Herrera-Lasso, V. (Valeria)
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- Angioedema severity and impact on quality of life: Chronic histaminergic angioedema versus chronic spontaneous urticaria(2022) Sabaté-Brescó, M. (Marina); Labrador-Horrillo, M. (Moises); Herrera-Lasso, V. (Valeria); Diaz-Donado, C. (Carmen); Baeza, M.L. (María Luisa); Azofra, J. (Julián); Gil, M.P. (María Pilar); Veleiro, B. (Beatriz); Gaig, P. (Pere); Rodríguez-Garijo, N. (Nuria); Sala-Cunill, A. (Anna); Guilarte, M. (Mar); Ferrer-Cardona, M. (Marta)Histamine-mediated angioedema is the most frequent form of angioedema. It is classified as idiopathic histaminergic acquired angioedema (IH-AAE)1 when allergies and other causes have been excluded and a positive treatment response to antihistamines, corticosteroids, or omalizumab has been reported. Idiopathic histaminergic acquired angioedema may occur in isolation, when it is termed chronic histaminergic angioedema (CHA), or it may be associated with wheals in chronic spontaneous urticaria angioedema (CSU-AE). The term CHA is equivalent to IH-AAE and mast cell-mediated angioedema. However, this term reflects the chronic and recurrent course of the disease. Therefore, we propose that the term CHA be internationally discussed in the following guidelines. Chronic spontaneous urticaria is classically characterized by the presence of recurrent episodes of wheals (hives) with or without angioedema for at least 6 weeks.2 Chronic histaminergic angioedema is typically considered a subtype of CSU without wheals. However, a recent study3 found several features that differentiate CHA from CSU, which suggests that CHA is a separate entity. Quality of life (QoL) studies specifically for CHA patients have not been performed, and their QoL has been assessed only in the context of CSU-AE.
- A Comparative Study of Sex Distribution, Autoimmunity, Blood, and Inflammatory Parameters in Chronic Spontaneous Urticaria with Angioedema and Chronic Histaminergic Angioedema(2021) Sabaté-Brescó, M. (Marina); Labrador-Horrillo, M. (Moises); Herrera-Lasso, V. (Valeria); Diaz-Donado, C. (Carmen); Baeza, M.L. (María Luisa); Gil-Sanchez, M.P. (María Pilar); Azofra, J. (Julián); Kaplan, A.P. (Allen .P); Veleiro, B. (Beatriz); Gaig, P. (Pere); Rodríguez-Garijo, N. (Nuria); Sala-Cunill, A. (Anna); Guilarte, M. (Mar); Ferrer-Cardona, M. (Marta)Background Recurrent idiopathic histaminergic angioedema is currently classified as a subtype of angioedema, as well as a subtype of chronic spontaneous urticaria (CSU), based on the fact that both are mast cell-mediated and respond to the same treatments. Objective In the present work, we sought to verify whether chronic histaminergic angioedema (CHA) is an entity distinct from CSU or represents a CSU subtype that lacks hives. Methods We performed a prospective study comparing 68 CHA patients, angioedema without hives, with 63 CSU patients, with hives and angioedema, from whom we collected demographic and clinical data, as well as blood and serum markers. Results We found key pathogenic features that differentiate CHA from CSU: gender distribution, basophil number, and antibodies against the IgE receptor. The male/female ratio in CHA was 0.78, whereas in CSU it was 0.36 (P = .0466). Basopenia was more often seen in CSU (n = 13 [20%]) than in CHA (n = 5 [7%]). Finally, 31.15% of CSU sera induced basophil activation, whereas no CHA sera were able to activate normal basophils. By contrast, nonspecific inflammation or immune markers, for example, erythrocyte sedimentation rate, C-reactive protein, or IgG antithyroid antibodies, were very similar between both groups. IgE anti–IL-24 could not be assessed because a control population did not differ from CSU. Conclusions Inclusion of CHA as part of the spectrum of CSU is an assumption not evidence-based, and when studied separately, important differences were observed. Until there is further evidence, CHA and CSU should not necessarily be considered the same disorder, and it is our opinion that review articles and guidelines should reflect that possibility.
- Serum Amyloid A as a potential biomarker for disease activity in chronic spontaneous urticaria(Elsevier, 2024) Sabaté-Brescó, M. (Marina); Labrador-Horrillo, M. (Moises); Herrera-Lasso, V. (Valeria); Diaz-Donado, C. (Carmen); Baeza, M.L. (María Luisa); Veleiro, B. (Beatriz); Carvallo, Á. (Álvaro); Rodríguez-Garijo, N. (Nuria); Guilarte, M. (Mar); Ferrer-Cardona, M. (Marta)Background: Chronic spontaneous urticaria (CSU) is an inflammatory skin disease with a complex physiopathology. Serum amyloid A (SAA), an acute-phase reactant, has been proposed as a potential biomarker in urticaria but has yet to be studied in a population with CSU or correlated with disease activity as indicated by the Urticaria Activity Score summed over 7 days (UAS7). Objective: We sought to determine SAA-1 levels in patients with CSU and correlate them with its activity and control, as well as with clinical features of CSU and other potential blood biomarkers. Methods: We conducted a retrospective multicenter study of 67 patients with CSU, from whom we obtained demographic and clinical data, UAS7 as an indicator of CSU activity, and blood and serum markers. Results: SAA-1 levels positively correlated with UAS7 (rs = 0.47, P < .001). SAA-1 levels were higher in patients with noncontrolled (UAS7 > 6) CSU than in those with controlled (UAS ≤ 6) CSU (P < .001) and were also higher in patients with concomitant angioedema (P = .003) or delayed pressure urticaria (P = .003). Conclusion: We propose SAA-1 as a potential biomarker for activity in CSU. Further studies are required to evaluate its potential role as a biomarker for other CSU outcomes, such as response to treatment.