| Popis: |
Chronic spontaneous (or idiopathic) urticaria (CSU) is a skin disease characterized by hives and/or angioedema, without specific external physical stimuli, which erupt daily (or almost daily) for more than 6 weeks, mediated by the release of inflammatory mediators stored in skin mast cells and/or peripheral basophils. The etiopathogenesis of the disease is still unknown. Numerous recent studies confirm the significant role of the coagulation system and fibrinolysis in the pathophysiology of CSU, although it is unclear how the coagulation system induces activation of skin mast cells and peripheral basophils in patients with CSU. Based on recent research, the explanation for the connection between coagulation and CSU highlights a new pathway for tissue mast cell activation through activation of the coagulation system and complement factors. In addition, an association between the values of individual inflammatory markers and severity of CSU was observed. Thus, it was observed that in the serum of patients with active CSU, values of inflammatory parameters, such as C-reactive protein (CRP), erythrocyte sedimentation rate (SE) and interleukin-6 (IL-6) are increased. Proinflammatory cytokines, such as TNF-α and IL-6, play a key role in the development of inflammation in various diseases, including CSU. It has also been observed that infection with microorganisms simultaneously with the intravascular release of histamine leads to the activation of TLR (Toll- like receptors) and stimulates the expression of tissue factor (TF) via endothelial cells, leading to the activation of the blood clotting cascade. Further studies in this field could help in diagnostic and therapeutic approach to patients with CSU, and open the possibility of using new and effective drugs for patients with severe and resistant CSU that target coagulation factors. |
