Chronic Urticaria as a New Autoimmune Disease?
Urticaria is conventionally classified as acute, intermittent and chronic (Greaves 2000a). Acute urticaria which frequently involves an IgE-mediated immunological mechanism, is common, its causes often recognised by the patient, and will not be considered further. Intermittent urticaria — frequent bouts of unexplained urticaria at intervals of weeks or months — will be discussed here on the same basis as ‘ordinary’ chronic urticaria. The latter is conventionally defined as the occurrence of daily or almost daily whealing for at least six weeks. The etiology of chronic urticaria is usually obscure. The different clinical varieties of chronic urticaria will be briefly considered here, and attention will be devoted to a newly emerged entity — autoimmune chronic urticaria, since establishing this diagnosis has conceptual, prognostic and therapeutic implications. Contact urticaria and angioedema without urticaria will not be dealt with in this account.
KeywordsAllergy Clin Immunol Chronic Urticaria Chronic Idiopathic Urticaria Urticarial Vasculitis Lung Mast Cell
Unable to display preview. Download preview PDF.
- Adams DD (1988) Long-acting thyroid stimulator: how receptor autoimmunity was discovered. J Autoimmunity 1: 3–9Google Scholar
- Burova GP, Mallet AI, Greaves MW (1998) Is Helicobacter pylori a cause of chronic urti caria? Br J Dermatol 139 (Suppl): 42Google Scholar
- Fiebiger E, Maurer D, Holubar H, Reininger B, Hartmann G, Woisetschlager M, Stingl G (1995) Serum IgG autoantibodies directed against the alpha chain of FcERI: a selective marker and pathogenetic factor for a distinct subset of chronic urticaria patients. J Clin Invest 96: 2606–2612PubMedCrossRefGoogle Scholar
- Fung-Leung W-P, Sousa-Hitzien JD, Ishaque A (1996) Transgenic mice expressing the human high affinity immunoglobulin ( Ig)E receptor a chain, respond to human IgE in mast cell degranulation and allergic reactions. J Exp Med 183: 49–56Google Scholar
- Grattan CEH, Francis DM (1999) Autoimmune urticaria. Advances Dermatol 15, 311–340Google Scholar
- Juhlin L, Michaelsson G (1969) Cutaneous reactions to kallikrein, bradykinin and histamine in healthy subjects and in patients with urticaria. Acta Derm Venereol (Stockh) 49: 26–36Google Scholar
- Kermani F, Niimi N, Francis DM, Barr RM, Black AK, Greaves MW (1995) Characterisation of a novel mast cell-specific histamine-releasing activity in chronic idiopathic urticaria. J Invest Dermatol 105: 452Google Scholar
- Lowman MA, Rees PH, Benyon RC (1988) Human mast cell heterogeneity. Histamine release from mast cells dispersed from skin, lung, adenoids, tonsils and colon in response to IgE-dependent and non-immunological stimuli. J Allergy Clin Immunol 81: 590–597Google Scholar
- MacGlashan DW, Bochner BS, Adelman DC (1987) Down regulation of FccRI expression on human basophils during in vivo treatment of atopic human patients with anti-IgE antibody. J Immunol 158: 1438–1445Google Scholar
- Misch K, Black AK, Greaves MW (1983) Almosauri T, Stanworth DR, Passive transfer of cold urticaria to monkeys. Acta Derm Venereol (Stockh) 63: 163–164Google Scholar
- Sabroe RA, Poon E, Orchard GE, Lane D, Francis DM, Barr RM, Black AK, Greaves MW (1999b) Cutaneous inflammatory cell infiltrate in chronic idiopathic urticaria: comparison of patients with and without anti-Fc RIa or anti-IgE autoantibodies. J Allergy Clin Immunol 103: 484–493PubMedCrossRefGoogle Scholar