The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria
One‐third of patients with chronic idiopathic urticaria (CIU) have circulating functional autoantibodies against the high affinity IgE receptor FcεRI, or IgE. The intradermal injection of autologous serum causes a weal and flare reaction in many patients with CIU, and this reaction forms the basis o...
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| Veröffentlicht in: | British journal of dermatology (1951) 1999-03, Vol.140 (3), p.446-452 |
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| container_title | British journal of dermatology (1951) |
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| creator | SABROE, R. A GRATTAN, C. E. H FRANCIS, D. M BARR, R. M BLACK, A. K GREAVES, M. W |
| description | One‐third of patients with chronic idiopathic urticaria (CIU) have circulating functional autoantibodies against the high affinity IgE receptor FcεRI, or IgE. The intradermal injection of autologous serum causes a weal and flare reaction in many patients with CIU, and this reaction forms the basis of the autologous serum skin test (ASST). We have determined the parameters of the ASST which define the optimal sensitivity and specificity for the identification of patients with autoantibodies. Two physicians (R.A.S. and C.E.H.G.) performed ASSTs in a total of 155 patients with CIU, 40 healthy control subjects, 15 patients with dermographism, nine with cholinergic urticaria and 10 with atopic eczema. Patients were classified as having functional autoantibodies by demonstrating in vitro serum‐evoked histamine release from the basophils of two healthy donors. There were significant differences (P |
| doi_str_mv | 10.1046/j.1365-2133.1999.02707.x |
| format | Article |
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A ; GRATTAN, C. E. H ; FRANCIS, D. M ; BARR, R. M ; BLACK, A. K ; GREAVES, M. W</creator><creatorcontrib>SABROE, R. A ; GRATTAN, C. E. H ; FRANCIS, D. M ; BARR, R. M ; BLACK, A. K ; GREAVES, M. W</creatorcontrib><description>One‐third of patients with chronic idiopathic urticaria (CIU) have circulating functional autoantibodies against the high affinity IgE receptor FcεRI, or IgE. The intradermal injection of autologous serum causes a weal and flare reaction in many patients with CIU, and this reaction forms the basis of the autologous serum skin test (ASST). We have determined the parameters of the ASST which define the optimal sensitivity and specificity for the identification of patients with autoantibodies. Two physicians (R.A.S. and C.E.H.G.) performed ASSTs in a total of 155 patients with CIU, 40 healthy control subjects, 15 patients with dermographism, nine with cholinergic urticaria and 10 with atopic eczema. Patients were classified as having functional autoantibodies by demonstrating in vitro serum‐evoked histamine release from the basophils of two healthy donors. There were significant differences (P < 0.001) in the mean weal diameter, weal volume, weal redness and flare area of the intradermal serum‐induced cutaneous responses at 30 min between patients with CIU with autoantibodies and either those without autoantibodies or control subjects. The optimum combined sensitivity and specificity of the ASST was obtained if a positive test was defined as a red serum‐induced weal with a diameter of ≥ 1.5 mm than the saline‐induced response at 30 min. For R.A.S. and C.E.H.G., the ASST sensitivity was 65% and 71% and specificity was 81% and 78%, respectively. Using these criteria, the following subjects had positive ASSTs: none of 15 dermographics, none of 10 atopics, one of nine cholinergics and one of 40 controls.</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1046/j.1365-2133.1999.02707.x</identifier><identifier>PMID: 10233264</identifier><identifier>CODEN: BJDEAZ</identifier><language>eng</language><publisher>Oxford BSL: Blackwell Science Ltd</publisher><subject>Allergic diseases ; autoantibodies ; Autoantibodies - analysis ; autologous serum skin test ; Biological and medical sciences ; Chronic Disease ; chronic idiopathic urticaria ; high affinity IgE receptor ; Humans ; Immunoglobulin E - immunology ; Immunopathology ; Medical sciences ; Receptors, IgE - immunology ; Sensitivity and Specificity ; Skin allergic diseases. 