ImageVerifierCode 换一换
格式:PDF , 页数:5 ,大小:117.92KB ,
资源ID:5879677      下载积分:10 金币
验证码下载
登录下载
邮箱/手机:
验证码: 获取验证码
温馨提示:
支付成功后,系统会自动生成账号(用户名为邮箱或者手机号,密码是验证码),方便下次登录下载和查询订单;
特别说明:
请自助下载,系统不会自动发送文件的哦; 如果您已付费,想二次下载,请登录后访问:我的下载记录
支付方式: 支付宝    微信支付   
验证码:   换一换

开通VIP
 

温馨提示:由于个人手机设置不同,如果发现不能下载,请复制以下地址【https://www.zixin.com.cn/docdown/5879677.html】到电脑端继续下载(重复下载【60天内】不扣币)。

已注册用户请登录:
账号:
密码:
验证码:   换一换
  忘记密码?
三方登录: 微信登录   QQ登录  
声明  |  会员权益     获赠5币     写作写作

1、填表:    下载求助     留言反馈    退款申请
2、咨信平台为文档C2C交易模式,即用户上传的文档直接被用户下载,收益归上传人(含作者)所有;本站仅是提供信息存储空间和展示预览,仅对用户上传内容的表现方式做保护处理,对上载内容不做任何修改或编辑。所展示的作品文档包括内容和图片全部来源于网络用户和作者上传投稿,我们不确定上传用户享有完全著作权,根据《信息网络传播权保护条例》,如果侵犯了您的版权、权益或隐私,请联系我们,核实后会尽快下架及时删除,并可随时和客服了解处理情况,尊重保护知识产权我们共同努力。
3、文档的总页数、文档格式和文档大小以系统显示为准(内容中显示的页数不一定正确),网站客服只以系统显示的页数、文件格式、文档大小作为仲裁依据,个别因单元格分列造成显示页码不一将协商解决,平台无法对文档的真实性、完整性、权威性、准确性、专业性及其观点立场做任何保证或承诺,下载前须认真查看,确认无误后再购买,务必慎重购买;若有违法违纪将进行移交司法处理,若涉侵权平台将进行基本处罚并下架。
4、本站所有内容均由用户上传,付费前请自行鉴别,如您付费,意味着您已接受本站规则且自行承担风险,本站不进行额外附加服务,虚拟产品一经售出概不退款(未进行购买下载可退充值款),文档一经付费(服务费)、不意味着购买了该文档的版权,仅供个人/单位学习、研究之用,不得用于商业用途,未经授权,严禁复制、发行、汇编、翻译或者网络传播等,侵权必究。
5、如你看到网页展示的文档有www.zixin.com.cn水印,是因预览和防盗链等技术需要对页面进行转换压缩成图而已,我们并不对上传的文档进行任何编辑或修改,文档下载后都不会有水印标识(原文档上传前个别存留的除外),下载后原文更清晰;试题试卷类文档,如果标题没有明确说明有答案则都视为没有答案,请知晓;PPT和DOC文档可被视为“模板”,允许上传人保留章节、目录结构的情况下删减部份的内容;PDF文档不管是原文档转换或图片扫描而得,本站不作要求视为允许,下载前自行私信或留言给上传者【xrp****65】。
6、本文档所展示的图片、画像、字体、音乐的版权可能需版权方额外授权,请谨慎使用;网站提供的党政主题相关内容(国旗、国徽、党徽--等)目的在于配合国家政策宣传,仅限个人学习分享使用,禁止用于任何广告和商用目的。
7、本文档遇到问题,请及时私信或留言给本站上传会员【xrp****65】,需本站解决可联系【 微信客服】、【 QQ客服】,若有其他问题请点击或扫码反馈【 服务填表】;文档侵犯商业秘密、侵犯著作权、侵犯人身权等,请点击“【 版权申诉】”(推荐),意见反馈和侵权处理邮箱:1219186828@qq.com;也可以拔打客服电话:4008-655-100;投诉/维权电话:4009-655-100。

