J Allergy Clin Immunol：奥马珠单抗治疗慢性自发性荨麻疹的疗效与嗜碱性粒细胞表型有关

2021-03-15 Nebula MedSci原创

慢性自发性荨麻疹(CSU)是一种以反复发生荨麻疹和/或血管水肿为特征的皮肤疾病，症状至少持续6周，患病率约为1%。

慢性自发性荨麻疹(CSU)是一种以反复发生荨麻疹和/或血管水肿为特征的皮肤疾病，症状至少持续6周，患病率约为1%。奥马珠单抗(omalizumab)是一种抗人IgE抗体的单克隆IgG，已获批用于组胺难治性患者（150或300 mg，皮下注射，1次/4周）。

目前，CSU的发病机制和奥马珠单抗改善CSU的机制尚未完全清楚。本研究旨在探讨临床缓解率与奥马珠单抗治疗期间嗜碱性粒细胞和(或)浆细胞样树突状细胞(PDC)IgE依赖性功能变化率是否一致。

研究计划

18例难治性CSU成人患者每月服用奥马珠单抗300 mg，疗程90天。受试者记录每日荨麻疹活动评分(UAS)，并在服用奥马珠单抗后的第1、3、6、10、20、30、60和90天进行临床抽血评估。基线时，受试者按嗜碱性粒细胞功能表型进行分类，根据体外对抗IgE抗体的组胺释放(HR)反应划分CSU应答者(CSU-R)或CSU无应答者(CSU-NR)，以及碱性开放(B)或非碱性开放(NB)。

临床治疗反应

CSU-R/NB患者症状改善最快、最彻底。第6天时，CSU-R/NB和CSU-NR/NB患者较基线均有抗IgE介导的嗜碱性粒细胞HR升高，但这些变化与症状改善无关。相反，CSU-NR/B患者的嗜碱性粒细胞HR在治疗过程中无明显变化。

表面IgE/FcεRI降低

3个表型组的表面IgE/FcεRI降低的动力学相似，且与临床反应时间无关。同样，pDC表面的IgE/FcεRI下降和TLR9诱导的IFN-α应答也不能反映临床变化。

综上，嗜碱性粒细胞的HR、表面IgE或FcεRI的变化与临床症状变化的动力学无关。以HR测定的基线嗜碱粒细胞计数和嗜碱粒细胞功能表型可预测患者对奥马珠单抗治疗的反应性。

原始出处：

Johal Kirti J,Chichester Kristin L,Oliver Eric T et al. The Efficacy of Omalizumab Treatment in Chronic Spontaneous Urticaria is Associated with Basophil Phenotypes. J Allergy Clin Immunol, 2021, 10.1016/j.jaci.2021.02.038

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2021-03-17 膀胱癌

#ALL#

37 0
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2021-03-17 zhaojie88

#麻疹#

38 0
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2021-03-17 jjjiang0199

#慢性自发性荨麻疹#

33 0
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2021-03-17 sodoo

#自发性#

29 0
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2021-03-17 tastas

#表型#

31 0
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2021-03-17 宋威

#嗜碱性粒细胞#

41 0
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2021-03-16 内科新手

谢谢梅斯提供这么好的信息，学到很多

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