Chronic urticaria is a common skin disorder characterized clinically by itching and clamminess that is usually induced by both allergic and non-allergic mechanisms. Approximately 15% to 25% of patients have had urticaria in their lifetime, and no external cause can be found for 80% to 90% of urticaria; these patients are traditionally said to have chronic idiopathic urticaria. The average duration of chronic urticaria is 3 to 5 years, and may last up to 20 years in some patients.
Disease Classification of Chronic Urticaria
Diseases are classified to better understand their pathogenesis and to guide treatment. Based on history and laboratory tests, urticaria can be categorized into allergic urticaria and nonallergic urticaria, where allergic urticaria is subdivided into allergen-specific IgE-mediated and non-IgE-mediated urticaria. The purpose of this in-depth classification is that specific immunotherapy can be attempted for IgE-mediated urticaria. The pattern of cellular infiltration of the cutaneous inflammatory response in chronic urticaria resembles an allergen-induced delayed-phase response that manifests as superficial perivascular inflammation. And its cytokine secretion pattern {interleukin-4 (IL-4), interleukin-5 (IL-5), r-interferon (r-IFN)} suggests a Th0 or mixed Th1/Th2 response pattern rather than a pure Th2 response.
Cutting-edge science in the treatment of chronic urticaria with antiallergen-specific IgE antibodies:
Currently, the most researched mechanism for the pathogenesis of chronic urticaria is the autoimmune theory, and the pathogenesis of autoimmune urticaria is increasingly emphasized in clinical urticaria research. Although histamine is considered to be the most important mediator in the pathogenesis of urticaria, patients with acute and chronic urticaria will quickly disappear and urticaria is relieved after taking antihistamines. In conjunction with the IgE-mediated immunity theory described above, mast cells in tissues and basophils circulating or chemotaxing to tissues are the 2 major source cells for histamine production, whereas mast cells and basophils have IgE high-affinity receptors on their surfaces, and allergen binding leads to cross-linking of the latter and induces the release of histamine as a major inflammatory mediator from the cells. Histamine and other mediators can also be released by non-metabolic mechanisms. In addition to histamine, other mast cell mediators (leukotrienes) also play a role in urticaria.
It has been suggested that about 2/3 of chronic urticaria is related to autoimmunity, and there is enough evidence to prove that: in some patients with chronic urticaria, there are antibodies to functional anti-IgE receptors that can degranulate cutaneous mast cells or eosinophils and/or anti-IgE antibodies, and in the acute exacerbation phase about 58% of the patients have autoantibodies to IgE molecules in their bodies, 25% of the patients have anti-IgE antibodies, and elevated serum IgE antibodies are behind the secretion of inflammatory mediators such as histamine. There have been some case reports of anti-IgE antibodies and anti-leukotriene preparations being effective in the treatment of some chronic urticaria.
Treatment of chronic urticaria
The severity and clinical type of chronic urticaria are highly variable, and therefore treatment regimens should be individualized. As with other allergic diseases, if a definite allergen is identified, avoidance of the allergen should be included in the treatment program.
Clinical treatment of urticaria commonly used drugs are antihistamines, the first generation such as paracetamol can effectively reduce the number of symptoms and lesions, but there are drowsiness and anticholinergic adverse reactions; the second generation such as loratadine, cetirizine hydrochloride and other sedative effect of the weak, is the first-line clinical drugs, but we will find that antihistamines on urticaria effect is very fast, but on the medication can be controlled, do not take the drug will still be up! Urticaria, from acute urticaria to chronic urticaria, drug treatment off and on, still can not get rid of urticaria, in recent years through the study of allergic diseases, as well as IgE-mediated allergy research, people have begun to anti-IgE antibody immunotherapy intervene in a number of chronic allergic diseases such as chronic urticaria, atopic dermatitis (eczema), perennial rhinitis, as well as cough allergy asthma anti-IgE antibody immune self-limiting therapy. IgE antibody immune self-limiting therapy.