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A</creatorcontrib><creatorcontrib>GRATTAN, C. E. H</creatorcontrib><creatorcontrib>FRANCIS, D. M</creatorcontrib><creatorcontrib>BARR, R. M</creatorcontrib><creatorcontrib>BLACK, A. K</creatorcontrib><creatorcontrib>GREAVES, M. W</creatorcontrib><title>The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria</title><title>British journal of dermatology (1951)</title><addtitle>British Journal of Dermatology</addtitle><description>One‐third of patients with chronic idiopathic urticaria (CIU) have circulating functional autoantibodies against the high affinity IgE receptor FcεRI, or IgE. The intradermal injection of autologous serum causes a weal and flare reaction in many patients with CIU, and this reaction forms the basis of the autologous serum skin test (ASST). We have determined the parameters of the ASST which define the optimal sensitivity and specificity for the identification of patients with autoantibodies. Two physicians (R.A.S. and C.E.H.G.) performed ASSTs in a total of 155 patients with CIU, 40 healthy control subjects, 15 patients with dermographism, nine with cholinergic urticaria and 10 with atopic eczema. Patients were classified as having functional autoantibodies by demonstrating in vitro serum‐evoked histamine release from the basophils of two healthy donors. There were significant differences (P < 0.001) in the mean weal diameter, weal volume, weal redness and flare area of the intradermal serum‐induced cutaneous responses at 30 min between patients with CIU with autoantibodies and either those without autoantibodies or control subjects. The optimum combined sensitivity and specificity of the ASST was obtained if a positive test was defined as a red serum‐induced weal with a diameter of ≥ 1.5 mm than the saline‐induced response at 30 min. For R.A.S. and C.E.H.G., the ASST sensitivity was 65% and 71% and specificity was 81% and 78%, respectively. Using these criteria, the following subjects had positive ASSTs: none of 15 dermographics, none of 10 atopics, one of nine cholinergics and one of 40 controls.</description><subject>Allergic diseases</subject><subject>autoantibodies</subject><subject>Autoantibodies - analysis</subject><subject>autologous serum skin test</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>chronic idiopathic urticaria</subject><subject>high affinity IgE receptor</subject><subject>Humans</subject><subject>Immunoglobulin E - immunology</subject><subject>Immunopathology</subject><subject>Medical sciences</subject><subject>Receptors, IgE - immunology</subject><subject>Sensitivity and Specificity</subject><subject>Skin allergic diseases. Stinging insect allergies</subject><subject>Skin Tests - methods</subject><subject>Urticaria - immunology</subject><issn>0007-0963</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkV9v0zAUxS0EYqXwFZCFEG8J_hPbNRIPY8A2VI2JDfFoObazukvjYiei-_ZzmmpDPPHkK_t3ru85FwCIUYlRxd-vS0w5KwimtMRSyhIRgUS5ewJmDw9PwQwhJAokOT0CL1JaI4QpYug5OMKIUEp4NQPmeuWgHvrQhpswJJhcHDYw3foO9i71H6CGyUTnOt_d7G9gE-JeoLve18F6l2CGzSqGzhvorQ9b3a9yOcTeGx29fgmeNbpN7tXhnIOfX79cn5wVy--n5yfHy8IwwkRBayK4NNZVFGlMasl4JWXNUWOtJI222opGClw74hhbZIsWV5xrJzhzjls6B--mvtsYfg95VrXxybi21Z3L3hSXomIMsQy--QdchyF2eTZFckhIyqrK0GKCTAwpRdeobfQbHe8URmrcglqrMWw1hq3GLaj9FtQuS18f-g_1xtm_hFPsGXh7AHQyum2i7oxPj5xgfJENzsHHCfvjW3f33_-rT98-j1XWF5Pep97tHvQ63iouqGDq18WpWl5eXf4Q8kpd0Hv8HLJg</recordid><startdate>199903</startdate><enddate>199903</enddate><creator>SABROE, R. A</creator><creator>GRATTAN, C. E. H</creator><creator>FRANCIS, D. M</creator><creator>BARR, R. M</creator><creator>BLACK, A. K</creator><creator>GREAVES, M. W</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>199903</creationdate><title>The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria</title><author>SABROE, R. A ; GRATTAN, C. E. H ; FRANCIS, D. M ; BARR, R. M ; BLACK, A. K ; GREAVES, M. W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5257-3b2769cde430a12b956499b60fdd92fadad7f971be2e558133d1466ae765ee6d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Allergic diseases</topic><topic>autoantibodies</topic><topic>Autoantibodies - analysis</topic><topic>autologous serum skin test</topic><topic>Biological and medical sciences</topic><topic>Chronic Disease</topic><topic>chronic idiopathic urticaria</topic><topic>high affinity IgE receptor</topic><topic>Humans</topic><topic>Immunoglobulin E - immunology</topic><topic>Immunopathology</topic><topic>Medical sciences</topic><topic>Receptors, IgE - immunology</topic><topic>Sensitivity and Specificity</topic><topic>Skin allergic diseases. Stinging insect allergies</topic><topic>Skin Tests - methods</topic><topic>Urticaria - immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SABROE, R. A</creatorcontrib><creatorcontrib>GRATTAN, C. E. H</creatorcontrib><creatorcontrib>FRANCIS, D. M</creatorcontrib><creatorcontrib>BARR, R. M</creatorcontrib><creatorcontrib>BLACK, A. K</creatorcontrib><creatorcontrib>GREAVES, M. 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W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>British Journal of Dermatology</addtitle><date>1999-03</date><risdate>1999</risdate><volume>140</volume><issue>3</issue><spage>446</spage><epage>452</epage><pages>446-452</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><coden>BJDEAZ</coden><abstract>One‐third of patients with chronic idiopathic urticaria (CIU) have circulating functional autoantibodies against the high affinity IgE receptor FcεRI, or IgE. The intradermal injection of autologous serum causes a weal and flare reaction in many patients with CIU, and this reaction forms the basis of the autologous serum skin test (ASST). We have determined the parameters of the ASST which define the optimal sensitivity and specificity for the identification of patients with autoantibodies. Two physicians (R.A.S. and C.E.H.G.) performed ASSTs in a total of 155 patients with CIU, 40 healthy control subjects, 15 patients with dermographism, nine with cholinergic urticaria and 10 with atopic eczema. Patients were classified as having functional autoantibodies by demonstrating in vitro serum‐evoked histamine release from the basophils of two healthy donors. There were significant differences (P < 0.001) in the mean weal diameter, weal volume, weal redness and flare area of the intradermal serum‐induced cutaneous responses at 30 min between patients with CIU with autoantibodies and either those without autoantibodies or control subjects. The optimum combined sensitivity and specificity of the ASST was obtained if a positive test was defined as a red serum‐induced weal with a diameter of ≥ 1.5 mm than the saline‐induced response at 30 min. For R.A.S. and C.E.H.G., the ASST sensitivity was 65% and 71% and specificity was 81% and 78%, respectively. Using these criteria, the following subjects had positive ASSTs: none of 15 dermographics, none of 10 atopics, one of nine cholinergics and one of 40 controls.</abstract><cop>Oxford BSL</cop><pub>Blackwell Science Ltd</pub><pmid>10233264</pmid><doi>10.1046/j.1365-2133.1999.02707.x</doi><tpages>7</tpages></addata></record> |
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| ispartof | British journal of dermatology (1951), 1999-03, Vol.140 (3), p.446-452 |
| issn | 0007-0963 1365-2133 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Allergic diseases autoantibodies Autoantibodies - analysis autologous serum skin test Biological and medical sciences Chronic Disease chronic idiopathic urticaria high affinity IgE receptor Humans Immunoglobulin E - immunology Immunopathology Medical sciences Receptors, IgE - immunology Sensitivity and Specificity Skin allergic diseases. Stinging insect allergies Skin Tests - methods Urticaria - immunology |
| title | The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria |
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