Keywords : Autologous Serum Skin Test (ASST)
Evaluation of Autologous Serum Therapy in Patients with Chronic Idiopathic Urticaria
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 4135-4144
Background: Chronic urticaria (CU) is one of the important challenges faced by dermatologists. Chronic autoimmune urticaria (CAU, 45%) and chronic idiopathic urticaria (CIU, 55%), are the 2 main subtypes of CU, with a combined incidence of 0.5% in the general population. Patients with chronic urticaria who frequently exhibit histamine-releasing autoantibodies and who frequently experience wheals and flares in response to intradermal testing with their sera are referred to as having autoimmune urticaria. The current study aimed to evaluate the efficacy of Autologous Whole Blood Therapy, in Autologous Serum Skin Test (ASST) positive and ASST negative Chronic Idiopathic Urticaria (CIU) patients.
Methods: Group (S): n=25 positive ASST for eight weeks, deep intramuscular, gluteal injections of autologous whole blood were administered to CIU patients. The median cubital vein was used to draw blood, which was then immediately injected intramuscularly. Group I (N): n=25 ASST-negative CIU patients received treatment with an 8-week course of once-weekly deep intramuscular gluteal injections of autologous whole blood. Eight IM injections were given to each group. Each successive injection was 5 ml after the initial 2.5 ml dosage. At the 0th, 6th, 8th, and 12th weeks, each of the 50 patients were assessed. The Urticaria severity scale was used to underpin the clinical evaluation (USS).
Results: At the baseline at 0 weeks both groups have no cases in the mild category and the group (S) 68% were in a severe category as compared to 12% of the group (N) the p values were not found to be significant. At the end of 4 weeks, none of the cases were in the mild category however, cases in the severe category decreased from 68% at the starting point in Group (S) to 20% at the end of 4 weeks. In group (N) the decrease was from 12% in the severe category to 8% at the end of 4 weeks. At the end of weeks of treatment, no cases remained in the severe category of group (S) and group (N) the number of cases increased to 40% in the mild category from zero percent at the end of 4 weeks in the group (S). Similarly in group (N), no cases were present in the severe category and the maximum number of cases were in the moderate category. At the end of 3 months (12 weeks), 88% of cases in the group (S) and 80% of cases in group (N) were converted to the mild category of USS.
Conclusion: This study demonstrates that autologous whole blood treatment (AWBT) works well in CIU and only has mild side effects. The effectiveness of AWBT has been demonstrated in several previous studies, including this one. Individuals with urticaria who test positive for ASST respond to AWBT a little bit better than ASST-negative patients do. In this study, we have found that people with urticaria who are ASST-positive get more benefits from AWBT/autohemotherapy than ASST-negative individuals
Chronic Idiopathic Urticaria (CIU), Autologous Serum Skin Test (ASST), Autologous Whole Blood Therapy (AWBT), Urticaria Severity Scale (USS)