Abstract:
Chronic spontaneous urticaria (CSU) is a disorder characterized by wheals and/or angioedema. The coagulation cascade and inflammation pathways are closely linked together. The aim of our study was first to investigate the dynamics of clot formation in plasma (Clot Waveform Analysis, CWA) in a group of 47 patients with CSU along with other coagulative parameters dedicated to the study of hypercoagulability, such as D-Dimer, F 1 + 2 peptide, Fibrinogen, Platelet count and Mean Platelet Volume (MPV). Secondly, 23 out of 47 patients were treated with Omalizumab at four administration intervals from T0 to T4. A statistically significant increase in Activated Partial Thromboplastin (aPTT) ratio, D-Dimer, F1 + 2, Platelet count and MPV was found when compared with 53 healthy controls (HC). In contrast, the 2nd Derivative of aPTT showed lower values than those of the HC. No differences were found between 1st derivative of aPTT and Fibrinogen. D-Dimer only showed a significant difference between T0 and T3. An activation of both coagulation and fibrinolysis along with a weaker clot acceleration may be in agreement with a low-grade DIC. The accelerated turnover of platelets expressed by both an increase in platelet count and MPV further supports this pathway in CSU. Omalizumab does not affect the relationship between the immune and the hemostatic systems.
摘要:
慢性自发性荨麻疹(CSU)是一种以风团和/或血管性水肿为特征的疾病。凝血级联和炎症途径紧密相连。我们研究的目的是首先研究血浆中凝块形成的动力学(凝块波形分析,CWA)在一组47例CSU患者中,以及其他致力于高凝状态研究的凝血参数,比如D-二聚体,F1+2肽,纤维蛋白原,血小板计数和平均血小板体积(MPV)。其次,47名患者中的23名在T0至T4的四个给药间隔中接受奥马珠单抗治疗。活化部分凝血活酶(aPTT)比率的统计学显着增加,D-二聚体,与53名健康对照(HC)相比,发现了F12,血小板计数和MPV。相比之下,aPTT的二阶导数显示出比HC更低的值。在aPTT的第一衍生物和纤维蛋白原之间没有发现差异。D-二聚体仅在T0和T3之间显示出显着差异。凝血和纤维蛋白溶解的激活以及较弱的凝块加速可能与低级DIC一致。通过血小板计数和MPV的增加表达的血小板的加速周转进一步支持CSU中的该途径。奥马珠单抗不影响免疫和止血系统之间的关系。