RESUMEN

BACKGROUND: Immunosuppression is an integral part of treating chronic spontaneous urticaria (CSU), but there is no literature to evaluate the efficacy of multiple immunosuppressive agents. OBJECTIVE: The comparison of the efficacy, safety, and incidence of adverse effects of four immunosuppressive medicines (tripterygium glycosides, methotrexate, cyclosporine A, and azathioprine) in combination with antihistamines in treating CSU provides a clinical reference and evidence-based medicine for treating CSU. METHODS: PUBMED, The Cochrane Library, EMBASE, WANFANG, CNKI, CBM, and clinical trial registration platform were searched to collect relevant randomized controlled trials (RCT) and cohort studies of four immunosuppressive medicines combined with antihistamines for treating CSU. The primary outcomes were the efficacy of weekly urticaria activity score 7 (UAS7) and adverse effects. RESULTS: This study pooled data from seven randomized clinical trials with 410 participants. The standardized mean differences for change in UAS7 were 0.10 (95% confidence interval (CI), 0.01 to 0.68) for cyclosporine A plus antihistamine; 0.03 (95% CI, 0.00 to 0.23) for azathioprine plus antihistamine; 0.52 (95% CI, 0.32 to 0.85) for tripterygium glycosides plus antihistamine; and 1.54 (95% CI, 0.64 to 3.67) for methotrexate plus antihistamine. There were no significant differences in side effects between these medicines in the limited number of trials and clinical samples. CONCLUSION: Our results indicate that cyclosporine A combined with antihistamine resulted in greater improvements regarding the UAS7 in CSU patients and that tripterygium glycosides are also effective in treating CSU.

Asunto(s)

Antialérgicos , Urticaria Crónica , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Urticaria , Humanos , Inmunosupresores/uso terapéutico , Ciclosporina/uso terapéutico , Metotrexato/uso terapéutico , Azatioprina/uso terapéutico , Metaanálisis en Red , Enfermedad Crónica , Urticaria Crónica/inducido químicamente , Urticaria Crónica/tratamiento farmacológico , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Urticaria/tratamiento farmacológico , Antagonistas de los Receptores Histamínicos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/tratamiento farmacológico , Glicósidos/uso terapéutico , Resultado del Tratamiento , Omalizumab/uso terapéutico , Antialérgicos/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto

RESUMEN

Objective:To study the immunological characteristics of recombinant Rv3425 protein,to evaluate its diagnosis value and the role in the pathogenicity. Methods: Rv3425 gene was cloned into pET28a vector,the recombinant protein was induced and purified;we analyzed the antigenicity and specificity of Rv3425 by ELISA ( Enzyme-linked immuno sorbent assay) and Western blot methods,apoptosis effect of Rv3425 to macrophage was deteced by FCM ( Flow cytometry method ) . Results: Purified prokaryotic expressed protein Rv3425 was acquired,we found Rv3425 could elicit high level of IFN-γin spleen cells and combine with the serum of iH37Rv (inactivated mycobacterium tuberculosis) immunized mice;the specific IgG and IgM antibodies of TB (Tuberculosis) patients were significantly higher than healthy donors;Rv3425 also could induce the necrosis of macrophage. Conclusion:Our study found that Rv3425 had strong antigenicity and could induce the apoptosis of macrophage,these findings were very important for the research of TB diagnosis and pathogenicity.