Evaluation of Serum Substance P Level in Chronic Urticaria and Correlation with Disease Severity
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Javad Fadaee
,
Maryam Khoshkhui
,
Maryam Emadzadeh
,
Seyed Isaac Hashemy
,
Reza Farid Hosseini
,
Farahzad Jabbari Azad
,
Hamid Ahanchian
,
Fahimeh Lavi Arab
Abstract
Substance P (SP) is a neurotransmitter emitted from neurons that plays a role in the pathogenesis of itching conditions including chronic urticarial (CU). The present research aims to investigate the serum level of S.P among CU patients and compare them with healthy subjects and explore how it correlates with the severity of urticaria. The present research was conducted on 87 CU patients who visited the allergy clinic of Ghaem Hospital, Mashhad, Iran from October 2017 to June 2018. Besides, 86 healthy subjects were recruited as the control group. Background information of patient was collected including age, sex, duration of the disease and the co-occurrence of angioedema. S.P serum level was measured in two groups by ELISA method. In the patients group, the autologous serum skin test (ASST) was performed along with the urticaria evaluation questionnaire include Urticaria Activity Score 7 (UAS7), Urticaria Control Test (UCT) and Chronic Urticaria Quality of Life (CU-Q2OL). Among the patients, the SP serum level showed to be about two times higher than the healthy subjects (p˂0.001). SP showed to be increased as patients’ age grew (p=0.010). In patients with a positive ASST, SP level was higher (p=0.012). No correlation was found between SP and the presence of angioedema among patients. There was no correlation between the SP serum level and the scores obtained from urticaria evaluation questionnaires. SP among CU patients was higher than healthy subjects. SP was also higher among female, older and positive ASST patients. The SP value was not correlated with the severity of urticaria, angioedema. In conclusion, Using SP antagonist drugs could be a potential treatment for chronic urticaria.
2. Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy 2014; 69(7):868-87.
3. Kocatürk E, Maurer M, Metz M, GrattanC. Looking forward to new targeted treatments for chronic spontaneous urticaria. Clin Transl Allergy 2017; 7(1):1.
4. Toubi E, Kessel A, Avshovich N, Bamberger E, Sabo E, Nusem D, et al. Clinical and laboratory parameters in predicting chronic urticaria duration: a prospective study of 139 patients. Allergy 2004; 59(8):869-73.
5. Kaplan A, Greaves M. Pathogenesis of chronic urticaria. Clinical and Experimental Allergy 2009; 39(6):777-87.
6. Vonakis BM, Saini SS. New concepts in chronic urticaria. Curr Opin Immunol 2008; 20(6):709-16.
7. Ying S, Kikuchi Y, Meng Q, Kay AB, Kaplan AP. TH1/TH2 cytokines and inflammatory cells in skin biopsy specimens from patients with chronic idiopathic urticaria: comparison with the allergen-induced late-phase cutaneous reaction. J Allergy Clin Immunol 2002; 109(4):694-700.
8. Azimi E, Reddy VB, Pereira PJS, Talbot S, Woolf CJ, Lerner EA. Substance P activates Mas-related G protein-coupled receptors to induce itch. J Allergy Clin Immunol 2017; 140(2):447-53.e3.
9. Kulka M, Sheen CH, Tancowny BP, Grammer LC, Schleimer RP. Neuropeptides activate human mast cell degranulation and chemokine production. Immunology 2008; 123(3):398-410.
10. Fuller RW, ConradsonTB, Dixon CM, Crossman DC, Barnes PJ. Sensory neuropeptide effects in human skin. Br J Pharmacol 1987; 92(4):781-8.
11. Lisowska B, Lisowski A, Siewruk K. Substance P and chronic pain in patients with chronic inflammation of connective tissue. PloS one:e0139206.
12. O'Connor TM, O'Connell J, O'Brien DI, Goode T, Bredin CP, Shanahan F. The role of substance P in inflammatory disease. J Cell Physiol 2004; 201(2):167-80.
13. Almeida T, Rojo J, Nieto P, Pinto F, Hernandez M, Martin J, et al. Tachykinins and tachykinin receptors: structure and activity relationships. Curr Med Chem 2004; 11(15):2045-81.
