title: Increased epidermal filaggrin in chronic idiopathic urticaria is associated with severity of urticaria.
abstract: BACKGROUND
  Chronic idiopathic urticaria (CIU) and atopic dermatitis (AD) are common allergic skin diseases associated with severe pruritus. AD skin is characterized by filaggrin deficiency, but it has not been studied in CIU.
  
  
  OBJECTIVE
  To compare the expression of filaggrin in skin from patients with CIU, patients with AD, and normal controls and to investigate whether altered filaggrin expression is associated with CIU severity.
  
  
  METHODS
  Skin biopsies were obtained from 16 patients with CIU, 11 patients with AD, and 14 normal controls. Filaggrin expression was evaluated using real-time reverse transcriptase polymerase chain reaction and immunostaining. Urticaria activity score, transepidermal water loss, and skin pH were measured.
  
  
  RESULTS
  FLG gene expression was significantly greater in lesional CIU skin compared with lesional AD skin (P < .01). The staining intensity of filaggrin was significantly increased in lesional CIU skin compared with skin from normal controls (P < .01) and lesional AD skin (P < .001). A significant correlation was observed between filaggrin staining intensity and urticaria activity score in patients with CIU (r = 0.538, P < .05). Transepidermal water loss was significantly increased in lesional skin of patients with AD compared with skin from normal controls (P < .01) and lesional skin from patients with CIU (P < .01). Skin pH was significantly decreased in lesional skin from patients with CIU compared with skin from normal controls (P < .01) and patients with AD (P < .001).
  
  
  CONCLUSIONS
  Filaggrin is overexpressed in lesional CIU skin, and increased filaggrin expression is positively correlated with urticaria severity in CIU. Altered filaggrin expression has physiologic effects on transepidermal water loss and pH in the skin of patients with CIU, suggesting increased barrier function compared with skin from patients with AD.
authors.affiliation: Department of Pediatrics, National Jewish Health, Denver, CO, U.S.A. 80206.|Department of Allergy and Clinical Immunology, Ajou University School of Medicine, South Korea.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Ye
authors.affiliation: Department of Pediatrics, National Jewish Health, Denver, CO, U.S.A. 80206.
authors.forename: Byung Eui
authors.initials: BE
authors.lastname: Kim
authors.affiliation: Department of Allergy and Clinical Immunology, Ajou University School of Medicine, South Korea.
authors.forename: Yoo-Seob
authors.initials: YS
authors.lastname: Shin
authors.affiliation: Department of Allergy and Clinical Immunology, Ajou University School of Medicine, South Korea.
authors.forename: Hae-Sim
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Pediatrics, National Jewish Health, Denver, CO, U.S.A. 80206.
authors.forename: Donald Y M
authors.initials: DYM
authors.lastname: Leung
mesh_terms: D000328:Adult; D000368:Aged; D003876:Dermatitis, Atopic / Q000378:metabolism / Q000473:pathology*; D004817:Epidermis / Q000378:metabolism / Q000473:pathology*; D000091344:Filaggrin Proteins; D015870:Gene Expression; D006801:Humans; D007381:Intermediate Filament Proteins / Q000096:biosynthesis* / Q000235:genetics; D008875:Middle Aged; D014581:Urticaria / Q000378:metabolism / Q000473:pathology*; D014870:Water Loss, Insensible; D055815:Young Adult
chemical_list: C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D007381:Intermediate Filament Proteins
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