Autoimmunity and Clinical Markers in Chronic Spontaneous Urticaria: A Retrospective Cohort Study

Abstract

BACKGROUND. Chronic spontaneous urticaria (CSU) is a skin condition that results in itchy hives or welts on the skin. The underlying cause of CSU is not fully understood, but it is believed to be mainly associated with autoimmunity. OBJECTIVES In this retrospective study, we analyzed correlations between several clinical and biological markers and their associations with disease control, response to H1-antihistamines, autoimmunity (ANA, IgG-anti-TPO), and distribution of comorbidities. METHODS The study was conducted from September 2020 to December 2022 at the Center of Allergy and Immunology in Tbilisi, Georgia. 131 adults and adolescents (≥ 12 years old) with a diagnosis of CSU were included. RESULTS Among the 131 patients included in the study, 83% (n=109) were female, and 17% (n=22) were male. The average age was 33.71 years (range 12-76). Antinuclear antibodies (ANA antibodies) were found to be positive in 17% of patients, while 33% had IgG-anti_TPO antibodies. Comparison between the controlled (n=83) and the uncontrolled disease group (n=48) shows that there is no substantial difference in age, but there are significant differences in sex (more females in the controlled group), total IgE (lower in the uncontrolled group), and the presence of ANA and anti–thyroid peroxidase (anti-TPO) antibodies (both higher in the uncontrolled group). The p-values for sex, total IgE, ANA, and anti- TPO are 0.003, 0.007, 0.03, and 0.028, respectively. CONCLUSIONS The results suggest that autoimmunity may play a role in the development of CSU and that treatments targeting the underlying autoimmune response may be effective in managing the condition.