Title: Post-Treatment Levels of Matrix Metalloproteinase-9 and Vascular Endothelial Growth Factor in Patients with Chronic Urticaria
Abstract: RationaleMatrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) plasma levels have been reported to correlate with disease activity in patients with chronic urticaria (CU), but their response to treatment has not been studied.MethodsFollowing IRB approval, 12 patients with CU were enrolled. Urticaria severity was monitored with Urticaria Severity Score (USS). The USS, plasma MMP-9 and VEGF levels were measured at baseline and at 2 weeks after treatment initiation (antihistamines and oral corticosteroids, as needed) and strict allergen elimination regimen.ResultsBaseline USS in the responder and nonresponder groups were similar (mean USS-51 vs. 60). After 2 weeks of treatment, USS in the responders (42% of patients) significantly decreased (mean USS=14) while in the nonresponders, USS remained the same (mean USS=55). At baseline, 58% of the patients had elevated plasma MMP-9 levels (normal < 144.2 ng/ml), and 83% had elevated plasma VEGF levels (normal < 62.1 pg/ml). In the responders, the mean level of plasma MMP-9 at baseline was normal (134 ng/ml), while in nonresponders was elevated (mean =317 ng/ml). The mean levels of plasma VEGF at baseline were elevated in both the responders and nonresponders (123 pg/ml and 165 pg/ml, respectively). After 2 weeks of treatment, the biomarkers mean levels remained elevated in both groups.ConclusionsBaseline levels of plasma MMP-9 were lower in patients with CU that responded to treatment. Baseline VEGF plasma levels were similar between responders and nonresponders. Biomarker levels did not decrease after 2 weeks of treatment, despite significant improvement in urticaria severity. RationaleMatrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) plasma levels have been reported to correlate with disease activity in patients with chronic urticaria (CU), but their response to treatment has not been studied. Matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) plasma levels have been reported to correlate with disease activity in patients with chronic urticaria (CU), but their response to treatment has not been studied. MethodsFollowing IRB approval, 12 patients with CU were enrolled. Urticaria severity was monitored with Urticaria Severity Score (USS). The USS, plasma MMP-9 and VEGF levels were measured at baseline and at 2 weeks after treatment initiation (antihistamines and oral corticosteroids, as needed) and strict allergen elimination regimen. Following IRB approval, 12 patients with CU were enrolled. Urticaria severity was monitored with Urticaria Severity Score (USS). The USS, plasma MMP-9 and VEGF levels were measured at baseline and at 2 weeks after treatment initiation (antihistamines and oral corticosteroids, as needed) and strict allergen elimination regimen. ResultsBaseline USS in the responder and nonresponder groups were similar (mean USS-51 vs. 60). After 2 weeks of treatment, USS in the responders (42% of patients) significantly decreased (mean USS=14) while in the nonresponders, USS remained the same (mean USS=55). At baseline, 58% of the patients had elevated plasma MMP-9 levels (normal < 144.2 ng/ml), and 83% had elevated plasma VEGF levels (normal < 62.1 pg/ml). In the responders, the mean level of plasma MMP-9 at baseline was normal (134 ng/ml), while in nonresponders was elevated (mean =317 ng/ml). The mean levels of plasma VEGF at baseline were elevated in both the responders and nonresponders (123 pg/ml and 165 pg/ml, respectively). After 2 weeks of treatment, the biomarkers mean levels remained elevated in both groups. Baseline USS in the responder and nonresponder groups were similar (mean USS-51 vs. 60). After 2 weeks of treatment, USS in the responders (42% of patients) significantly decreased (mean USS=14) while in the nonresponders, USS remained the same (mean USS=55). At baseline, 58% of the patients had elevated plasma MMP-9 levels (normal < 144.2 ng/ml), and 83% had elevated plasma VEGF levels (normal < 62.1 pg/ml). In the responders, the mean level of plasma MMP-9 at baseline was normal (134 ng/ml), while in nonresponders was elevated (mean =317 ng/ml). The mean levels of plasma VEGF at baseline were elevated in both the responders and nonresponders (123 pg/ml and 165 pg/ml, respectively). After 2 weeks of treatment, the biomarkers mean levels remained elevated in both groups. ConclusionsBaseline levels of plasma MMP-9 were lower in patients with CU that responded to treatment. Baseline VEGF plasma levels were similar between responders and nonresponders. Biomarker levels did not decrease after 2 weeks of treatment, despite significant improvement in urticaria severity. Baseline levels of plasma MMP-9 were lower in patients with CU that responded to treatment. Baseline VEGF plasma levels were similar between responders and nonresponders. Biomarker levels did not decrease after 2 weeks of treatment, despite significant improvement in urticaria severity.