Blood Adhesion Molecules as Biomarkers in Children with Chronic Urticaria

Abstract

Background: The prevailing etiological model of both acute and chronic urticaria implicates specific allergen exposure that triggers the local release of vasoactive factors and inflammatory adhesion molecules, including vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), endothelial leukocyte adhesion molecule 1 (ELAM-1), P-selectin and E-selectin in the superficial dermis. This study focused on the possible role of VCAM-1 and ICAM-1 as biomarkers in children with acute and chronic urticaria.

Methods: This study involved 184 children, 40 with acute urticaria, 71 with chronic urticaria, and 73 matched comparison subjects. The serum levels of ICAM-1 and VCAM-1 were determined in venous blood in all the participants on enrollment. Antihistamine treatment was administered to all the patients. In the children with chronic urticaria, the Urticaria Activity Score Questionnaire (UAS7) was completed daily by the parents. In 16 of the patients with acute urticaria and 43 with chronic urticaria, the serum levels of ICAM-1 and VCAM-1 were determined at follow-up after 6-8 weeks of treatment.

Results: The mean serum levels of both VCAM-1 and ICAM-1 were higher in both groups of children with urticaria than in the comparison subjects at the start of the study. In the chronic urticaria group, the levels decreased significantly (p = 0.03 and p = 0.01, respectively) following treatment. Similarly, the acute urticaria group exhibited significant reduction in the mean levels of VCAM and ICAM (p < 0.001). In both groups, the mean level of ICAM after treatment was comparable with that of the comparison group.

Conclusions: VCAM-1 and ICAM-1 are suggested as promising biomarkers for monitoring both acute and chronic urticaria in children. Future research should explore their utility in larger cohorts and investigate their role in personalized treatment strategies.

Keywords: acute urticaria; childhood; chronic urticaria; intercellular adhesion molecule 1; vascular cell adhesion molecule 1.

Figure 1

Flow chart of the study population of children with acute and chronic urticaria.

Figure 2

Bar chart showing the mean serum levels of vascular cell adhesion molecule (VCAM-1) and intercellular adhesion molecule (ICAM-1) in children with acute and chronic urticaria, before and after treatment, and in comparison subjects; acute-1: before treatment; acute-2: after treatment; chronic-1: before treatment; chronic-2: after treatment. SD: standard deviation; ICAM-1: intercellular adhesion molecule 1; VCAM-1: vascular cell adhesion molecule 1.

Figure 3

Scatter plot with bar presentation of the data: (A) serum levels of intercellular adhesion molecule-1 (ICAM) and vascular cell adhesion molecule-1 (VCAM) (mg/mL) in patients with acute urticaria before treatment (Acute-1) compared with the comparison subjects; (B) ICAM and VCAM in patients with chronic urticaria before treatment (Chronic-1) compared with the comparison subjects; (C) ICAM and VCAM in patients with acute urticaria after treatment (Acute-2) compared with the comparison subjects; (D) ICAM and VCAM in patients with chronic urticaria after treatment compared with the comparison subjects; *** p-value < 0,001; **** p-value < 0.0001; ns: not significant.