Increased circulating Fe[epsilon] RII-bearing b-lymphocytes and serum levels of IL-4 in non - autoreactive chronic idiopathic urticaria

The exact pathophysiology of chronic idiopathic urticaria [CIU] is not well understood. The concept of autoreactivity has evolved to explain the disease in up to 50% of cases, while the search for other mechanisms is still needed to explain the disease, at least among the remaining subpopulation of non-autoreactive CIU. Therefore, we thought to investigate some aspects of the IgE-dependent, lymphocyte-mediated late-phase response [LPR] of anaphylaxis. We searched for percentages of Fc[epsilon]RII-bearing [CD23[+]] B and T lymphocytes and correlated this with total IgE serum levels, IL-4 serum levels and the disease severity scores. Twenty-five patients with non-autoreactive CIU and ten healthy control subjects participated in this study. CD23[+] B- and T-cells were assessed by flow cytometry, total IgE serum levels were estimated by enzyme linked fluorescent assay [ELFA], IL-4 serum levels were estimated by Enzyme Amplified Sensitivity Immunoassay [EASIA], while disease severity was determined by a daily self-assessment urticaria activity and itching score. Our results showed that the mean values for percentages of CD23[+] B-cells [6.7 +/- 2.3%], total IgE serum levels [139.6 +/- 103.9 micro g/dl] and IL-4 serum levels [18.3 +/- 14.7ng/ml] for patients were statistically significant [p=0.002, 0.013 and 0.008, respectively], when compared with the corresponding values for controls [4.0 +/- 1.7%, 51.5 +/- 25.1 micro g/dl, and 5.1 +/- 4.1ng/ml, respectively], while the difference between the mean percentage of CD23[+] T-cells for patients [2.8 +/- 2%] and that for controls [2.1 +/- 0.6%] was nonsignificant [p=0.267]. Strong positive correlations were detected between percentages of CD23[+] B-cells and severity scores [r= 0.678, p= 0.0001], total IgE serum levels [r= 0.756, p= 0.0001] and IL-4 serum levels [r= 0.709, p= 0.0001], while no correlation was detected between CD23[+] B-cells and CD23[+]T-cells [r= 0.188, p= 0.368]. It is concluded, that CD23[+] B-cells, regulated by IL-4, may contribute in the pathogenesis of non-autoreactive CIU, by producing high levels of IgE and possibly lymphokines, while CD23[+] T-cells may be involved in early antigen recognition. This may have a future therapeutic ramification in this distinct subset of CIU by targeting low-affinity IgE receptors

Popular urticaria among atopic and Non - atopic pediatric patients in Suez canal region: a parasitological and immunological study

This study aimed to identify the species of insects that might be responsible for papular urticaria [PU] and to study some immunological aspects of the disease among affected atopic patients [AP] and non- atopic patients [NAP]. This study included 40 urban pediatric patients with PU of different duration and ten healthy age matched control subjects. It was concluded that during summer, Culex pipiens is the most common cause of PU in urban areas of Suez-Canal region, followed by human fleas. Antibodies of the IgE class play a central role in insect bite allergy and PU, while antibodies of IgG class may be formed to either sensitize mast cells and basophils for a short period or help natural desensitization during a long-term exposure. Helper T-lymphocytes may initiate the immunologic response of PU, while suppressor T-lymphocytes may serve to terminate it