Participation of the coagulation system and fibrinolysis as well as selected biomarkers in pathogenesis of chronic urticaria with various activity degree

Abstract

Introduction: Chronic urticaria is a complex disease process in which chronic spontaneous urticaria (CSU) and chronic inducible urticaria are distinguished. Its etiopathogenesis still remains unknown. Some recent studies indicated a significant participation of vitamin D in the etiopathogenesis of urticaria. In 40-50% of patients with CSU on the basis of the positive result of the autologous serum skin test (ASST), autoimmunological background of the disease is diagnosed. Moreover, numerous test results confirm involvement of the coagulation system/fibrinolysis and non-infectious inflammatory factors in the pathophysiology of CSU.

Aim: To determine whether some factors may play a role in pathogenesis and contribute to the severity of chronic spontaneous urticaria.

Material and methods: One hundred and forty-two patients with diagnosed CSU were enrolled in the study. The activity of urticaria was assessed using the UAS-7 (Urticaria Activity Score). The study participants were divided into 4 groups depending on the UAS-7. ASST was performed and blood was collected to determine the biomarkers (CRP, vitamin D, D-dimers, fibrinogen, MPV, PLT).

Results: Statistical analysis was performed using Statistica 13. A statistically significant difference between groups with various activity of urticaria in D-dimer concentration average values (p < 0.05) was observed. Moreover, a statistically significant negative correlation between activity of urticaria and vitamin D concentration (p < 0.001) was noted.

Conclusions: Our results might support the possible involvement of both coagulation and fibrinolysis pathway and vitamin D in the urticaria pathomechanism. Further prospective studies in larger populations conducted at multiple centres are required to expand further our findings.

Keywords: chronic urticaria; coagulation; fibrinolysis; vitamin D.

Figure 1

Distribution of the degree of activity of urticaria in the examined groups of patients

Figure 2

D-dimer concentration in four groups in relation to the degree of urticaria activity

Figure 3

Vitamin D concentration in four groups in relation to the degree of urticaria activity

Figure 4

Activity of urticaria in the group of ASST positive and negative patients

Figure 5

Vitamin D concentration in the group of ASST positive and negative patients

Figure 6

Fibrinogen concentration in four groups in relation to the degree of urticaria activity