BACKGROUND : in patients with chronic urticaria (CU), plasma shows signs of thrombin generation and autologous plasma skin tests score positive in as many as 95% of cases OBJECTIVE : to evaluate the initiators of blood coagulation that lead to thrombin generation and fibrinolysis in CU METHODS : activated factor VII, activated factor XII, fragment F(1+2), and D-dimer plasma levels were measured in 37 patients with CU and 37 controls. Skin specimens from 10 patients with CU and 10 controls were tested for tissue factor immunohistochemically RESULTS : mean F(1+2) levels were higher in patients than controls (2.54 [SD 2.57] nmol/L vs 0.87 [0.26] nmol/L; P < .001); disease activity was moderate or severe in 9 of 11 (82%) and 9 of 26 (35%) patients showing high or normal F(1+2) levels, respectively (P < .025). Mean D-dimer plasma levels were higher in patients than controls (329 [188] ng/mL vs 236 [81] ng/mL; P < .01); disease activity was moderate or severe in 6 of 8 (75%) and 11 of 29 (38%) showing elevated or normal plasma D-dimer levels (P = NS). Factor VIIa levels were higher in patients than controls (2.86 ng/mL [0.66] vs 1.97 ng/mL [0.65]; P < .001). Activated factor VII and F(1+2) levels were correlated (r = 0.529; P = .008). Tissue factor reactivity was observed only in CU skin specimens CONCLUSION : the extrinsic pathway of clotting cascade is activated in CU. Disease severity is associated with the activation of the coagulation cascade CLINICAL IMPLICATIONS : the involvement of the coagulation pathway in CU opens new perspectives for a better understanding of the pathogenesis and, possibly, for the treatment of this disease
Activation of the tissue factor pathway of blood coagulation in patients with chronic urticaria / R. Asero, A. Tedeschi, R. Coppola, S. Griffini, P. Paparella, P. Riboldi, A.V. Marzano, D. Fanoni, M. Cugno. - In: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. - ISSN 0091-6749. - 119:3(2007 Mar), pp. 705-710.
Activation of the tissue factor pathway of blood coagulation in patients with chronic urticaria
S. Griffini;P. Riboldi;A.V. Marzano;D. Fanoni;M. CugnoUltimo
2007
Abstract
BACKGROUND : in patients with chronic urticaria (CU), plasma shows signs of thrombin generation and autologous plasma skin tests score positive in as many as 95% of cases OBJECTIVE : to evaluate the initiators of blood coagulation that lead to thrombin generation and fibrinolysis in CU METHODS : activated factor VII, activated factor XII, fragment F(1+2), and D-dimer plasma levels were measured in 37 patients with CU and 37 controls. Skin specimens from 10 patients with CU and 10 controls were tested for tissue factor immunohistochemically RESULTS : mean F(1+2) levels were higher in patients than controls (2.54 [SD 2.57] nmol/L vs 0.87 [0.26] nmol/L; P < .001); disease activity was moderate or severe in 9 of 11 (82%) and 9 of 26 (35%) patients showing high or normal F(1+2) levels, respectively (P < .025). Mean D-dimer plasma levels were higher in patients than controls (329 [188] ng/mL vs 236 [81] ng/mL; P < .01); disease activity was moderate or severe in 6 of 8 (75%) and 11 of 29 (38%) showing elevated or normal plasma D-dimer levels (P = NS). Factor VIIa levels were higher in patients than controls (2.86 ng/mL [0.66] vs 1.97 ng/mL [0.65]; P < .001). Activated factor VII and F(1+2) levels were correlated (r = 0.529; P = .008). Tissue factor reactivity was observed only in CU skin specimens CONCLUSION : the extrinsic pathway of clotting cascade is activated in CU. Disease severity is associated with the activation of the coagulation cascade CLINICAL IMPLICATIONS : the involvement of the coagulation pathway in CU opens new perspectives for a better understanding of the pathogenesis and, possibly, for the treatment of this diseaseFile | Dimensione | Formato | |
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