Role of serum IgE and IL-17A in pathogenesis of spontaneous urticaria

Abstract

Objective: a comparative analysis of the level of serum IgE, IL-17A in patients with acute spontaneous urticaria, and their consideration as predictors of progression to chronic forms. 

Materials and methods. The study group consisted of 48 patients with acute spontaneous urticaria, the control group consisted of 18 healthy donors. The study of IL-17A, IgE in serum was performed by ELISA. 

Results. Patients are divided into groups according to the level of serum IgE: I - 24 patients with a normal level (up to 100 IU/ml), II - 13 with a moderately elevated (100-500 IU/ml), III - 11 with a significantly high (over 500 IU/ml), in the control group - 22.19 ± 46.08 IU/ml. In patients I, the IgE content is comparable with the control (33.92 ± 27.46 IU/ml), II - 9.9 times (220.75 ± 135.1 IU/ml), III - 85. 4 times (1,894.28 ± 1,171.73 IU/ml) exceeded the control values. In patients I, IL-17A is 2 times higher than the control (45.16 ± 6.49 pg/ml, 23.05 ± 19.92 pg/ml, respectively), II is also 2 times higher (44.9 ± 4.32 pg/ml), III - exceeded 2.2 times (49.66 ± 3.98 pg/ml). A significant increase in IL-17A was revealed both in patients with normal serum IgE levels (p = 0.0044, p<0.05, Mann-Whitney U test = 45.5), and in patients with high (p = 0.0011, p<0.05, Uemp, Mann-Whitney U test = 26.0) and a significantly high level of this indicator (p = 0.0004, p<0.05, Mann-Whitney U test= 76.5). A significant correlation was revealed between the elevated serum IgE and IL-17A (R = 0.29, p = 0.045, p<0.05). 

Conclusion. The increased production of IL-17A in patients with acute spontaneous urticaria indicates its role in pathogenesis. A reliable correlation between elevated serum IgE and IL-17A suggests: a high level of serum IgE in acute urticaria reflects not only an IgE-mediated response, but also the possibility of developing a Th2 response under conditions of autoreactivity. Patients with high levels of serum IgE, IL-17A may be at risk of having the chronic disease.