慢性自发性荨麻疹(CSU)是一种免疫性疾病,由患者和社会的高患病率和突出负担来描述,这归因于症状的任意性质以及评估活动和严重程度的工具不一致。转谷氨酰胺酶-2(TG2)是在包括肥大细胞的许多细胞和组织类型中普遍表达的翻译后酶。它具有多种生物学功能,它在过敏性疾病中的作用已经通过几种假定的机制得到了强调和描述。本病例对照研究旨在确定血清TG2水平与CSU严重程度之间的关系。据我们所知,这是埃及首次确定血清TG2与CSU严重程度之间关系的研究。我们招募了60例确诊为CSU的成年患者。根据荨麻疹活动评分(UAS),患者分为3组[20例轻度疾病;UAS=0,20例中度疾病;UAS=1-3,20例重度疾病;UAS=4-6].另外20名健康个体(年龄和性别匹配)作为对照组。所有患者都有详细的病史,临床检查,有差别的全血细胞计数,血清总IgE,CRP,ESR,TSH,安娜,肝肾功能检查.通过定量ELISA对所有入选患者和对照进行TG2的血清水平。患者组血清TG2明显高于对照组(P值<0.001)。重症患者的血清TG2水平明显高于中度或轻度疾病患者。这通过血清TG2和UAS之间的显着正相关(r0.814和P值0.000)来说明。此外,血清TG2准确地将CSU患者分为轻度,中度和重度亚组:关于轻度和中度病例之间的区别(敏感性70%,特异性80%,PPV77.8,NPV72.7)以及中度和重度病例之间的区别(敏感性95%,特异性90%,PPV90.5,净现值94.7)。血清TG2可能作为CSU患者严重程度的标志物具有关键作用。
Chronic spontaneous urticaria (CSU) is an immunological disease that is depicted by high prevalence and eminent burden for patients and society that is attributable to the arbitrary nature of symptoms and inconsistent tools for assessment of activity and severity. Transglutaminase-2 (TG2) is a posttranslational enzyme that is pervasively expressed in many cells and tissue types including mast cells. It has various biological functions, and its role in allergic disorders has been highlighted and delineated through several postulated mechanisms. This case-control study aimed at determining the relationship between serum levels TG2 and severity of CSU. To the best of our knowledge, this is the first study in Egypt to determine the relationship between serum TG2 and severity of CSU. We enrolled 60 adult patients with confirmed diagnosis of CSU. According to urticaria activity score (UAS), patients were categorized into three groups [20 with mild disease; UAS = 0, 20 with moderate disease; UAS = 1-3, 20 with severe disease; UAS = 4-6]. Another 20 healthy individuals (age and gender matched) served as a control group. All patients were subjected to detailed medical history, clinical examination, complete blood count with differential, serum total IgE, CRP, ESR, TSH, ANA, liver and renal function tests. Serum level of TG2 was done by quantitative ELISA for all enrolled patients and controls. Serum TG2 is significantly higher in patients group compared to control group (P value < 0.001). Serum TG2 levels were significantly higher in patients with severe disease compared to patients with moderate or mild disease. This is illustrated by the significant positive correlation between serum TG2 and UAS (r 0.814 and P value 0.000). Moreover, serum TG2 accurately classified CSU patients into mild, moderate and severe subgroups: as regards differentiation between mild and moderate cases (sensitivity 70%, specificity 80%, PPV 77.8, NPV 72.7) and as for the differentiation between moderate and severe cases (sensitivity 95%, specificity 90%, PPV 90.5, NPV 94.7). Serum TG2 may have a pivotal role as a marker of severity in patients with CSU.