注意事项

本文(慢性特发性荨麻疹.pdf)为本站上传会员【xrp****65】主动上传,咨信网仅是提供信息存储空间和展示预览,仅对用户上传内容的表现方式做保护处理,对上载内容不做任何修改或编辑。 若此文所含内容侵犯了您的版权或隐私,请立即通知咨信网(发送邮件至1219186828@qq.com、拔打电话4008-655-100或【 微信客服】、【 QQ客服】),核实后会尽快下架及时删除,并可随时和客服了解处理情况,尊重保护知识产权我们共同努力。
温馨提示:如果因为网速或其他原因下载失败请重新下载,重复下载【60天内】不扣币。 服务填表

慢性特发性荨麻疹.pdf

1、Autoimmune Urticaria:Immunological Markers J Investig Allergol Clin Immunol 2011;Vol.21(7):546-550 2011 Esmon PublicidadORIGINAL ARTICLEChronic Autoimmune Urticaria:Frequency and Association With Immunological MarkersM Abd El-Azim,S Abd El-AzimMedical Microbiology and Immunology,Faculty of Medicine,

2、Zagazig University,Zagazig,Egypt AbstractBackground:Chronic autoimmune urticaria(CAU),a subgroup of chronic idiopathic urticaria(CIU),is characterized by severe and persistent wheals accompanied by redness and itching.Diagnosis is almost completely based on clinical suspicion and the results of the

3、autologous serum skin test(ASST).Objectives:To determine the frequency of CAU and compare the clinical and laboratory parameters of patients with positive and negative ASST results.Patients and Methods:A total of 165 patients with chronic urticaria(CU)were enrolled;31 were excluded(known causes and

4、pregnancy/breastfeeding),leaving 134 patients with CIU.A clinical evaluation and routine and specifi c laboratory tests were performed.Results:The cause of CU was identifi ed in 18.9%of patients;81.2%patients were considered to have CIU.The ASST result was positive in 39.6%of patients with CIU,who h

5、ad more frequent urticaria attacks than patients with a negative ASST result.Patients with positive results had a higher urticaria activity score than those with negative results,although the difference was not statistically signifi cant.As for immunological markers,the absolute eosinophil count and

6、 serum immunoglobulin(Ig)E titer were lower in patients with a positive ASST result than in those with a negative ASST result,although,again,the difference was not statistically signifi cant(P=.07).Antithyroid antibody titer and B-cell percentage were higher in patients with a positive ASST result t

7、han in those with a negative result,and the difference was statistically signifi cant(P=.04 and.004,respectively).Conclusions:ASST remains a baseline diagnostic test for CAU.Patients with CAU had more frequent attacks and higher antithyroid antibody titers and peripheral B-cell percentages,as well a

8、s lower absolute eosinophil counts and serum IgE concentrations.Key words:Autologous serum skin test.Chronic urticaria.Autoimmunity.ResumenAntecedentes:La urticaria crnica autoinmunitaria(UCA),un subgrupo de urticaria crnica idioptica(UCI),se caracteriza por la presencia de habones de carcter grave

9、y persistente acompaados de enrojecimiento y prurito.El diagnstico se basa casi por completo en la sospecha clnica y los resultados de la prueba cutnea con suero autlogo(PCSA).Objetivos:Determinar la frecuencia de la UCA y comparar los parmetros clnicos y de laboratorio de pacientes con resultados p

10、ositivos y negativos en la PCSA.Pacientes y mtodos:Se incluy a 165 pacientes con urticaria crnica(UC),de los que se excluy a 31(causas conocidas y embarazo/lactancia),quedando 134 pacientes con UCI.Se llevaron a cabo una evaluacin clnica y anlisis de rutina y especfi cos.Resultados:La causa de la UC

11、 se identifi c en un 18,9%de los pacientes;se consider que un 81,2%de pacientes padeca UCI.El resultado de la PCSA fue positivo en un 39,6%de pacientes con UCI,que tenan episodios de urticaria con mayor frecuencia que los pacientes con un resultado negativo en la PCSA.Los pacientes con resultados po

12、sitivos presentaron una puntuacin de actividad de urticaria ms elevada que aquellos con resultados negativos,si bien la diferencia no fue estadsticamente signifi cativa.En cuanto a los marcadores inmunolgicos,el recuento absoluto de eosinfi los y el ttulo de inmunoglobulina(Ig)E en suero fueron ms b

13、ajos en pacientes con un resultado positivo en la PCSA que en aquellos con un resultado negativo en dicha prueba,aunque,de nuevo,la diferencia no fue estadsticamente signifi cativa(p=0,07).El ttulo de anticuerpos antitiroideos y el porcentaje de linfocitos B fueron mayores en los pacientes con un re

