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Chronic urticaria and coagulation: Pathophysiological and clinical aspects

机译：慢性荨麻疹和凝血：病理生理和临床方面

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摘要

Chronic urticaria (CU) is a widespread skin disease, characterized by the recurrence of transient wheals and itch for more than 6 weeks. Besides autoimmune mechanisms, coagulation factors, in particular tissue factor and thrombin, might also participate in the disease pathophysiology. Tissue factor expressed by eosinophils can induce activation of blood coagulation generating thrombin which in turn can increase vascular permeability both directly, acting on endothelial cells, and indirectly, inducing degranulation of mast cells with release of histamine, as demonstrated in experimental models. D-dimer, a fibrin degradation product, generated following activation of the coagulation cascade and fibrinolysis, has been found to be increased during urticaria exacerbations; moreover, it has been proposed as a biomarker of severity and resistance to H1-antihistamines in CU patients. The possible role of coagulation in CU is also supported by case reports, case series and a small controlled study showing the efficacy of anticoagulant therapy in this disease. The purpose of this review was to summarize the available data on the possible contribution of coagulation to the pathophysiology of CU focusing on clinical aspects and possible future therapeutic developments.
机译：慢性荨麻疹（CU）是一种广泛的皮肤疾病，其特征是短暂的皮疹和瘙痒复发超过6周。除自身免疫机制外，凝血因子，特别是组织因子和凝血酶，也可能参与疾病的病理生理。嗜酸性粒细胞表达的组织因子可以诱导凝血的活化，从而产生凝血酶，进而可以直接增加血管通透性，作用于内皮细胞，并间接诱导肥大细胞脱粒并释放组胺，如实验模型所示。 D-二聚体是一种纤维蛋白降解产物，是在凝血级联反应激活和纤维蛋白溶解后产生的，在荨麻疹发作期间会增加;此外，已经提出将其作为CU患者中H1-抗组胺药的严重性和耐药性的生物标记。病例报告，病例系列和一项小型对照研究也证明了凝血在CU中的可能作用，该研究显示了抗凝疗法在该疾病中的功效。这篇综述的目的是总结有关凝结对CU病理生理的可能贡献的可用数据，重点是临床方面和可能的未来治疗发展。

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