慢性自发性荨麻疹(CSU)是一种非常普遍且难以控制的皮肤病,其特征是复发性荨麻疹,血管性水肿,或者两者兼而有之,为期6周或更长时间。用于具有自身免疫背景和疾病控制不良的CSU患者的生物治疗方法之一是奥马珠单抗,抗IgE单克隆抗体。了解CSU中这种生物药物的作用机制以及识别临床反应的潜在生物标志物可能有助于疾病的个性化管理。
■这项研究的目的是分析奥马珠单抗对CSU患者外周血淋巴细胞亚群的影响,以确定治疗反应的潜在生物标志物。
■我们分析了71例CSU患者[33例接受奥马珠单抗治疗,38例接受非免疫调节药物(抗组胺药物治疗;NID)]和50例健康对照。全血T细胞亚群的详尽免疫表型分析,包括天真,中央存储器,效应器记忆,效应细胞,Th1、Th2和Th17通过多参数流式细胞术进行。此外,在CSU患者中,我们分析了炎症标志物(ESR,DD,CRP),特应性(点刺测试,IgE定量),和自身免疫(抗甲状腺抗体和间接嗜碱性粒细胞激活试验)。为了评估临床活动,使用荨麻疹活动评分7(UAS7)测试。
■在接受奥马珠单抗治疗的CSU患者中,初始百分比显着降低,中枢记忆CD4T细胞百分比增加,初始百分比降低,效应CD8T细胞亚群百分比增加.此外,接受奥马珠单抗治疗的患者的Th1和Th2细胞百分比高于接受NID治疗的患者.
■CSU患者T细胞亚群的免疫监测开始奥马珠单抗,可能是在临床实践中分析治疗反应的有用策略。
UNASSIGNED: Chronic spontaneous urticaria (CSU) is a highly prevalent and difficult to manage cutaneous disease characterized by the presence of recurrent urticaria, angioedema, or both, for a period of 6 weeks or longer. One of the biological treatments used for patients with CSU with an autoimmune background and bad control of the disease is omalizumab, an anti-IgE monoclonal antibody. The understanding of the mechanism of action of this biological drug in CSU along with the identification of potential biomarkers of clinical response can be helpful in the personalized management of the disease.
UNASSIGNED: The purpose of this study was to analyze the effect of omalizumab on peripheral blood lymphocyte subpopulations in patients with CSU in order to identify potential biomarkers of treatment response.
UNASSIGNED: We analyzed 71 patients with CSU [33 under omalizumab and 38 under non-immunomodulatory drugs (treated with antihistamines; NID)] and 50 healthy controls. An exhaustive
immunophenotyping of whole blood T-cell subpopulations, including naïve, central memory, effector memory, effector cells, Th1, Th2, and Th17 was performed by multiparametric flow cytometry. Moreover, in CSU patients, we analyzed markers of inflammation (ESR, DD, CRP), atopy (prick test, IgE quantification), and autoimmunity (anti-thyroid antibodies and indirect basophil activation test).To evaluate the clinical activity, the Urticaria Activity Score 7 (UAS 7) test was used.
UNASSIGNED: In patients with CSU under treatment with omalizumab, there was a significant decrease in the percentage of naïve and an increase in the percentage of central memory CD4 T cells as well as a decrease in the percentage of naïve and increase in the percentage of effector CD8 T-cell subsets. Moreover, patients under treatment with omalizumab had higher percentages of Th1 and Th2 cells than patients under treatment with NID.
UNASSIGNED: The immune monitoring of T-cell subpopulations in patients with CSU starting omalizumab, may be a useful strategy to analyze treatment response in the clinical practice.