Importance of type M1 and M2 macrophage expression in patients with
chronic spontaneous urticaria
Abstract
Mast cells and basophils interact with various cells in the urticaria
lesion microenvironment, such as macrophages,.which form an essential
component of innate immunity, and are involved in numerous functions
including protein secretion. Objective: The aim of the present study was
to characterize the macrophage phenotype in urticarial lesions of
patients with chronic spontaneous urticaria (CSU) nonresponsive to
antihistamines at optimized doses. And compare the phenotype with
clinical and laboratory parameters such as age, gender, urticaria time,
C-reactive protein (CRP), and total serum IgE, and autologous serum skin
test (ASST). Methods: Twenty-eight patients with CSU refractory to
antihistamines were included in the study. Epidemiological data,
C-reactive protein, D-dimers, basophils in peripheral blood, and total
serum IgE and ASST were assessed. The mannose receptor (CD206), CD163,
CMAF, and pSTAT 1 were used to characterize the M1/M2 macrophage
subpopulations. The immunolabeled cells per square millimeter were
manually enumerated at a 400× magnification in 12 optical fields via
light microscopy. Results: A predominance of M2 macrophages was seen in
CSU patients. Statistical differences were observed between the CD206
marker and the disease course. No correlation was found between
biomarkers and macrophage populations. Expression of CMAF was
significantly higher in the patient sample compared to that in the
control skin (patients without history of urticaria; p-value <
0.001). Conclusion: M2 macrophages were seen with significantly higher
CMAF expression, which indicates macrophage activation in patients with
CSU. CD206 expression was inversely correlated with disease time.