Uji kulit serum otolog modifikasi pada pasien Urtikaria Otoimun di RSUP Palembang

M. Athuf Thaha

Abstract


There is an urgent need to find reliable and relevant diagnostic tools for patients with autoimmune urticaria especially in a developing country such as Indonesia. The basophil histamine release assay (HRA) is currently the “gold standard” for detecting functional autoantibodies in serum of patients with chronic urticaria. However, this bioassay is difficult to standardize because it requires fresh basophils from healthy donors, is not widely commercially available, and is time consuming. The detection of patients with autoantibodies using in vivo autologous serum skin test (ASST) also poses challenges. Firstly, the ASST is at best around 80% sensitive and specific using in vitro HRA as the “gold standard”, and secondly, there is some divergence results obtained by different methods used to detect patients with autoantibodies, due to inconsistency in methods, results and interpretation of the ASST in the literatures. The purpose of this study was to find and develop a new method of ASST. This new method should be practical and with higher reliability (sensitivity and specificity) as a diagnostic tool for autoimmune urticaria. The method used in this study was to perform a preliminary study followed by advanced study through cross sectional designs. The results of this study showed that the new ASST, has a higher reliability than the former ASST methods reported in literatures. In addition, we also found that disease severity with cut-off value of < 12, could be used as an adjunct to detect patients with positive functional autoantibodies. Finally, we also report with pride that we have now the ability to perform HRA which was never done before.

Keywords


histamine release assay; autologous serum skin test; functional autoantibodies

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References


Altmann LC 2003. Serum skin test definive for chronic, autoimmune urticaria: differential Dx. The Pacific Northwest Dermatological Society.

Anon 2000. Methods for Sample Preparation. National Referral Laboratory for Lysosomal, Peroxisomal and Related Genetic Disorders. Department of Chemical Pathology, Adelaide.

Anon 2007. Specimen Collection, Preparation, Reparation, and handling, Available from: http://www.labcorp.com/datasets/labcorp/html/frontm_group/frontm/section/speccal.htm#qns

Asero R, Lorini M, Tedeschi A 2004. Chronic autoreactive urticaria at six years of age J Invest Allergol Clin Immunol 14(4):343345.

Buhring HJ, Streble A, Valent P 2004. The Basophil-Specific Ectoenzyme E-NPP3 (CD203c) as a marker for Cell Activation and Allergy Diagnosis. Int Arch Immunol 133:317-329.

Di Lella E, Agostinelli D, Brunelli L, Stingeni L and Lisi P 2004. The intradermal autologous serum skin test: possible interfering factors. Societa’ Italiana di Dermatologia Allergologica Professionale Ambientale (SIDAPA) 58:12-15.

Docrat ME 2006. Skin Focus. Curr Allergy Clin Immunol 19:145150.

Fagiolo U, Kricek F, Ruf C, Peserico A, Amadori A, Cancian M, 2000. Effects of complement Inactivation and IgG depletion on skin reactivity to autologous serum in chronic idiopathic urticaria. J Allergy Clin Immunol. 106:567-572.

Fiebiger E, Hammerschmid F, Stingl G and Maurer D 1998. Anti- FceRIa Autoantibodies in Autoimmune-mediated Disorders. Identification of a Structure-Function Relationship. J. Clin. Invest. 101:243-251.

Fux M 2005. A New Molecular Approach for Monitoring Autoantibodies against Fc?RI? in Healthy Donors and Urticaria Patients (Dissertation). Inaugural dissertation der Philosophisch - Naturwissenschaftlichen Fakultät der Universitat, Bern.

Goryachkina LA, Nenasheva NM, Borzova EU 2004. The clinical relevance of autologous serum skin test in autoimmune chronic urticaria. Russian Medical Academy of Postgraduate Education, Department of Clinical Allergology.

Grattan CE, Walpole D, Niimi N 1997. Flow cytometric analysis of basophil numbers in Chronic urticaria: basopenia is related to serum histamine releasing activity. Clin Exp Allergy 27:14171424.

Grattan CEH, Sabroe RA, Greaves MW 2002. Chronic urticaria. Continuing Medical Education. J Am Acad Dermatol. 46:645657.

Hudson L, Hay FC 1991. Cell counting with haemocytometer in Practical Immunology, 3rd ed., pp. 94–95, Oxford Blackwell Scientific Publications.

Long CM, Drew L, Miner R, McMullen DJ, Impraim C, Kao S-Y 1998. Detection of Cytomegalovirus in Plasma and Cerebrospinal Fluid Specimens from Human immunodeficiency Virus-Infected Patients by AMPLICOR CMV Test. J Clin Microbiol 36:2434-2438.

Neogen Corporation 2004. Competitive direct ELISA. The Histamine ELISA test kit.

Nettis E, Dambra P, D’Oranzio L 2002. Reactivity to autologous serum skin test and clinical features in chronic idiopathic urticaria. Clin Exp. Dermatol. 27:29-31.

Platzer MH, Grattan CEH, Poulsen LK, Skov PS 2005. Validation of basophil histamine release against the autologous serum skin test and outcome of serum – induced basophil histamine release studies in a large population of chronic urticaria patients. Allergy 60:1152-1156.

Sabroe RA, Grattan CEH, Francis DM 1999. The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. Brit J Dermatol 140:446-452.

Sabroe RA and Greaves MW 2006. Chronic idiopathic urticaria with functional auto-antibodies: 12 years on. Br J Dermatol 154:813-819.

Sheikh J 2005. Autoantibodies to the High-affinity IgE Receptor in Chronic Urticaria. How important are they? Curr Opin Allergy Clin Immunol 5(5):403-407.

Tanus T, Atkins PC, Zweiman M 1996. Comparison of serum histamine-releasing activity and Clinical Manifestations in Chronic Idiopathic Urticaria. Clin Diag Lab Immunol 3:135137

Tong LJ, Balakrishnan G, Kochan JP 1997. Assessment of autoimmunity in patients with chronic urticaria. J Allergy Clin Immunol 99:461-465.

Toubi E, Kessel A, Avshovich N, Bamberger E, Sabo E, Nusem D, Panasoff J 2004. Clinical and laboratory parameters in predicting chronic urticaria duration: a prospective study of 139 patients. Original article. Allergy 59 (8), 869–873.

Vasagar K, Vonakis BM, Viksman et al., 2004. Evidence of in vivo basophil activation in chronic idiopathic urticaria. J Allergy Clin Immunol 113:S257-S259.

Wedi B, Novacovic V, Koerner M, Kaap A 2000. Chronic urticaria serum induces histamine release, leukotriene production, and basophil CD63 surface expression — Inhibitory effects of anti-inflammatory drugs. Dermatologic and Ocular diseases. J Allergy Clin Immunol 105:552-560.

Young DJ 2006. Dextran Sedimentation of Erythrocytes. University of California, San Diego (UCSD).




DOI: https://doi.org/10.33476/jky.v16i2.240

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