Effect of stress on basophil function in chronic idiopathic urticaria.
BACKGROUND
Chronic idiopathic urticaria (CIU) is a distressing skin condition involving recurrent itchy hives lasting 6 weeks or longer. The mechanism involves mast cell and basophil degranulation, which releases inflammatory mediators including histamine. In our clinical practice, we have observed that the onset of CIU is often preceded by a major life event.


OBJECTIVE
To investigate the role of the hormones of the hypothalamic-pituitary-adrenal (HPA) axis in the link between psychological stress and CIU.


METHODS
Thirty people with CIU and 30 normal controls were recruited. A flow cytometric CD63 expression assay was used to quantify basophil activation, and serum cortisol concentrations were measured as an indication of stress.


RESULTS
Both corticotrophin releasing factor (CRF) and adrenocorticotrophic hormone (ACTH) were shown to activate basophils. There was no significant difference between numbers of CIU patients and normal controls responding to CFR, ACTH or cortisol. However, the responses in the CIU patients were stronger than those in normal controls. There was also a trend towards higher serum cortisol concentrations in CIU patients. The basophil response to CRF and ACTH correlated with the serum cortisol concentration in normal controls, but not in CIU patients.


CONCLUSIONS
Although our data have not supported the hypothesis that stress makes a major contribution to CIU, the heightened basophil response to CFR and ACTH and higher levels of serum cortisol do suggest a derangement of the HPA axis in CIU.
Dyke
S M
SM
Department of Immunology, Derriford Combined Laboratory, Derriford Hospital, Plymouth, UK.
Carey
B S
BS
Kaminski
E R
ER
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D001491:Basophils / Q000187:drug effects / Q000276:immunology* / Q000378:metabolism; D006634:Histamine H1 Antagonists / Q000494:pharmacology; D006728:Hormones / Q000494:pharmacology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008875:Middle Aged; D008954:Models, Biological; D009240:N-Formylmethionine Leucyl-Phenylalanine / Q000494:pharmacology; D010902:Pituitary Gland / Q000187:drug effects / Q000276:immunology; D010980:Platelet Membrane Glycoproteins / Q000378:metabolism; D060149:Tetraspanin 30; D014581:Urticaria / Q000276:immunology* / Q000378:metabolism / Q000473:pathology*
D015703:Antigens, CD; C554586:CD63 protein, human; D006634:Histamine H1 Antagonists; D006728:Hormones; D010980:Platelet Membrane Glycoproteins; D060149:Tetraspanin 30; D009240:N-Formylmethionine Leucyl-Phenylalanine; D006854:Hydrocortisone