Predictors of Response to Oral Medications and Low-Histamine Diet in Patients with Chronic Urticaria
Background. Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management. Methods. This study enrolled 78 patients with CU. Serum erythrocyte sedimentation rate, hemoglobin, hematocrit, eosinophil count, IgE, antinuc...
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Published in | Journal of Immunology Research Vol. 2022; pp. 5243825 - 7 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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Hindawi
22.02.2022
John Wiley & Sons, Inc Hindawi Limited Wiley |
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Abstract | Background. Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management. Methods. This study enrolled 78 patients with CU. Serum erythrocyte sedimentation rate, hemoglobin, hematocrit, eosinophil count, IgE, antinuclear antibody (ANA), and serum diamine oxidase (DAO) levels of the patients were measured and were compared according to the patient’s response to second-generation antihistamines (sgAH), corticosteroids, leukotriene receptor antagonist (LTRA), H2 blockers, and low-histamine diet. Results. Age- and sex-adjusted logistic regression analysis showed that patients with duration of CU>3 years (adjusted odd ratio aOR=4.39) and a DAO level<10 U/mL (aOR=3.90) were significantly associated with a good sgAH response. Age>50 years (aOR=0.02), duration of chronic urticaria>3 years (aOR =0.06), and an ANA titer≥1:80 (aOR=0.03) were significantly and inversely associated with corticosteroid response. A low-histamine diet response was significantly associated with LTRA response (aOR=67.29). In addition, a DAO level<5.4 U/mL (aOR=71.95) was significantly associated with H2 blocker response. Furthermore, concomitant angioedema (aOR=10.56), multiple food triggers (aOR=11.69), and a DAO level<5.4 U/mL (aOR=3.78) were significantly associated with a low-histamine diet response. Conversely, dermatographic urticaria and a hematocrit level<36% were significantly and inversely associated with low-histamine diet response. Conclusions. Several promising biomarkers were identified in this study to predict the efficacy of chronic urticaria treatment. DAO could be a novel biomarker for predicting the efficacy not only of dietary intervention but also for antagonists of H1 and H2 receptors. |
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AbstractList | Background. Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management. Methods. This study enrolled 78 patients with CU. Serum erythrocyte sedimentation rate, hemoglobin, hematocrit, eosinophil count, IgE, antinuclear antibody (ANA), and serum diamine oxidase (DAO) levels of the patients were measured and were compared according to the patient's response to second-generation antihistamines (sgAH), corticosteroids, leukotriene receptor antagonist (LTRA), H[sub.2] blockers, and low-histamine diet. Results. Age- and sex-adjusted logistic regression analysis showed that patients with duration of CU>3 years (adjusted odd ratio [aOR]=4.39) and a DAOlevel<10U/mL (aOR=3.90) were significantly associated with a good sgAH response. Age>50 years (aOR=0.02), duration of chronicurticaria>3 years (aOR=0.06), and an ANAtiter≥1:80 (aOR=0.03) were significantly and inversely associated with corticosteroid response. A low-histamine diet response was significantly associated with LTRA response (aOR=67.29). In addition, a DAO level<5.4U/mL (aOR=71.95) was significantly associated with H[sub.2] blocker response. Furthermore, concomitant angioedema (aOR=10.56), multiple food triggers (aOR=11.69), and a DAOlevel<5.4U/mL (aOR=3.78) were significantly associated with a low-histamine diet response. Conversely, dermatographic urticaria and a hematocritlevel<36% were significantly and inversely associated with low-histamine diet response. Conclusions. Several promising biomarkers were identified in this study to predict the efficacy of chronic urticaria treatment. DAO could be a novel biomarker for predicting the efficacy not only of dietary intervention but also for antagonists of H[sub.1] and H[sub.2] receptors. Background. Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management. Methods. This study enrolled 78 patients with CU. Serum erythrocyte sedimentation rate, hemoglobin, hematocrit, eosinophil count, IgE, antinuclear antibody (ANA), and serum diamine oxidase (DAO) levels of the patients were measured and were compared according to the patient’s response to second-generation antihistamines (sgAH), corticosteroids, leukotriene receptor antagonist (LTRA), H2 blockers, and low-histamine diet. Results. Age- and sex-adjusted logistic regression analysis showed that patients with duration of CU>3 years (adjusted odd ratio aOR=4.39) and a DAO level<10 U/mL (aOR=3.90) were significantly associated with a good sgAH response. Age>50 years (aOR=0.02), duration of chronic urticaria>3 years (aOR =0.06), and an ANA titer≥1:80 (aOR=0.03) were significantly and inversely associated with corticosteroid response. A low-histamine diet response was significantly associated with LTRA response (aOR=67.29). In addition, a DAO level<5.4 U/mL (aOR=71.95) was significantly associated with H2 blocker response. Furthermore, concomitant angioedema (aOR=10.56), multiple food triggers (aOR=11.69), and a DAO level<5.4 U/mL (aOR=3.78) were significantly associated with a low-histamine diet response. Conversely, dermatographic urticaria and a hematocrit level<36% were significantly and inversely associated with low-histamine diet response. Conclusions. Several promising biomarkers were identified in this study to predict the efficacy of chronic urticaria treatment. DAO could be a novel biomarker for predicting the efficacy not only of dietary intervention but also for antagonists of H1 and H2 receptors. BACKGROUNDChronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management. METHODSThis study enrolled 78 patients with CU. Serum erythrocyte sedimentation rate, hemoglobin, hematocrit, eosinophil count, IgE, antinuclear antibody (ANA), and serum diamine oxidase (DAO) levels of the patients were measured and were compared according to the patient's response to second-generation antihistamines (sgAH), corticosteroids, leukotriene receptor antagonist (LTRA), H2 blockers, and low-histamine diet. RESULTSAge- and sex-adjusted logistic regression analysis showed that patients with duration of CU > 3 years (adjusted odd ratio [aOR] = 4.39) and a DAO level < 10 U/mL (aOR = 3.90) were significantly associated with a good sgAH response. Age > 50 years (aOR = 0.02), duration of chronic urticaria > 3 years (aOR =0.06), and an ANA titer ≥ 1 : 80 (aOR = 0.03) were significantly and inversely associated with corticosteroid response. A low-histamine diet response was significantly associated with LTRA response (aOR = 67.29). In addition, a DAO level < 5.4 U/mL (aOR = 71.95) was significantly associated with H2 blocker response. Furthermore, concomitant angioedema (aOR = 10.56), multiple food triggers (aOR = 11.69), and a DAO level < 5.4 U/mL (aOR = 3.78) were significantly associated with a low-histamine diet response. Conversely, dermatographic urticaria and a hematocrit level < 36% were significantly and inversely associated with low-histamine diet response. CONCLUSIONSSeveral promising biomarkers were identified in this study to predict the efficacy of chronic urticaria treatment. DAO could be a novel biomarker for predicting the efficacy not only of dietary intervention but also for antagonists of H1 and H2 receptors. Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management. This study enrolled 78 patients with CU. Serum erythrocyte sedimentation rate, hemoglobin, hematocrit, eosinophil count, IgE, antinuclear antibody (ANA), and serum diamine oxidase (DAO) levels of the patients were measured and were compared according to the patient's response to second-generation antihistamines (sgAH), corticosteroids, leukotriene receptor antagonist (LTRA), H blockers, and low-histamine diet. Age- and sex-adjusted logistic regression analysis showed that patients with duration of CU > 3 years (adjusted odd ratio [aOR] = 4.39) and a DAO level < 10 U/mL (aOR = 3.90) were significantly associated with a good sgAH response. Age > 50 years (aOR = 0.02), duration of chronic urticaria > 3 years (aOR =0.06), and an ANA titer ≥ 1 : 80 (aOR = 0.03) were significantly and inversely associated with corticosteroid response. A low-histamine diet response was significantly associated with LTRA response (aOR = 67.29). In addition, a DAO level < 5.4 U/mL (aOR = 71.95) was significantly associated with H blocker response. Furthermore, concomitant angioedema (aOR = 10.56), multiple food triggers (aOR = 11.69), and a DAO level < 5.4 U/mL (aOR = 3.78) were significantly associated with a low-histamine diet response. Conversely, dermatographic urticaria and a hematocrit level < 36% were significantly and inversely associated with low-histamine diet response. Several promising biomarkers were identified in this study to predict the efficacy of chronic urticaria treatment. DAO could be a novel biomarker for predicting the efficacy not only of dietary intervention but also for antagonists of H and H receptors. Background. Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management. Methods. This study enrolled 78 patients with CU. Serum erythrocyte sedimentation rate, hemoglobin, hematocrit, eosinophil count, IgE, antinuclear antibody (ANA), and serum diamine oxidase (DAO) levels of the patients were measured and were compared according to the patient’s response to second-generation antihistamines (sgAH), corticosteroids, leukotriene receptor antagonist (LTRA), H2 blockers, and low-histamine diet. Results. Age- and sex-adjusted logistic regression analysis showed that patients with duration of CU > 3 years (adjusted odd ratio aOR = 4.39 ) and a DAO level < 10 U / mL ( aOR = 3.90 ) were significantly associated with a good sgAH response. Age > 50 years ( aOR = 0.02 ), duration of chronic urticaria > 3 years (aOR =0.06), and an ANA titer ≥ 1 : 80 ( aOR = 0.03 ) were significantly and inversely associated with corticosteroid response. A low-histamine diet response was significantly associated with LTRA response ( aOR = 67.29 ). In addition, a DAO level < 5.4 U / mL ( aOR = 71.95 ) was significantly associated with H2 blocker response. Furthermore, concomitant angioedema ( aOR = 10.56 ), multiple food triggers ( aOR = 11.69 ), and a DAO level < 5.4 U / mL ( aOR = 3.78 ) were significantly associated with a low-histamine diet response. Conversely, dermatographic urticaria and a hematocrit level < 36 % were significantly and inversely associated with low-histamine diet response. Conclusions. Several promising biomarkers were identified in this study to predict the efficacy of chronic urticaria treatment. DAO could be a novel biomarker for predicting the efficacy not only of dietary intervention but also for antagonists of H1 and H2 receptors. |
Audience | Academic |
Author | Koo, Malcolm Tsai, Tzung-Yi Wu, Cheng-Han Chiang, Hui-Ling Chen, Chen-Hung |
AuthorAffiliation | 1 Division of Immunology, Allergy and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan 5 Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan 6 Department of Nursing, Tzu Chi University of Science and Technology, Hualien City, Hualien, Taiwan 3 Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City, Hualien, Taiwan 2 Division of Allergy, Immunology and Rheumatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, School of Medicine, Tzu Chi University, Hualien, Taiwan 4 Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan |
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Cites_doi | 10.1155/2018/5615109 10.1111/all.12078 10.1177/0394632015617170 10.1080/07315724.2015.1014120 10.1111/cea.12494 10.1016/B978-0-323-08593-9.00037-1 10.2500/aap.2021.42.200088 10.1111/j.1365-2222.2008.03110.x 10.1111/jdv.13966 10.1016/j.aller.2015.01.009 10.1111/all.13397 10.5021/ad.2013.25.2.189 10.1002/sim.1047 10.23822/EurAnnACI.1764-1489.05 10.1111/j.1398-9995.2009.02130.x 10.1016/j.bpg.2005.11.010 10.1016/j.jaip.2019.08.025 10.1159/000430442 10.1007/s00403-011-1203-3 |
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Copyright | Copyright © 2022 Hui-Ling Chiang et al. COPYRIGHT 2022 John Wiley & Sons, Inc. Copyright © 2022 Hui-Ling Chiang et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0 Copyright © 2022 Hui-Ling Chiang et al. 2022 |
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Snippet | Background. Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management.... Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management. This study... BACKGROUNDChronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management.... |
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SubjectTerms | Age Angioedema Antihistamines Antinuclear antibodies Autoantibodies Biomarkers Blood Care and treatment Chronic Disease Chronic Urticaria - drug therapy Comparative analysis Corticosteroids Diet Enzymes Erythrocyte sedimentation rate Females Hematocrit Hemoglobin Histamine Histamine H2 receptors Humans Immunoglobulin E Immunology Laboratories Leukocytes (eosinophilic) Medical examination Medical research Medicine, Experimental Nonsteroidal anti-inflammatory drugs Nutrient deficiency Omalizumab Oral administration Oral medication Oxidases Patients Phenotypes Regression analysis Standard deviation Steroids Urticaria Urticaria - diagnosis Urticaria - drug therapy Variables |
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Title | Predictors of Response to Oral Medications and Low-Histamine Diet in Patients with Chronic Urticaria |
URI | https://dx.doi.org/10.1155/2022/5243825 https://www.ncbi.nlm.nih.gov/pubmed/35242884 https://www.proquest.com/docview/2636150858 https://search.proquest.com/docview/2636145048 https://pubmed.ncbi.nlm.nih.gov/PMC8888069 https://doaj.org/article/fd449d64db684d6685738e0105ef87f6 |
Volume | 2022 |
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