lvrachЛечащий ВрачLechaschi Vrach1560-51752687-1181ООО «Издательство "Открытые системы"»10.26295/OS.2020.22.86.006lvrach-217Research ArticleСтатьиПотенциальные маркеры ответа на лечение у больных хронической спонтанной крапивницейPotential markers of response to treatment of patients with chronic spontaneous urticariaПереверзинаН. О.PereverzinaN. O.

Moscow

noemail@neicon.ruГрибалеваЕ. О.GribalevaE. O.

Moscow

noemail@neicon.ruАлленоваА. С.AllenovaA. S.

Moscow

noemail@neicon.ruСкандерД. М.SkanderD. M.

Moscow

noemail@neicon.ruКолхирП. В.KolkhirP. V.

Moscow

pavel.kolkhir@yandex.ruFederal State Budgetary Educational Institution of additional professional education «Central state Medical Academy for managing affairs of the president of the Russian Federation»Russian FederationN. I. Sechenov First Moscow State Medical UniversityRussian Federation2020230620210112731Copyright © Переверзина Н.О., Грибалева Е.О., Алленова А.С., Скандер Д.М., Колхир П.В., 20212021Переверзина Н.О., Грибалева Е.О., Алленова А.С., Скандер Д.М., Колхир П.В.Pereverzina N.O., Gribaleva E.O., Allenova A.S., Skander D.M., Kolkhir P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.lvrach.ru/jour/article/view/217

Хроническая спонтанная крапивница (ХСК) распространенное заболевание кожи, при котором волдыри и/или ангиоотеки появляются без видимой причины и сохраняются не менее 6 недель. Рекомендуемое лечение ХСК заключается в назначении Н1-антигистаминных препаратов второго поколения (терапия первой-второй линии), омализумаба и циклоспорина. Выявление, изучение и внедрение маркеров, предсказывающих вероятность ответа пациента на терапию, позволит оптимизировать фармакотерапию заболевания путем повышения эффективности и уменьшения побочных эффектов лечения. Проведен анализ литературы баз данных MEDLINE/PubMed по ключевым словам predictors AND treatment AND chronic urticaria, biomarkers AND treatment AND chronic urticaria. Отобрано 25 статей. Установлено, что эозинопения, базопения и высокий уровень С-реактивного белка до лечения указывают на возможную неэффективность терапии Н1-антигистаминными препаратами второго поколения. Эозинопения, низкий уровень общего IgE в сыворотке, положительные результаты кожного теста с аутологичной сывороткой, теста активации базофилов и выделения гистамина из базофилов могут быть связаны с неэффективностью омализумаба, но эффективностью циклоспорина. Данные литературы указывают на интересные потенциальные маркеры ответа на лечение у больных ХСК. Тем не менее необходимо проведение обширных рандомизированных клинических исследований перед тем, как эти маркеры будут внедрены в рутинную клиническую практику.

Chronic spontaneous urticaria (CSU) is characterized by wheals and/or angioedema arising spontaneously and persisting for at least 6 weeks. The recommended treatment options include second generation H1-antihistamine drugs (sgAH, as first- and second-line therapy), omalizumab and cyclosporine. Revealing of biomarkers of the response to treatment and their implementation into clinical practice may facilitate the treatment effectiveness and decrease the frequency of adverse events. The review of literature was conducted in MEDLINE/Pubmed electronic databases using the keywords «predictors AND treatment AND chronic urticaria», «biomarkers AND treatment AND chronic urticaria». 25 articles were included. It was found that baseline eosinopenia, basopenia and/or high level of C-reactive protein might predict the poor response to sgAH. Baseline eosinopenia, low levels of serum total IgE, positive results of autologous serum skin test, histamine release test and/or basophil activation test are associated with the poor response to omalizumab but good response to cyclosporine. Potential biomarkers of response to treatment in patients with CSU have been reported in the literature. However, randomized clinical trials are required before implementing the biomarkers into the routine clinical practice. 

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The authors declare that there are no conflicts of interest present.