14、sultado positivo en la PCSA que en aquellos con un resultado negativo,y la diferencia fue estadsticamente signifi cativa(p=0,04 y 0,004,respectivamente).Conclusiones:La PCSA sigue siendo una prueba diagnstica bsica para la UCA.Los pacientes con UCA presentaron episodios ms frecuentes,ttulos de antic

15、uerpos antitiroideos y porcentajes de linfocitos B perifricos ms elevados,as como recuentos absolutos de eosinfi los y concentraciones sricas de IgE ms bajos.Palabras clave:Prueba cutnea con suero autlogo.Urticaria crnica.Autoinmunidad.J Investig Allergol Clin Immunol 2011;Vol.21(7):546-550 2011 Esm

16、on PublicidadM Abd El-Azim,et al547IntroductionChronic urticaria(CU)is a common skin disorder,affecting 0.1%-1%of the general population.It is characterized by recurrent and transitory(5%or 350 cells/mm3 18.3.Serum total IgE level(Immundiagnostik IgE ELISA kit,Immundiagnostik AG,Bensheim,Germany).4.

17、Antithyroid peroxidase(anti-TPO)antibody(Medizym anti-TPO ELISA,Medipan Diagnostica,Dahlewitz/Berlin,Germany).All the procedures were performed according to the manufacturers instructions.Anti-TPO antibody values of 30 IU/mL were considered positive.5.Flow cytometry.The percentage of CD3 CD19+B lymp

18、hocytes in peripheral blood was detected.Two-color analysis was performed using monoclonal antibodies marked with CD19-fl uorescein isothiocyanate(HIB19 clone;BD Pharmingen,San Diego,California,USA)and CD3-allophycocyanin(UCHT1clone;BD PharMingen)according to the manufacturers instructions.Cells wer

19、e analyzed using a FACScan fl ow cytometer(Becton Dickinson,San Diego,California,USA)and CellQuest software(Becton Dickinson,Mountainview,California,USA).6.ASST technique.Patients received an intradermal injection(50 L of autologous serum,histamine diphosphate,and sterile physiological saline)into t

20、he volar forearm 15,19,avoiding areas known to have had spontaneous wheals in the previous 48 hours(mast cells may be refractory to further activation local tachyphylaxis)20.After 30 minutes(15 minutes for histamine),the wheal was measured at its 2 longest perpendicular diameters and the average was

21、 calculated 6.A positive ASST result was defi ned as a serum-induced wheal with a diameter of 1.5 mm as compared to a saline-induced wheal at 30 minutes(Figure).Autoimmune Urticaria:Immunological Markers J Investig Allergol Clin Immunol 2011;Vol.21(7):546-550 2011 Esmon Publicidad548Figure.A positiv

22、e result in the autologous serum skin test.Serum was injected more proximally and histamine more distally,with normal saline in the middle.A signifi cant wheal and fl are response was seen at the serum and histamine injection sites only.The diameter of the serum-induced wheal is 1.7 mm greater than

23、that of the saline-induced wheal.Statistical AnalysisData were recorded and processed using SPSS version 12.0(SPSS Inc.,Chicago,Illinois,USA).Quantitative variables were expressed as mean(SD)and compared using the Mann-Whitney test for 2 independent variables.Qualitative variables were expressed as

24、frequency and percentage and compared using the 2 test or Fisher exact test when appropriate.A P value 5/wk,No.(%)49(92.5%)52(52.8%)5 times/week)was signifi cantly greater in the positive group than in the negative group(P5 times/week)were signifi cantly more common in ASST-positive patients than in

25、 ASST-negative patients.This fi nding was consistent with the results of George et al and could be explained by the diffi culty in controlling CAU.Our study showed that the severity of urticaria was greater,although not signifi cantly so,if the ASST result was positive.This is consistent with the fi

26、 ndings of Bajaj et al 17.However,Caproni et al 21 found that patients with a positive ASST result presented more severe clinical features than those with a negative result.As for immunological markers,absolute eosinophil count was not signifi cantly lower in patients with a positive ASST result,alt

