IgE and IgG Anti-Thyroid Autoantibodies in Chinese Patients With Chronic Spontaneous Urticaria and a Literature Review

Liming Zhang; Li Qiu; Jian Wu; Yumeng Qi; Hexiao Wang; Ruiqun Qi; Xu Yao; Hong Zhu; Yuzhen Li; Siyu Hao; Qianjin Lu; Hai Long; Shi Lian; Haiping Zhang; Wei Zhu; Wei Lai; Xiangyang Su; Rongbiao Lu; Zaipei Guo; Jingyi Li; Mengmeng Li; Quanzhong Liu; Huiping Wang; Li He; Xiang Nong; Fuqiu Li; Yang Li; Chunli Yao; Jinhua Xu; Hui Tang; Duoqin Wang; Zhenlu Li; Huiqian Yu; Shengxiang Xiao; Jingang An; Xiongming Pu; Shirong Yu; Jianzhong Zhang; Xue Chen; Xinghua Gao; Hongduo Chen; Ting Xiao

doi:10.4168/aair.2022.14.1.131

IgE and IgG Anti-Thyroid Autoantibodies in Chinese Patients With Chronic Spontaneous Urticaria and a Literature Review

Allergy Asthma Immunol Res. 2022 Jan;14(1):131-142. doi: 10.4168/aair.2022.14.1.131.

Authors

Liming Zhang¹, Li Qiu¹, Jian Wu¹, Yumeng Qi¹, Hexiao Wang¹, Ruiqun Qi¹, Xu Yao², Hong Zhu², Yuzhen Li³, Siyu Hao³, Qianjin Lu⁴, Hai Long⁴, Shi Lian⁵, Haiping Zhang⁵, Wei Zhu⁵, Wei Lai⁶, Xiangyang Su⁶, Rongbiao Lu⁶, Zaipei Guo⁷, Jingyi Li⁷, Mengmeng Li⁷, Quanzhong Liu⁸, Huiping Wang⁸, Li He⁹, Xiang Nong⁹, Fuqiu Li¹⁰, Yang Li¹⁰, Chunli Yao¹⁰, Jinhua Xu¹¹, Hui Tang¹¹, Duoqin Wang¹¹, Zhenlu Li¹², Huiqian Yu¹², Shengxiang Xiao¹³, Jingang An¹³, Xiongming Pu¹⁴, Shirong Yu¹⁴, Jianzhong Zhang¹⁵, Xue Chen¹⁵, Xinghua Gao¹, Hongduo Chen¹⁶, Ting Xiao¹⁷

Affiliations

¹ Department of Dermatology, The First Hospital of China Medical University, National Health Commission Key Laboratory of Immunodermatology, Key Laboratory of Immunodermatology of Ministry of Education, Shenyang, China.
² Department of Allergy and Rheumatology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China.
³ Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
⁴ Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China.
⁵ Department of Dermatology, Xuan Wu Hospital Capital Medical Univerisity, Beijing, China.
⁶ Department of Dermatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁷ Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China.
⁸ Department of Dermatology, Tianjin Medical University General Hospital, Tianjin, China.
⁹ Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China.
¹⁰ Department of Dermatology, The Second Hospital of Jilin University, Changchun, China.
¹¹ Department of Dermatology, Huashan Hospital, Fudan Univeristy, Shanghai, China.
¹² Department of Dermatology, Henan Provincial People's Hospital, Zhengzhou, China.
¹³ Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
¹⁴ Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, China.
¹⁵ Department of Dermatology, Peking University People's Hospital, Beijing, China.
¹⁶ Department of Dermatology, The First Hospital of China Medical University, National Health Commission Key Laboratory of Immunodermatology, Key Laboratory of Immunodermatology of Ministry of Education, Shenyang, China. hongduochen@hotmail.com.
¹⁷ Department of Dermatology, The First Hospital of China Medical University, National Health Commission Key Laboratory of Immunodermatology, Key Laboratory of Immunodermatology of Ministry of Education, Shenyang, China. cmuxt@126.com.

Abstract

Immunoglobulin (Ig) E and IgG anti-thyroid autoantibodies (AAbs) play important roles in the immunopathogenesis of chronic spontaneous urticaria (CSU). To date, association of IgE and IgG AAbs with Chinese CSU patients has not been fully investigated. We aimed to explore prevalence rates of IgE and IgG AAbs in Chinese CSU patients and their association with clinical and laboratory parameters. Serum IgE and IgG AAbs against thyroid peroxidase (TPO) and thyroglobulin (TG), total IgE (tIgE) and specific IgEs were measured using enzyme-linked immunosorbent assay, chemiluminescence microparticle immunoassay and immunoblotting. Meta-analyses and literature review were conducted. The meta-analyses indicated that CSU cases were 4.98, 6.90 and 6.68 times more likely to have positive anti-TPO IgE, anti-TPO IgG and anti-TG IgG (all P < 0.001) compared with controls, respectively, and revealed a positive correlation between the prevalence rates of anti-TPO IgE and anti-TPO IgG (r = 0.53, P = 0.025). A total of 1,100 Chinese Han adult CSU patients and 1,100 ethnicity-, age- and sex-matched healthy controls were recruited from 15 centers. Prevalence rates of anti-TPO IgE, anti-TPO IgG, anti-TG IgE or anti-TG IgG in the patients were all significantly higher than those in the controls. Significant correlations were observed between prevalence rates of anti-TPO IgE and anti-TPO IgG (r = 0.297, P < 0.001) as well as between those of anti-TG IgE and anti-TG IgG in the patients (r = 0.137, P < 0.001). Patients with anti-TPO IgE or anti-TPO IgG had significantly lower tIgE levels (P < 0.001). Positive anti-TPO IgE, positive anti-TPO IgG and tIgE < 40 IU/mL were independent predictors of antihistamine-refractory cases. In conclusion, the prevalence rates of IgE and IgG AAbs in Chinese CSU patients are significantly elevated and reciprocally correlated. This study verifies the results of previous case-control studies of CSU patients from other populations and ethnicities.

Keywords: Chronic spontaneous urticaria; immunoglobulin E; thyroglobulin; thyroid peroxidase.