Adult anti-allergy probiotic formula Kang Min Yuan anti-allergy probiotics can participate in allergen-specific IgE-mediated immunomutagenic reactions, through the determination of human dendritic cells and anti-allergy probiotics *** with the culture of the secretion of interleukin (IL-12) regulation of Th1 immunity to screen out anti-allergy ability of anti-allergy probiotic strains composed of Kang Min Yuan Anti-allergy probiotics can use active, non-pathogenic microorganisms to improve the ecological balance of the body's largest immune organ - intestinal microorganisms, and thus promote immune tolerance, containing Lactobacillus salivarius has a lower serum IgE allergy antibody of the international patents, continuous supplementation for more than three months to make the body's concentration of IgE reduced, which prevents allergens and IgE antibody binding in the body, and then the body can not be used to prevent the allergen. As a result, the allergens cannot bind with the IgE antibodies in the body, and the series of biochemical reactions of allergy will no longer occur. Therefore, KangMinYuan probiotics can fight against IgE antibodies and adjust the allergic body, while drugs can only relieve the symptoms, but not adjust the allergic body. The effective combination of anti-allergy drugs and anti-allergy probiotics to lower IgE antibody immunotherapy can also produce ideal recovery results, and ultimately shorten the duration of the treatment of urticaria and reduce the recurrence rate of urticaria.
Urticaria (urticaria), commonly known as "rubella", is a limited edema reaction due to the expansion of the skin, mucous membrane elementary school hall and increased permeability. Urticaria can occur at any age, most commonly in adults 20-40 years old, more women than men, according to the different course of urticaria can be divided into acute and chronic two categories. Acute urticaria lasts less than 6 weeks, usually 1~2 weeks, mostly occurring in children and young people, most patients have a clear cause. Urticaria lesions are manifested as wheals, which have the following clinical features: 1) the wheals are bright red and pale white edematous damages with clear boundaries; 2) they vary in size, are round, circular or spread to the surrounding area to form irregular shapes, and can be fused into patches; 3) they occur suddenly, usually subside within 1~24h, and recur repeatedly without leaving any traces; 4) they are accompanied by intense itching or burning sensation; 5) they may occur in any part of the body, mucous membrane involvement, abdominal pain, diarrhea, laryngeal edema, etc., the latter, if occurring in severe patients can be asphyxiation and life-threatening; 6) some patients are also accompanied by fever, nausea, vomiting, chest tightness, palpitations, headache, dizziness, blood pressure drop and other systemic symptoms. In severe cases, symptoms of anaphylactic shock may occur.
Diagnosis of allergic urticaria
The diagnosis of urticaria can be made on the basis of history and clinical manifestations, but it is difficult to determine the cause of the disease, and it is necessary to rely on a detailed history, physical examination and necessary laboratory tests. The history should include the following aspects: the onset of the disease, the duration and frequency of the wind mass, the pattern of diurnal variation, the size, shape and distribution of the wind mass, whether accompanied by angioedema, accompanied by symptoms, family history of allergic diseases, whether to suffer from medical diseases, infectious diseases, history of medication, surgical history, treatment effects, personal preferences, diet, smoking habits, living environment and type of work, mosquito bites, female patients and menstrual cycle, physical examination, and the cause of the urticaria. and menstrual cycle, physical factors and exercise, mental factors, and quality of life. In addition to the detection of antinuclear antibodies and IgE antibody measurement, IgE antibody elevation is also very helpful in the diagnosis of urticaria.
Treatment of allergic urticaria
(I) General treatment
Elimination or treatment of the irritant or cause is most important in the treatment of urticaria because urticaria may subside naturally after elimination of the irritant or suspected factor. Conversely, recurrence of urticaria after re-exposure to the factor in question may provide evidence for the determination of the causative agent.
(2) Systemic therapy
The current systemic therapeutic measures mainly include inhibition of mast cell release mediators and control of inflammatory response, supplementation of anti-allergic probiotic Kangmin yuan to reduce IgE antibodies in serum, and systemic anti-allergic combination therapy is conducive to shortening the treatment cycle of urticaria.
