Relevance of the basophil high-affinity IgE receptor in chronic urticaria: Clinical experience from a tertiary care institution

Publication date: Available online 25 January 2019

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Gustavo Deza, Alvaro March-Rodríguez, Silvia Sánchez, Clara Ribas-Llauradó, Dulce Soto, Ramon M. Pujol, Ramon Gimeno, Ana M. Giménez-Arnau

Abstract

Background

The high-affinity IgE receptor (FcεRI) expression on effector cells has been poorly characterized in patients with chronic urticaria (CU) to date.

Objectives

To investigate the FcεRI expression on blood basophils in a large cohort of CU patients and its potential relationship with relevant features of the disease.

Methods

Basophil FcεRI expression was measured by flow cytometry in 287 CU patients (192 with Chronic Spontaneous Urticaria and 95 with Chronic Inducible Urticaria) at their initial evaluation in our Department. A control group of healthy non-atopic individuals was included to provide reference data, and the effect of antihistamine and anti-IgE therapy on the basophil FcεRI expression was also evaluated in a cohort of CU patients.

Results

The median FcεRI expression was found significantly higher in CU patients compared to healthy controls (p<0.0001). A positive correlation was found between serum IgE levels and basophil FcεRI expression (R=0.422; p<0.001). Significantly higher FcεRI levels on basophils were detected in CU patients who presented with concomitant atopic features (p=0.003), negative autologous serum skin test (p=0.002), negative autologous plasma skin test (p=0.009) or undetected levels of anti-thyroid antibodies (p=0.01). Baseline FcεRI expression was not related with the activity and duration of the disease, and was not significantly modified during antihistamine therapy; however, it correlated with the clinical response to omalizumab (p=0.003).

Conclusion

Although further multicenter studies are needed to corroborate these findings, the assessment of basophil FcεRI levels might be relevant in daily clinical practice supporting an autoimmune pathogenesis and predicting response to anti-IgE treatment.

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