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Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Online ISSN 1827-1820
Fabbri P., Volpi V., Caproni M.
Università degli Studi - Firenze Dipartimento di Scienze Dermatologiche Clinica Dermatologica II
Chronic urticaria (CU) is defined as the occurrence of widespread wheals daily or almost daily for at least 8 weeks. Until now, the most common CU was idiopathic (CIU) in which it is impossible to characterize the pathogenesis and to identify the etiologic agent. Recently, it has become clear that in 25 to 50% of patients with CU the intradermal injection of autologous serum leads to an immediate wheal and flare response. In the serum from patients with positive autologous serum skin tests the histamine-releasing activity was identified as autoantibodies (IgG sometime IgM) directed against epitopes in the a-chain of the IgE high-affinity receptor (FceRI). Lately other IgG autoantibodies with histamine-releasing activity were identified: 1) directed against epitopes (non a-chain) of FceRI; 2) directed against IgE; 3) directed against IgG-IgE complex adhered to FceRI. In summary the presence of autoantibodies in patients with CIU appears to indicate a subset of CU defined as autoimmune chronic urticaria, in which anthistamines have not been effective in control of symptoms with a more severe clinical picture and a more often association with autoimmune diseases.