27、hough it was within the upper limits of normal.This reduction is consistent with the accumulation of eosinophils in lesional skin 28:eosinophils are recruited following the release of cytokines and chemotactic factors and activation and recruitment of adhesion molecules on migrating eosinophils and

28、on endothelial cells 29.The role of tissue eosinophilia is unclear,although it is possible that release of toxic major basic protein and eosinophil cationic protein further augments histamine release from mast cells in the late phase of the urticarial wheal 9.We found that a positive ASST result was

29、 more likely to be associated with signifi cantly lower IgE levels than ASST-negative patients.This fi nding agrees with those of Huilan et al 5,who attributed this association to IgEanti-IgE immune complex formation that reduces the amount of detectable free IgE in patients with anti-IgE autoantibo

30、dies.In contrast,other authors showed serum IgE level to be signifi cantly higher in ASST-positive patients 6,30,and this could be due to an improvement in CAU patients after treatment with the anti-IgE antibody omalizumab,which selectively binds to IgE,thus decreasing IgE receptor density on basoph

31、ils and cutaneous mast cells and preventing activation by autoantibodies 6.The signifi cant association between a positive ASST result and anti-TPO antibody titer is consistent with the fi ndings of other studies and can be explained by segregation of anti-TPO antibodies from IgE receptor antibodies

32、 because of B-cell hyperreactivity 23,31.However,other authors did not detect a difference in the incidence of thyroid disease,probably as a result of insuffi cient sample size(thyroid autoimmunity occurs in less than 6%of the general population)32.Finally,we found that ASST-positive CAU patients we

33、re more likely to be associated with a higher percentage of B cells.This fi nding agrees with those of Huilan et al 5 and Toubi et al 33,who reported increased proliferation rates and decreased apoptosis rates for B cells.In conclusion,ASST is a baseline diagnostic test for CAU.Patients with CAU hav

34、e more frequent attacks and higher anti-TPO antibody titers and peripheral B-cell percentages,as well as lower absolute blood eosinophil counts and serum IgE titers.Thyroid function and anti-TPO antibody titers should be routinely assessed in CU patients.In addition,successful therapy for urticaria

35、should target the regulatory pathway linking B cells and IgE in order to downregulate FcRI expression.References 1.Greaves MW,Tan KT.Chronic urticaria:recent advances.Clin Rev Allergy Immunol.2007;33:134-43.2.Ferrer M,Kinet,JP,and Kaplan AP.Comparative studies of functional and binding assays for Ig

36、G anti-FceRI(-subunit)in chronic urticaria.J Allergy Clin Immunol.1998;101:672-6.3.Platzer MH,Grattan CEH,Poulsen LK,Skov PS.Validation of basophil histamine release against the autologous serum skin test and outcome of serum-induced basophil histamine release studies in a large population of chroni

37、c urticaria patients.Allergy.2005;60:1152-6.4.Schocket AL.Chronic urticaria:pathophysiology and etiology,or the what and why.Allergy Asthma Proc.2006;27:90-5.5.Huilan Z Runxiang L Bihua L Qing G.Role of the subgroups of T,B,natural killer lymphocyte and serum levels of interleukin-15,interleukin-21

38、and immunoglobulin E in the pathogenesis of urticaria.J Dermatol.2010;37:441-7.6.Kaplan AP and Greaves MW.Pathogenesis of chronic urticaria.Clin Exp Allergy.2009;33:777-87.7.Grattan CE,Wallington TB,Warin RP,Kennedy CT,Bradfi eld JW.A serological mediator in chronic idiopathic urticaria:a clinical,i

39、mmunological and histological evaluation.Br J Dermatol.1986;114:583-90.8.Sabroe RA,Seed PT,Francis DM,Barr RM,Black AK,Greaves MW.Chronic idiopathic urticaria:comparison of the clinical features of patients with and without anti-Fc epsilon RI or anti-IgE autoantibodies.J Am Acad Dermatol.1999;40:443

40、-50.9.Sabroe RA,Grattan CE,Francis DM,Barr RM,Kobza Black A,Greaves MW.The autologous serum skin test:a screening test for autoantibodies in chronic idiopathic urticaria.Br J Dermatol.1999;140:446-52.10.Grattan CE,Sabroe RA,Greaves MW.Chronic urticaria.J Am Acad Dermatol.2002;46:645-57,quiz 57-60.11