14. Puxeddu I, Pratesi F, Ribatti D, Migliorini P. Mediators of Inflammation and Angiogenesis in Chronic SpontaneousUrticaria: Are They Potential Biomarkers of the Disease? Mediators Inflamm 2017; 2017:4123694.
15. Amatya B, El Nour H, Holst M, Theodorsson E, Nordlind K. Expression of tachykinins and their receptors in plaque psoriasis with pruritus.Br J Dermatol 2011; 164(5):1023-9.
16. Tedeschi A, Lorini M, Asero R. No evidence of increased serum substance P levels in chronic urticaria patients with and without demonstrable circulating vasoactive factors. Clin Exp Dermatol 2005; 30(2):171-5.
17. Metz M, Krull C, Hawro TS, R., Groffik A, Stanger C, Staubach P, et al. Substance P is upregulated in the serum of patients with chronic spontaneous urticaria. J Invest Dermatol 2014; 134(11):2833-6.
18. Basak P, Erturan I, Yuksel O, Kazanoglu O, Vural H. Evaluation of serum neuropeptide levels in patients with chronic urticaria. Indian J Dermatol Venereol Leprol 2014; 80(5):483.
19. Zheng W, Wang J, Zhu W, Xu C, He S. Upregulated expression of substanceP in basophils of the patients with chronic spontaneous urticaria: induction of histamine release and basophil accumulation by substance P. Cell Biol Toxicol 2016; 32(3):217-28.
20. Wang W, Zhang H, Zheng W, He S. [Up-regulated expression of NK1R in eosinophil-enriched blood cells from patients with chronic spontaneous urticaria]. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2017; 33(8):1108-12.
21. Sanger GJ, Andrews PLR. A History of Drug Discovery for Treatment of Nausea and Vomiting and the Implications for Future Research. Front Pharmacol 2018; 9:913.
22. Raap U, Ständer S, Metz M. Pathophysiology of itch and new treatments. Curr Opin Allergy Clin Immunol 2011; 11(5):420-7.
23. Ständer S, Weisshaar E. Medical treatmentof pruritus. Expert Opin Emerg Drugs 2012; 17(3):335-45.
24. Tey H, Yosipovitch G. Targeted treatment of pruritus: a look into the future. Br J Dermatol 2011; 165(1):5-17.
25. Yosipovitch G, Bernhard JD. Chronic pruritus. N Engl J Med 2013; 368(17):1625-34.
26. Metz M, Ständer S. Chronic pruritus–pathogenesis, clinical aspects and treatment. J J Eur Acad Dermatol Venereol 2010; 24(11):1249-60.
27. Ohanyan T, Schoepke N, EirefeltS, Hoey G, Koopmann W, Hawro T, et al. Role of substance P and its receptor neurokinin 1 in chronic prurigo: a randomized, proof-of-concept, controlled trial with topical Aprepitant. Acta Derm Venereol 2018; 98(1-2):26-31.
28. Tavakol M, Mohammadinejad P, Baiardini I, Braido F, Gharagozlou M, Aghamohammadi A, et al. The persian version of the chronic urticaria quality of life questionnaire: factor analysis, validation, and initial clinical findings. Iran J Allergy Asthma Immunol 2014; 13(4):278-85.
29. Hawro T, Ohanyan T, Schoepke N, Metz M, Peveling-Oberhag A, Staubach P, et al. The Urticaria Activity Score-Validity, Reliability, and Responsiveness. J Allergy Clin Immunol Pract 2018; 6(4):1185-90.e1.
30. Weller K, Groffik A, Church MK, Hawro T, Krause K, Metz M, et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol 2014; 133(5):1365-72.
31. Sabroe R, Grattan C, Francis D, Barr R, Black AK, Greaves M. The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. Br J Dermatol 1999; 140(3):446-52.
32. Konstantinou GN, Asero R, Maurer M, Sabroe RA, Schmid-Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria. Allergy 2009; 64(9):1256-68.
| Files | ||
| Issue | Vol 19, No 1 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijaai.v19i1.2414 | |
| PMID | 32245317 | |
| Keywords | ||
| Chronic urticaria Substance P Urticaria severity | ||
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