Protease inhibitor profiles in urticaria and angio-oedema
Eftekhari, N.; Ward, A.M.; Allen, R.; Greaves, M.W.
British Journal of Dermatology 103(1): 33-39
1980
ISSN/ISBN: 0007-0963 PMID: 6968579 Document Number: 162641
Plasma levels of 6 protease inhibitors were measured in patients with chronic urticaria, chronic urticaria with anglo-edema, cold and cholinergic urticaria. In chronic urticaria CI esterase inhibitor activity was increased compared with a reference control population but there was no detectable abnormality of any other protease inhibitor. Patients with chronic urticaria/angio-edema showed a reduction in inter-.alpha. trypsin inhibitor. They also manifested a rise in CI esterase inhibitor. In cold urticaria there was a significant lowering of .alpha.I antichymotrypsin. The reduction in .alpha.I antitrypsin in this group probably reflects a genetic difference compared with the control population. Patients with cholinergic urticaria also showed a reduction of .alpha.I antichymotrypsin. Apparently, the elevated levels of .alpha.2 macroglobulin in the 3 groups are due to differences in the mean age of these groups compared with the reference population. Comparison of levels in subgroups of patients with and without active lesions suggest that a consumptive effect contributes to the reduced values, although it is unlikely to account for them entirely. Involvement of pharmacologically active products of protein digestion may be involved in the pathogenesis of urticaria and attempts to identify these agents and encourage trial of medications which lead to inhibition of proteolytic activity in urticaria should be made.