41、.Soundararajan S,Kikuchi Y,Joseph K,Kaplan AP.Functional 549Autoimmune Urticaria:Immunological Markers J Investig Allergol Clin Immunol 2011;Vol.21(7):546-550 2011 Esmon Publicidadassessment of pathogenic IgG subclasses in chronic autoimmune urticaria.J Allergy Clin Immunol.2005;115:815-21.12.Vohra

42、S,Sharma NL,Mahajan VK.Autologous serum skin test:methodology,interpretation and clinical applications.J Dermatol Venereol Leprol.2009;75:545-8.13.Inamadar AC,Palit A.Management of autoimmune urticaria.Indian J Dermatol Venereol Leprol.2008;74:89-91.14.ODonnell BF,Nell CMO,Francis DM,Niimi N,Barr MR

43、,Barlow RJ,et al.Human leucocyte antigen class II associations in chronic idiopathic urticaria.Br J Dermatol.1999;140:853-8.15.Godse KV.Autologous serum skin test in chronic urticaria.Indian J Dermatol Venereol Leprol.2004;70:283-4.16.Thomas P,Perkin MR,Rayner N,Cox H,Fox AT,Leech S,et al.The invest

44、igation of chronic urticaria in childhood:which investigations are being performed and which are recommended?Clin Exp Allergy.2008;38:1061-2.17.Bajaj Ak,Saraswat A,Upedhyay A,Damisetty R,Dhar S.Autologous serum therapy in chronic urticaria:old wine in a new bottle.Indian J Dermatol Venerol Leprol.20

45、08;74:109-1318.Burrows B,Hasan FM,Barbee RA,Halonen M,Lebowitz MD.Epidemiologic observations on eosinophilia and its relation to respiratory disorders.Am Rev Respir Dis.1980;122:709.19.Kontou-Fili K,Borici-Mazi R,Kapp A,Matjevic LJ,Mitchel FB.Physical urticaria:classifi cation and diagnostic guideli

46、nes.An EAACI position paper.Allergy.1997;52:504-13.20.Grattan CE,Hamon CG,Cowan MA,Leeming RJ.Preliminary identifi cation of a low molecular weight serological mediator in chronic idiopathic urticaria.Br J Dermatol.1988;119:179-83.21.Caproni M,Volpi W,Giomi B,Cardinali C,Antiga E,Melani L,Dagata A,F

47、abbri P.Chronic idiopathic and chronic autoimmune urticaria:clinical and immunopathological features of 68 subjects.Acta Derm Venereol.2004;84:288-90.22.Bakos N,Hillander M.Comparison of chronic autoimmune urticaria with chronic idiopathic urticaria.Int J Dermatol.2003;42:613-5.23.Nettis E,Dambra P,

48、DOronzio L,Cavallo E,Loria MP,Fanelli M,Ferrannini A,Tursi A.Reactivity to autologous serum skin test and clinical features in chronic idiopathic urticaria.Clin Exp Dermatol.2002;27:29-31.24.Saini S.Chronic urticaria:Diagnosis,theories of pathogenesis,and natural history.Available at:http:/ May 2011

49、.25.Kulthanan K,Jiamton S,Gorvanich T,Pinkaew S.Autologous serum skin test in chronic idiopathic urticaria:prevalence,correlation and clinical implications.Asian Pac J Allergy Immunol.2006;24:201-6.26.George M,Balachandran C,Prabhu S.Chronic idiopathic urticaria:comparison of clinical features with

50、positive autologous serum skin test.Indian J Dermatol Venereol Leprol.2008;74:105-8.27.Boguniewicz M.The autoimmune nature of chronic urticaria.Allergy Asthma Proc.2008;29:433-8.28.Haas N,Toppe E,Henz BM.Microscopic morphology of different types of urticaria.ArchDermatol.1998;134:41-6.29.Lee KH,Kim

移动网页_全站_页脚广告1

关于我们      便捷服务       自信AI       AI导航        获赠5币

©2010-2025 宁波自信网络信息技术有限公司  版权所有

客服电话:4008-655-100  投诉/维权电话:4009-655-100

gongan.png浙公网安备33021202000488号   

icp.png浙ICP备2021020529号-1  |  浙B2-20240490  

关注我们 :gzh.png    weibo.png    LOFTER.png 

客服