自己免疫性蕁麻疹とアフェレシス

概要

論文の詳細を見る
Chronic urticaria is a common disorder characterized by the eruption of transitory, itchy swellings of the skin that can recur for weeks to years. Until recently the cause of chronic urticaria remained unknown ; thus the term "idiopathic." In many cases the aetiology of chronic urticaria remains unknown. Subsets of the disorder have been defined, however, where there is an identifiable cause, and this has important consequences for treatment. In 50% to 60% of patients with chronic urticaria, the wheals are caused by circulating histamine-releasing factors indicated from autologous serum skin tests. In half of them the histamine-releasing activity has been identified as IgG autoantibodies directed against epitopes expressed on the extracellular portion of the alpha subunit of the high affinity IgE receptor (FcεRI). In a small minority of these patients, the autoantibodies were demonstrated to be lgG anti-IgE autoantibodies. Both evoke histamine release from mast cells and basophils through the same mechanism, namely, through cross-linking of the α subunit of adjacent FcerRI. Plasmapheresis, which decreases the concentration of immunoglobulins in serum, may be dramatically beneficial in selected patients with autoantibody-positive chronic urticaria, but this treatment should be provided with intense care by specialized centers.
日本アフェレシス学会の論文
2000-10-31