):398-401. DOI: https://doi.org/10.5114/ada.2023.129009
Asero R, Tedeschi A, Riboldi P, Cugno M. Plasma of patients with chronic urticaria shows signs of thrombin generation, and its intradermal injection causes wheal-and-flare reactions much more frequently than autologous serum. J Allergy Clin Immunol. 2006 [acceso 20/12/2023];117(5):1113-7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/16675340/
Cugno M, Tedeschi A, Asero R, Meroni P, Marzano A. Skin autoimmunity and blood coagulation. Autoimmunity. 2010 [acceso 10/02/2024];43(2):189-94. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19883336/
Puccetti A, Bason C, Simeoni S, Millo E, Tinazzi E, Beri R, et al. In chronic idiopathic urticaria autoantibodies against Fc epsilonRII/CD23 induce histamine release via eosinophil activation. Clin Exp Allergy. 2005 [acceso 13/01/2024];35(12):1599-607. Disponible en: https://pubmed.ncbi.nlm.nih.gov/16393326/
Bracken S, Abraham S, MacLeod A. Autoimmune theories of chronic spontaneous urticaria. Front Immunol. 2019 [acceso 28/08/2023];10:627. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30984191/
Raghavendra K, Bangaru H. Efficacy of autologous serum therapy in positive and negative autologous serum skin test patients in chronic urticaria in a tertiary care centre. Dermatol Reports. 2022 [acceso 29/10/2023];15(1):9525. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37034471/file:///C:/Users/alergia/Downloads/efusinato,+9525-Article+Text-68325-1-6-20220621.pdf
Staubach P, Onnen K, Vonend A, Metz M, Siebenhaar F, Tschentscher I, et al. Autologous whole blood injections to patients with chronic urticaria and a positive autologous serum skin test: a placebo-controlled trial. Dermatol. 2006 [acceso 12/10/2023];212(2):150-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/16484822/
Datta A, Chandra S, Saha A, Sil A, Das N. Exploring the safety and effectiveness of subcutaneous autologous serum therapy versus conventional intramuscular autologous serum therapy in chronic urticaria: an observer-blind, randomized, controlled study. Indian J Dermatol VenereolLeprol. 2020 [acceso 12/10/2023];86(6):632-42. Disponible en: https://ijdvl.com/exploring-the-safety-and-effectiveness-of-subcutaneous-autologous-serum-therapy-versus-conventional-intramuscular-autologous-serum-therapy-in-chronic-urticaria-an-observer-blind-randomized-controll/
Ibrahim B, Khaddam J, Ismaiel M. Efficacy of autologous serum therapy in chronic urticaria, a prospective experimental cohort study. J Open Dermatol. 2022 [acceso 22/10/2023];16(1). Disponible en: https://opendermatologyjournal.com/VOLUME/16/ELOCATOR/e187437222209260/FULLTEXT/
Chang H, Sung C, Lin M. Efficacy of autologous whole blood or serum therapy for chronic spontaneous urticaria: a systematic review and meta-analysis. J Dermatolog Treat. 2019 [acceso 17/10/2023];30(8):818-25. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30661442/
Keumala W, Mahri S, Almira D. El papel de la terapia adyuvante en el tratamiento de la urticaria crónica espontánea. Actas Dermo-Sifiliogr. 2023 [acceso 12/10/2023];114(6):523-30. Disponible en: https://www.sciencedirect.com/science/article/pii/S0001731023001710
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