| Objective: Chronic Spontaneous Urticaria(CSU)is a common skin disease,mainly manifested as temporary inflammatory hyperemia and intratissue edema of the skin,mucous membranes and blood vessels.This study aimed to investigate the therapeutic effect of autologous serum injection therapy in patients with chronic spontaneous urticaria and to conduct a preliminary discussion of its possible mechanisms.Methods: Sixty patients with chronic spontaneous urticaria who had positive autologous blood serotest were randomly divided into control group and observation group.The control group(30 cases)was treated with oral loratadine tablets alone,and the observation group(30 cases)was treated with autologous serum injection therapy combined with oral loratadine tablets.After 4 weeks of treatment,the therapeutic effect of both groups of patients was evaluated using UAS7 and DLQI scales.The levels of IL-2,IL-4,IL-9 and Ig E in serum before and after treatment were measured by enzymelinked immunosorbent assay in both groups.The possible mechanisms of autologous serum therapy in the treatment of chronic spontaneous urticaria were explored by analysing changes in treatment effects and levels of associated inflammatory factors.Results: There were no significant differences in the number of wheals,itching degree score,UAS7 and DLQI scores between the observation group and the control group before treatment(P>0.05).After treatment,the number of wheals and the degree of itching were improved in both groups,and the number of wheals and itching in the observation group were more significant than those in the control group(P<0.01),and the UAS7 and DLQI scores in the control group and the observation group before treatment were lower than those after treatment,and the reduction was more significant in the observation group(P<0.01).There were no significant differences between IL-2,IL-4,IL-9 and Ig E levels between the observation and control groups before treatment(P>0.05).The levels of IL-4,IL-9 and Ig E decreased and the level of IL-2 increased(P<0.05)after treatment in both groups,and the serum levels of IL-4,IL-9 and Ig E in the observation group were significantly lower than those in the control group(P<0.05),and the serum IL-2 levels were significantly higher than those in the control group(P<0.05).In 30 patients in the control group,the overall effective rate after treatment was 80.00%;The total effective rate of the observation group was 96.67%.In comparison,the observation group was always more efficient and had obvious advantages(P<0.05).At the same time,3 of the 30 patients in the observation group had symptoms of redness,swelling and pain after buttock injection,and all of them disappeared after 1-2 days.During the treatment,no obvious discomfort symptoms such as dizziness,palpitations,fever,nausea,vomiting,and drowsiness were found.In comparison,the observation group was always more efficient and had obvious advantages(P<0.05).Conclusion: The serum content of inflammatory factors such as IL-4,IL-9 and Ig E decreased after 4 weeks of autologous serum injection.The content of inflammatory factors such as IL-2 gradually increased during the treatment process.The concentration of inflammatory factors in patients varied with the degree of disease,among which IL-4,IL-9 and Ig E were positively correlated with the severity of the disease,and IL-2 was negatively correlated with the severity of the disease.Autologous serological therapy plus antihistamine has been shown to be safe and effective in treating ASST-positive patients with chronic spontaneous urticaria.According to the current preliminary confirmation,the mechanism of action of autohemotherapy may be by affecting the expression of inflammatory factors such as serum IL-2,IL-4,IL-9,and IgE. |
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