| Abstract | Uvod: Kronična spontana urtikarija (KSU) upalna je bolest kože nepoznatog uzroka, obilježena urtikama, svrbežom i mogućim pridruženim angioedemom, u trajanju dužem od 6 tjedana.
Ispitanici i metode: U ovom prospektivnom istraživanju u 41 bolesnika sa KSU-om određivane su salivarne vrijednosti IL-6 i amilaze (kontrola) i serumski biomarkeri KSU-a (IL6, KKS, SE, CRP, TSH, T3, T4, anti-TPO, anti-TG, D-dimeri i vitamin D) koji su uspoređivani s aktivnosti KSU-a [procijenjenom upitnikom aktivnosti urtikarije (dnevni UAS i UAS7)] i kontrolom KSU-a (upitnik UCT) te kvalitetom života bolesnika [upitnik dermatološke kvalitete života (DLQI) i upitnik kvalitete života specifične za KU (CU-Q2oL)]. Bolesnici su prospektivno praćeni i liječeni antihistaminicima tijekom 3 mjeseca, a uzorci sline i krvi te upitnici uzeti su i procijenjeni u inicijalnom (T1) i u kontrolnom (T2) mjerenju.
Rezultati: Iako vrijednosti serumskog i salivarnog IL-6 nisu ovisile o težini KSU-a, nešto viši serumski IL-6 uočen je u bolesnika s težim oblikom bolesti. Viši salivarni IL-6 uočen je u bolesnika s blagim KSU-om, iako bez statističke značajnosti. Serumski IL-6 statistički je značajno korelirao s CRP-om, SE-om, D-dimerima, T3 i T4 (p < 0,001), dok je salivarni IL-6 statistički značajno korelirao samo s CRP-om (p = 0,044). Koncentracija bazofila statistički je značajno povezana s aktualnom težinom KSU-a (dnevni UAS, p = 0,017). Vrijednosti SE-a bile su statistički značajan prediktor aktivnosti KSU-a (UAS7, p = 0,038). Vrijednosti T4 statistički su značajno negativno korelirale s trajanjem KSU-a (p = 0,036). Nakon 3 mjeseca praćenja, aktivnost KSU-a (dnevni UAS i UAS7) statistički se značajno smanjila (p = 0,014 i p = 0,015), a kvaliteta života (DLQI) i kontrola KSU-a (UCT) značajno su se povećale (p = 0,006 i p = 0,005).
Zaključak: Viši serumski IL-6, bazopenija i viši SE uočeni su kod težeg i slabije kontroliranog KSU-a te lošije kvalitete života bolesnika, a viši T4 kod duljeg trajanja KSU-a. Standardnim liječenjem KSU-a smanjuje se aktivnost te povećava kontrola bolesti i kvaliteta života bolesnika, a navedeni serumski/salivarni parametri mogli bi biti dobri biomarkeri i pokazatelji KSU-a pri praćenju i liječenju. |
| Abstract (english) | Introduction: Chronic spontaneous urticaria (CSU) is an inflammatory skin disease of a not known cause characterized by hives, itching and possible associated angioedema, lasting for at least 6 weeks.
Subjects and Methods: This prospective study included 41 patients with CSU. Values for salivary IL-6, amylase (control) and serum CSU biomarkers (IL-6, KKS, ESR, CRP, TSH, T3, T4, anti-TPO, anti-TG, D-dimers and vitamin D) were measured and compared with CSU activity as measured by the Urticaria Activity Score (once-daily UAS and UAS7), CSU control as measured by the Urticaria Control Test (UCT), and patients’ quality of life as measured by the Dermatology Life Quality Index (DLQI) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL). Patients were prospectively monitored and treated with antihistamines for 3 months. Saliva and blood samples were taken, and the questionnaires were filled out and evaluated, at an initial timepoint (T1) and control (T2) follow-up time.
Results: Although serum and salivary IL-6 values did not correlate with CSU severity, slightly higher serum IL-6 values were observed in patients with more severe forms of the disease. Higher salivary IL-6 values were observed in patients with mild CSU, although without statistical significance. Serum IL-6 values statistically significantly correlated with CRP, ESR, D-dimers, T3 and T4 (p < 0.001), while salivary IL-6 values were only statistically significantly correlated with CRP (p = 0.044). Basophil concentration statistically significantly correlated with CSU severity (once-daily UAS, p = 0.017). ESR values were a statistically significant predictor of CSU activity (UAS7, p = 0.038), and T4 values had a statistically significant negative correlation with CSU duration (p = 0.036). At the 3-month follow-up timepoint, CSU activity (once-daily UAS and UAS7) had significantly decreased (p = 0.014 and p = 0.015), while quality of life (DLQI) and CSU control (UCT) had significantly increased (p = 0.006 and p = 0.005).
Conclusion: Higher serum IL-6, basopenia and higher ESR were observed in more severe and poorly controlled cases of CSU, while poorer patient quality of life and higher T4 values were seen in CSU cases of longer duration. Standard CSU treatment reduced disease activity and increased disease control and patient’s quality of life. The serum and salivary parameters mentioned above could potentially be reliable biomarkers and indicators of CSU during treatment and follow-up. |
