Abstract
Chronic idiopathic urticaria (CIU) is a dermatological syndrome, characterized by raised erythematous skin lesions, that affects 20% of the general population and has been associated with autoimmunity. However, some reports have also suggested a close relationship between CIU and Helicobacter pylori infection, which is endemic in developing countries and associated with chronic gastritis, peptic ulcer disease, and gastric carcinoma. In the present study, we investigated the occurrence of autoantibodies in sera from 23 CIU subjects infected with H. pylori and from 23 CIU subjects without this infection. The presence of anti-thyroid antibodies was determined by indirect hemagglutination assay and the presence of autoantibodies to IgE and C1INH was determined by ELISA. Antibodies to thyroid antigens were detected at low titers from 100 to 400 in three of 23 (13%) CIU-infected subjects and in four of 23 (17%) CIU-noninfected subjects. The titers of anti-IgE autoantibodies were similar in these CIU groups, presenting absorbances of 1.16 +/- 0.09 and 1.07 +/- 0.16, respectively, while a titer of 1.14 +/- 0.15 was detected in the healthy control group. The concentration of anti-C1INH autoantibodies was the same in the CIU-infected and -noninfected subjects (7.28 +/- 1.31 and 7.91 +/- 2.45 ng/ml, respectively), and was 7.20 +/- 2.25 ng/ml in the healthy control group. However, the serum levels of complexed anti-C1INH antibodies were increased in CIU-infected subjects compared to CIU-noninfected subjects and healthy controls with an absorbance of 1.51 +/- 0.21 vs 1.36 +/- 0.16 and 1.26 +/- 0.23, respectively (P<0.05), indicating an impaired clearance of immune complexes in CIU-infected patients. In conclusion, no correlation was observed between H. pylori infection and autoantibody production in CIU patients consistent with reports of clinical studies.
Highlights
Urticaria is a common syndrome that affects 20% of the general population, clinically characterized by the sudden appearance of raised erythematous skin lesions at different sites which are usually pruritic and tend to disappear [1]
Some Chronic idiopathic urticaria (CIU) patients may present angioedema, a reaction closely similar to urticaria that occurs in deeper tissues, which may be observed as an isolated clinical event [1]
It was suggested that H. pylori infection might participate in the pathogenesis of acquired angioedema in infected persons due the excessive consumption of complement by specific antibodies produced against the bacterium [11]
Summary
Urticaria is a common syndrome that affects 20% of the general population, clinically characterized by the sudden appearance of raised erythematous skin lesions at different sites which are usually pruritic and tend to disappear [1]. The objective of the present study was to investigate the occurrence of anti-thyroid, anti-IgE and antiC1INH autoantibodies in sera from CIU patients and to obtain information about the association of this autoimmune response with H. pylori infection. The following immunologic parameters were investigated: anti-IgE IgG autoantibodies, autoantibodies to thyroglobulin and thyroid peroxidase (TPO), IgG autoantibodies to C1INH and their respective immune complexes.
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