Acute-phase response and its biomarkers in acute and chronic urticaria

Introduction
Since urticaria is a persisting inflammatory disease it is important to establish the prognostic factors for the duration and severity of the disease.

Aim
To evaluate serum concentrations of selected acute-phase proteins (APP) in patients with various forms of urticaria as compared to healthy volunteers and also to analyze these concentrations in different types of urticaria. Additionally, to evaluate the correlation between serum levels of selected APP and disease activity.

Material and methods
Serum concentrations of C-reactive protein (CRP), α₁-acid glycoprotein (AGP), α₁-anti­chymotrypsin (ACT), α₁-antitrypsin (AT), ceruloplasmin (Cp), transferrin (Tf), α₂-macroglobulin (α₂M) and haptoglobin (Hp) were measured. Quantitative measurement was conducted using the rocket immunoelectrophoresis. Disease activity was assessed with the use of total symptom score.

Results
Analysis of serum APP concentrations revealed statistically higher serum concentrations of CRP, AGP and ACT in the entire group of patients with urticaria in comparison with the control group. In the entire group of patients with urticaria, CRP, AGP, ACT, Cp and Hp correlated positively with disease activity, intensity of pruritus and the number and size of urticarial wheals. Statistically lower serum concentrations of CRP, ACT, Cp and Hp were detected in the group of patients with acute urticaria (AU) and angioedema together, compared to the patients suffering from AU only.

Conclusions
Patients with symptoms of various forms of urticaria present a distinct profile of serum APP concentrations. A significant correlation observed between CRP, AGP, ACT, Cp, Hp and clinical activity score points to the potential role of APP as markers of the urticarial activity.