Background: Asthma and urticaria are both partially mediated by an increased release of histamine from highly activated mast cells. They are pathophysiologically different, as mast cell degranulation in these 2 disorders results from different mechanisms. Objective: To assess the incidence of urticaria in patients with asthma, and of asthma in patients with chronic spontaneous urticaria (CSU). Patients and Methods: Over 1 year of follow-up, asthma patients (n = 110) were assessed for the incidence and characteristics of urticaria, and a link, if it existed, to seasonal exacerbations and the severity of asthma was traced. We also prospectively assessed CSU patients (n = 95) during the same period of time for the incidence of asthma. Healthy individuals (n = 100), serving as a control group, were also assessed. Results: Episodes of urticaria occurred in 26/110 asthma patients (23.6%), but in only 2/100 healthy control subjects (2%) (p < 0.0001). During the 1-year observation period, episodes of urticaria were significantly more frequent in asthma patients with positive skin-prick test reactions (mainly seasonal pollens), and consequently occurred mostly during seasonal asthma exacerbation, i.e. during acute episodes of urticaria. The incidence of asthma in CSU patients was recorded in 10.5% of the group, similar to that in the healthy control population. Discussion: Our study demonstrates, for the first time, that asthma patients frequently develop acute urticaria, mainly during seasonal exacerbations. In contrast, CSU patients do not show an increased incidence of asthma.

Keywords:
Urticaria, Asthma, Seasonal allergy
1.
Papadopoulos J, Karpouzis A, Tentes J, Kouskoukis C: Assessment of interleukins IL-4, IL-6. IL-8, IL-10 in acute urticaria. J Clin Med Res 2014;6:133-137.
2.
Saluja R, Khan M, Church M, Maurer M: The role of IL-33 and mast cells in allergy and inflammation. Clin Transl Allergy 2015;5:33.
3.
Kessel A, Yaacoby-Bianu K, Vadasz Z, Peri R, Halasz K, Toubi E: Elevated serum B-cell activating factor in patients with chronic urticaria. Hum Immunol 2012;73:620-622.
4.
Toubi E, Kessel A, Avshovich N, Bamberger E, Sabo E, Nusem D, Panasoff J: Clinical and laboratory parameters in predicting chronic urticaria: a prospective study of 139 patients. Allergy 2004;59:869-873.
5.
Ferrer M, Sastre J, Jauregui I, Davila I, Montoro J, del Cuvillo A, Mullol J, et al: Effects of anti-histamine up-dosing in chronic urticaria. J Investing Allergol Clin Immunol 2011;3:34-39.
6.
Mizuma H, Tanaka A, Uchida Y, Fujiwara A, Manabe R, Furukawa H, Kuwahara N, et al: Influence of omalizumab on allergen-specific IgE in patients with adult asthma. Int Arch Allergy Immunol 2015;168:165-172.
7.
Asero R, Madonini E: Bronchial hyperresponsiveness is a common feature in patients with chronic urticaria. J Investig Allergol Clin Immunol 2006;16:19-23.
8.
Isik AR, Karakaya G, Celikel S, Demir AU, Kalyoncu AF, Association between asthma, rhinitis, and NSAID hypersensitivity in chronic urticaria patients and prevalence rates. Int Arch Allergy Immunol 2009;150:299-306.
9.
Kessel A, Helou W, Bamberger E, Sabo E, Nusem D, Panassof J, Toubi E: Elevated serum total IgE - a potential marker for severe chronic urticaria. Int Arch Allergy Immunol 2010;153:288-293.
10.
Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, Church MK, et al: The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy 2014;69:868-887.
11.
Lim SY, Jo YJ, Chun EM: The correlation between bronchial hypersensitiveness to methacholine, and asthma like symptoms by GINA questionnaires for the diagnosis of asthma. BMC Pulm Med 2014;14:161-165.
12.
Weller K, Maurer M, Grattan C, Nakonechna A, Abuzakouk M, Berard F, Sussman G, et al. ASSURE-CSU: a real-world study of burden of disease in patients with symptoms of CSU. Clin Transl Allergy 2015;5:29-32.
13.
Groger M, Klemens C, Wendt S, Becker S, Canis M, Havel M, et al: Mediators and cytokines in persistent allergic rhinitis and non-allergic rhinitis with eosinophilia syndrome. Int Arch Allergy Immunol 2012;159:171-178.
14.
Bahrami Mahneh S, Movahedi M, Aryan Z, Bahar MA, Rezaei A, Sadr M, Rezaei N: Serum IL-33 is elevated in children with asthma and is associated with disease severity. Int Arch Allergy Immunol 2015;168:193-196.
15.
Kay AB, Clark P, Maurer M, Ying S: Elevations in T-helper-2-initiating cytokines (IL-33, IL-25 and thymic stromal lymphopoitin) in lesional skin from chronic spontaneous urticaria. Br J Dermatol 2015;172:1294-1302.
16.
Hong GU, Park BS, Park JW, Kim SY, Ro JY: IgE production in CD40/CD40L cross-talk of B and mast cells, and mediator release via TGase in mouse allergic asthma. Cell Signal 2013;25:1514-1525.
17.
Jonsson UB, Hakansson LD, Jogi R, Janson C, Venge P: Associations of ECP (eosinophil cationic protein)-gene polymorphisms to allergy, asthma, smoke habits and lung function in two Estonian and Swedish sub cohorts of the ECRHS II study. BMC Pulm Med 2010;10:36-44.
18.
Acharya KR, Ackerman SJ: Eosinophil granule proteins: form and function. J Biol Chem 2014;289:17406-17414.
19.
Kay AB, Ying S, Ardelean E, Mlynek A, Kita H, Clark P, Maurer M: Calcitonin gene-related peptide and vascular endothelial growth factor are expressed in lesional but not uninvolved skin in chronic spontaneous urticaria. Clin Exp Allergy 2014;44:1053-1060.
20.
Barbaud A, Poreaux C, Penven E, Waton J: Occupational protein contact dermatitis. Eur J Dermatol 2015;25:527-534.
21.
Asero R: Peach-induced contact urticaria is associated with lipid transfer protein sensitization. Int Arch Allergy Immunol 2011;154:345-348.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.