| Objective: In recent years, the study about the pathogenesis of chronic urticaria was made great progress. Generally, urticaria can be classified by pathogenesis: immunologic, and nonimmunologic. Most of immunologic pathogenesis is IgE-dependent, type I hypersensitivity. Some studies indicated that the function of T helper cell subpopulation is unbalanced, which lead to allergy diseases, and that Interleukin-4 (IL-4) secreted by the PBMC (peripheral blood mononuclear cells) which were cultured in vitro with phytohemagglutinin(PHA) in chronic urticaria patients were significantly higher than in normal controls. The serum level of IL-4 is found higher than normal controls in studies. Many studies showed that IL-4 is the key factor in the allergy diseases. Vascular adhesion molecule-1 (VCAM-1) belongs to immunoglobulin superfamily. In normal case, it express lowly on the surface of vascular cells and lymphocytes. Soluble vascular adhesion molecule-1 (sVCAM-1) has the most alignment of VCAM-1, it is separated from the membrane. Recent evidence indicated that the level of VCAM-1 could reflect the disease activity and response to treatment. The incidence rate of chronic urticaria is high, and drug treatment is effective but easy to relapse. Specific immunotherapy is super to drug treatment for its persistent effect and little side effect, however its mechanism is unclear. We treated 30 patients with chronic urticaria with specific immunotherapy, having observed the effect and measured the serum levels of IL-4 and sVCAM-1 before and after treatment. Our purpose is to evaluate the effect of specific immunotherapy objectively and accurately, at the same time observe the affection of specific immunotherapy to the serum levels of IL-4 and sVCAM-1, further to research the mechanism of specific immunotherapy, thereby provide evidence to clinic therapy for chronic urticaria. Materials and methods: 30 patients with chronic urticaria were collected from the dermatology department of the Second Affiliated Hospital of Hebei Medical University from 2002.10 to 2003.12. All patients were classic chronic urticaria, excluded SLE, pemphigus, dermtomyositis, autoimmune diseases and other allergy diseases. Any drugs affected immune function had not used in recent 2 months. 20 healthy persons were taken as normal controls. Specific immunotherapy was taken by patient group for more than 3 months. We recorded the score of clinic symptom before and after treatment. At the same time, we collected 4 ml blood from patients, separated serum, and measured the levels of IL-4, sVCAM-1 by ELISA. Results: 1. After treatment, most patients symptom remitted, the SSRI (symptom score reduce index) decreased significantly. The effective rate was 83.33%, and no side effect was found. 2. The serum level of IL-4 in chronic urticaria patients (average 48.157±33.523pg/ml) was significantly increased compared to normal controls (average 31.223±15.477pg/ml)(P<0.05). After treatment, the serum level of IL-4 in chronic urticaria patients decreased significantly(average 34.240±18.218pg/ml) (P<0.01). 3. The serum level of sVCAM-1 in chronic urticaria patients (average 2014.03±1095.95ng/ml) was significantly increased compared to normal controls (average 1148.41±872.98ng/ml)(P<0.01). After treatment, the level of sVCAM-1 in chronic urticaria patients decreased significantly (average 1409.57±904.46ng/ml)(P<0.001). 4. In chronic urticaria patients, there was no significant correlation between the serum level of sVCAM-1 and IL-4 (P<0.05). Conclusions: Our results proved that specific immunotherapy is an effective and safe therapy for chronic urticaria. Our findings showed that the serum level of IL-4 and sVCAM-1 was reduced with the SSRI decreasing, which suggested that IL-4 and sVCAM-1 may be used as a maker for monitoring disease activity and response to treatment in chronic urticaria. In chronic urticaria patients, there was no significant correlation between the serum level of sVCAM-1 and IL-4. Above findings, it was indicated that spe...
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