Allergy Asthma Immunol Res.  2015 Sep;7(5):476-482. 10.4168/aair.2015.7.5.476.

Activation of the Intrinsic Coagulation Pathway in Patients With Chronic Urticaria

• Kim JA
• Kim S
• Kim JE
• Gu JY
• Yoo HJ
• Kang HR
• Kim HK

• KMID: 2147956
• DOI: http://doi.org/10.4168/aair.2015.7.5.476

Abstract

PURPOSE
Although coagulation activation has been reported in chronic urticaria, data pertaining to detailed changes in coagulation factors and global coagulation status are lacking. The current study evaluated global coagulation status in patients with chronic urticaria using thrombin generation assay (TGA) and the levels of individual coagulation factors.
METHODS
Patients with chronic urticaria (n=57) and 20 healthy controls were enrolled. TGA was performed under stimulation with 2 concentrations of tissue factor (TF). Coagulation factors and conventional coagulation assays were also analyzed.
RESULTS
Although patients with chronic urticaria showed prolonged activated partial thromboplastin time, prothrombin time did not differ significantly between patients and controls. In both 1 pM and 5 pM TF-stimulated TGA, peak thrombin and endogenous thrombin potential (ETP) levels were markedly decreased in patients with chronic urticaria. As expected, intrinsic coagulation factors (VIII, IX, and XII), as well as coagulation factors of the common pathway (II, V, and X), were consistently decreased. Additionally, D-dimer was significantly increased in patients as compared to controls. In multivariate regression analysis, the presence of chronic urticaria was the only significant independent contributor to the low ETP value.
CONCLUSIONS
Chronic urticaria is characterized by in vivo coagulation activation through the intrinsic coagulation pathway, which can be measured with sensitivity using TGA.

Keyword

Chronic urticaria; coagulation factors; contact pathway; intrinsic coagulation pathway; thrombin generation assay

MeSH Terms

Blood Coagulation Factors
Humans
Partial Thromboplastin Time
Prothrombin Time
Thrombin
Thromboplastin
Urticaria*
Blood Coagulation Factors
Thrombin
Thromboplastin

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