The expression of serotonin transporter protein in the skin of patients with chronic spontaneous urticaria and its relation with depression and anxiety

  • Naghmeh Zabolinejad
  • Sara Molkara
  • Behnoosh Bakhshodeh
  • Haniyeh Ghaffari-Nazari
  • Maryam KhoshkhuiEmail author
Original Paper


Studies have indicated a possible role for serotonin transporter protein (SERT) in the pathophysiology of inflammatory skin disorders. This study was aimed to determine the expression of SERT in the skin of patients with chronic spontaneous urticaria (CSU) and its relation to depression and anxiety. In this case–control study, 30 CSU patients and 30 healthy controls were evaluated with skin biopsies to evaluate the expression of the SERT protein based on histopathologic findings. Beck depression and anxiety inventories were used to investigate depression and anxiety in the case group. Data were analyzed by SPSS software. P values < 0.05 were considered significant. The case group showed significantly higher percentage of stained cells (P < 0.0001) and intensity of SERT expression (P < 0.0001) compared with the control group. The patients with uncontrolled CSU showed significantly higher percentage (P < 0.002) and intensity (P < 0.006) of SERT expression, compared with those with controlled CSU. The intensity of SERT expression in CSU patients had no significant correlation with the severity of depression, but was significantly correlated with the severity of anxiety (r = 0.555; P = 0.001). The percentage of stained cells was significantly correlated with the severities of depression (r = − 0.433; P = 0.017) and anxiety (r = 0.528; P = 0.003). The SERT expression in patients with CSU was higher compared with controls, which can demonstrate the role of serotonin in the pathogenesis of this disease. This higher SERT expression is correlated with the severity of the disease.


Chronic spontaneous urticaria Serotonin transporter protein Anxiety Depression 



The authors wish to thank the Vice Chancellor for Research of Mashhad University of Medical Sciences for their financial support.


This project was part of a thesis by Dr. Sara Molkara (Grant number: 951756), supported by a Grant from the Vice Chancellor for Research of Mashhad University of Medical Sciences.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures involving human participants were in accordance with the ethical standards of the national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the ethics committee of Mashhad University of Medical Sciences (Registered no.:

Informed consent

Informed consent was obtained from all individuals who participated in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Cutaneous Leishmaniasis Research Center, Mashhad University of Medical SciencesMashhadIran
  2. 2.Student Research CommitteeMashhad University of Medical SciencesMashhadIran
  3. 3.Immunogenetic and Cell Culture Department, Immunology Research Center, School of MedicineMashhad University of Medical SciencesMashhadIran
  4. 4.Allergy Research CenterMashhad University of Medical SciencesMashhadIran

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