Reactivity to autologous serum skin test and relationship with complement levels in chronic idiopathic urticaria and angio-oedema

• Published in: Clinical and experimental dermatology Vol. 34; no. 5; pp. 587 - 590
• Main Authors: Zamiri, M., Jury, C. S., Dawe, R. S., O'Neill, S., Douglas, W. S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-07-2009; Wiley-Blackwell
• Subjects: Adolescent; Adult; Aged; Allergic diseases; Angioedema - immunology; Biological and medical sciences; Complement C3 - analysis; Complement C4 - analysis; Complement System Proteins - analysis; Dermatology; Female; Humans; Immunopathology; Male; Medical sciences; Middle Aged; Skin allergic diseases. Stinging insect allergies; Skin Tests - methods; Urticaria - immunology; Young Adult; Allergy; Immunopathology; Skin disease; Chronic; Angioneurotic edema; Dermatology; Urticaria; Idiopathic; Exploration; Serum; Skin test
• ISSN: 0307-6938; 1365-2230
• DOI: 10.1111/j.1365-2230.2008.03032.x

Summary
Background.  A role for complement in autoantibody‐mediated histamine release in urticaria has been suggested but not proven in vivo.
Aim.  To study serum complement levels in patients with chronic idiopathic urticaria (CIU) and to determine whether there was a relationship with autologous serum skin test (ASST) reactivity.
Methods.  We recruited 35 patients with CIU. Complement (C3, C4) levels and ASST were measured in all patients; additional investigations were undertaken dependent on history and examination.
Results.  Complement concentrations were outside the population reference intervals in 19/35 patients, with low C3 noted in 3/35 and low C4 in 18/35. Of 12 patients with a positive ASST, 7 had low complement levels, and 12/23 with a negative ASST had low complement levels. Patients with a positive ASST had a median C3 of 1.24 g/L (range 0.35–1.51) compared with a median of 1.25 g/L in those with a negative ASST (P = 0.36), and a median C4 of 0.20 g/L (range 0.185–0.452) in those with a positive ASST compared with 0.18 g/L in those with a negative ASST (P = 0.88).
Conclusions.  We conclude that both a reduction in C4 and positive ASST are common in CIU and although these immunological abnormalities often coexist, there is no clear relationship between them. Other components of the complement system may be worth exploring.