Researchers from Berlin evaluated the correlation between clinical and laboratory findings in 151 studies of chronic spontaneous urticaria
(CSU) patients to identify biomarkers for a range of CSU criteria including differential diagnosis, activity, duration, patient subgroups allocation and response to treatment.
Pavel Kolkhir, MD, PhD, of I.M. Sechenov First Moscow State Medical University, and several colleagues from Charite-Universitatsmedizin Berlin, assessed 133 of those studies, which reported the presence or absence of significant differences in blood levels of biomarkers between CSU patients and healthy controls or patients with other diseases.
Evidence for each potential biomarker was rated “strong,” “weak,” no evidence, “or “inconsistent” based on aggregate study findings in a version of the rating system
developed by de Croon et al.
All the ten biomarkers the team identified were found to be supported by strong evidence for distinguishing CSU patients from healthy controls, specifically D-dimer, C-reactive protein (CRP), matrix metalloproteinase-9 (MMP-9), mean platelet volume (MPV), factor VIIa, prothrombin fragment 1+2 (F1+2), tumor necrosis factor, dehydroepiandrosterone sulfate, and vitamin D.
Strong evidence of a significant association between CSU activity and blood levels or values of D-dimer, F1+2, CRP, IL-6 and MPV was also found.
Strong evidence for reduced basophil count and high levels of IgG anti-FcεRI in the subgroup of CSU patients with positive autologous serum skin test was shown.
Notably lacking was any evidence for blood biomarkers differentiating CSU from other diseases, or a role in prognosis, which the data showed as weak, inconsistent or non-existent.
Recognizing the limitations of the current strictly clinical diagnosis methods, Kolkhir et al concluded that continued research to identify biomarkers for prognosis and treatment efficacy must be the logical next step.
The paper, “Potential blood biomarkers in chronic spontaneous urticaria
,” was published online in Clinical & Experimental Immunology
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