ABSTRACT
BACKGROUND:
Chronic spontaneous urticaria (CSU) is a chronic inflammatory
skin disease where activation of
endothelial cells (ECs) at sites of
skin lesions leads to increased
blood flow,
leakage of fluid into the
skin, cellular infiltration, and
vascular remodeling. To understand the
disease duration and the sometimes vague systemic symptoms accompanying flares, the objective of this study was to examine if CSU comes with systemic vascular changes at the microcirculatory level.
METHODS:
We investigated CSU
patients (n = 49) and healthy controls (HCs, n = 44) for microcirculatory differences by nailfold
videocapillaroscopy (NVC) and for
blood levels of the soluble EC
biomarkers serum vascular endothelial growth factor (
VEGF), soluble
E-selectin, and
stem cell factor (SCF).
Patients were also assessed for clinical characteristics,
disease activity, and markers of autoimmune CSU (aiCSU).
RESULTS:
CSU
patients had significantly lower
capillary density, more
capillary malformations, and more irregular
capillary dilations than HCs on NVC.
Serum levels of
VEGF, soluble
E selectin and SCF were
similar in CSU
patients and HCs. CSU
patients with higher
VEGF levels had significantly more abnormal
capillaries.
Patients with markers of aiCSU, that is, low
IgE levels or increased anti-TPO levels, had significantly more
capillaries and less
capillary dilations than those without.
CONCLUSION:
Our results suggest that CSU comes with systemic microcirculatory changes, which may be driven, in part, by
VEGF.