1, inhibit mast cell release mediator
Mast cell release mediator is an important link in the pathogenesis of urticaria, inhibit mast cell release mediator in the treatment of urticaria has a very important position, but can stabilize the mast cell membrane, inhibit mast cell release mediator of the effective drugs are very few. Although adrenocorticotropic hormone has a strong inhibition of mast cell mediators, but must be used for a long time with a large dose, so may produce adverse reactions.
2, antihistamines
Commonly used drugs are cetirizine, loratadine, imipramine, etc., can compete for histamine in the body, thus effectively alleviating allergy symptoms. However, cetirizine can have drowsiness in some patients, imipramine can cause prolongation of the Q-T interval on the electrocardiogram, liver damage and other adverse reactions, and should be used in reduced doses in patients with renal disease.
For acute urticaria can choose 1~2 kinds.
For chronic urticaria, the time of administration can be determined by the time of the onset of the windsock. If there are more hives in the morning, a slightly larger dose should be given before going to bed; if there are more hives at bedtime, a slightly larger dose should be given after dinner. When one antihistamine is ineffective, both can be given at the same time. For intractable urticaria H1 receptor antagonist and H2 receptor antagonist and other joint applications.
3, adult anti-allergy probiotic formula Kang Min Yuan anti-allergy probiotic to reduce allergen-specific IgE antibodies immunomodulation anti-allergy:
People are now on the treatment of hives only focus on symptomatic treatment, and not on the allergic reaction itself: due to allergen stimulation leads to the body's immune function disorders, so that the body of the immunoglobulin E abnormally increased, repeated exposure to allergens make the The body produces a large number of IgE antibodies and long attached to the immune cells, resulting in histamine and other inflammatory mediators of the secretion of harm to the body of an immune response, from the immunological point of view of urticaria, the fundamental treatment should be to control the IgE, regulating the balance of immunoglobulin is the main focus of the current urticaria treatment stays in the stage of inflammation such as antihistamine, part of the people will try to improve immunity to try to treat, but allergies are not However, allergy is not caused by low immunity, the body's five immunoglobulin secretion imbalance is the root cause of the disease, the current international immunological research to solve the problem of urticaria caused by IgE anti-human antibody treatment is a large number of supplementation of the body's anti-allergy probiotic KangMinYuan strengthened to reduce the body's IgE antibodies, by stimulating the secretion of interferon to regulate the balance of immunoglobulin, so as to make the body's immune response to restore the correct. The effective combination of anti-allergy drugs and anti-allergy probiotics can also produce ideal recovery results.
(3) Local treatment
The local topical application of drugs with soothing, anti-itching and astringent effects, such as glycerite lotion, several times a day.
(D) non-drug anti-allergy immunomodulation: intestinal lack of anti-allergy probiotics
There are many types of allergens, such as: dust mites, bacteria, pollen, protein, milk, soy, wheat, mold, meat ...... There are many different kinds of allergens such as dust mites, bacteria, pollen, milk, soy, wheat, mold, meat, etc. Many medical researches have pointed out that allergies caused by "excessive secretion of immune-tolerant IgE" are closely related to good and bad bacteria in the intestinal tract. Some studies have indicated that: allergies, beneficial bacteria in the intestinal tract such as Lactobacillus spp. is relatively small, although there are tens of thousands of Lactobacillus strains exist in nature, but only a very small number of Lactobacillus strains with anti-allergy qualities, this "immune tolerance IgE secretion of excessive" has a special regulation of the effectiveness of the bacteria strains of Lactobacillus salivarius, Lactobacillus griseus, Lactobacillus salivarius, Lactobacillus graminicus, Lactobacillus coelicolor, Lactobacillus paracasei, and Lactobacillus royalei are combined to form Probiotics Cominform. Lactobacillus salivarius reduces serum IgE antibodies and promotes the secretion of interferon to improve Th1-type immune response; while Lactobacillus griseus reduces serum IgG and helps to reduce the secretion of the allergy-related cellular hormone IL-5, which can effectively enhance the body's immune system, and the Kang Min Yuan Enhanced has the ability to assist in the adjustment of the body's allergy.