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    The efficacy and safety of omalizumab in refractory chronic spontaneous urticaria: real-life experience in Turkey
    (DERMATOVENEROLOGICAL SOC SLOVENIA, 2018) Bulur, Isil; Baskan, Emel Bulbul; Ozdemir, Mustafa; Balevi, Ali; Goncu, Emek Kocaturk; Altunay, Ilknur; Gonul, Muzeyyen; Ergin, Can; Ertam, Ilgen; Erdogan, Hilal Kaya; Bilgin, Muzaffer; Erdem, Mustafa Teoman
    Introduction: This study used real-world data to evaluate the effectiveness and reliability of omalizumab in treating recalcitrant chronic spontaneous urticaria in Turkish patients. Methods: Study data were collected retrospectively from eight tertiary-care hospitals in Turkey. This study included 132 patients with chronic spontaneous urticaria that were resistant to H-1 antihistamine treatment in a dose up to four times the licensed dose and were treated with 300 mg/month of omalizumab for 6 months. Results: The mean weekly urticarial activity score (UAS(7)) after omalizumab treatment improved significantly compared to the pretreatment score (p < 0.001). Treatment response was detected primarily in the 1st and 2nd months after treatment. No significant association was observed between omalizumab's treatment effectiveness and disease-related parameters or laboratory data. The mean dermatology life quality index was 23.12 +/- 6.15 before treatment and decreased to 3.55 +/- 3.60 6 months after treatment (p < 0.001). No side effects were reported in 89.4% (118) of the patients. Conclusion: This study showed that UAS(7) decreased significantly and quality of life improved in omalizumab-treated patients. Moreover, treatment effectiveness was mainly observed in the first 2 months after treatment. However, no association was observed between omalizumab treatment effectiveness and disease-related parameters or laboratory data.
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    Evaluation of the Relationship Between T Regulatory Cells and Vitamin D Levels in Chronic Spontaneous Urticaria
    (GALENOS YAYINCILIK, 2018) Bulur, Isil; Erdogan, Hilal Kaya; Yigitaslan, Semra; Akay, Iga Meltem; Saracoglu, Zeynep Nurhan
    Objective: T regulatory (Treg) cells play a role in autoimmunity and vitamin D is one of the factors involved in regulation of Treg cells. In this study, it is aimed to evaluate the relationship between Treg cells and disease-related parameters and serum vitamin D levels in chronic spontaneous urticaria (CSU) patients. Methods: The percentage of Treg cells were evaluated by flow cytometric analysis and serum 25 hydroxy vitamin D (25(OH)Vit D) levels were determined by commercial available ELISA kit. Results: Thirty eight CSU patients and 30 healthy controls were included in the study. The percentage of CD4(+)CD25(+) and CD4(+)FOXP3(+) T cells in the patient group were found lower than in the control group (p=0.018, p=0.000). No difference was detected between groups in terms of the percentage of CD4(+)CD25(+)FOXP3(+) T cells and the 25(OH) Vit D levels (p=0.192, p=0.218). There was no significant relationship between disease duration, weekly urticaria activity score, autologous serum skin test (ASST), serum 25(OH) Vit D levels and the percentage of Treg cells in CSU patients. Conclusion: The percentage of CD4(+)CD25(+) and CD4(+)FOXP3(+) T cells in CSU patients were observed to be lower than control group independent from the serum 25(OH)Vit D levels, ASST positivity, disease duration and severity. This result suggests that Treg cells are one of the factors involved in the pathogenesis of CSU.