Different serum cytokine levels in chronic vs. acute Anisakis simplex sensitization-associated urticaria

P>The knowledge on immune mechanisms of chronic urticaria (CU) at the cytokine level is widely scarce. We compared pro- and anti-inflammatory as well as Th1- and Th2-associated serum cytokine levels in two phenotypes of CU: associated with (CU+) and without (CU-) sensitization against Anisakis simplex, a ubiquitous fish parasite, that has been associated with acute urticaria in gastro-allergic anisakiasis (GAA) and with CU+. Thirteen CU+ and 19 CU- patients were compared with 13 GAA patients and 15 control subjects for cytokines, measured by cytometric bead array. Urticaria activity score was positively correlated with IL-6 in CU-. Serum levels of IL-10 were lower in CU+ and CU- with respect to the control group. Median IFN-gamma was lower in all urticaria groups. Patients with previous parasitism by A. simplex displayed higher TGF-beta levels than subjects without previous parasitism. The main finding was lower levels of IL-17 in CU+ with respect to GAA or controls, with a further tendency to even lower levels in CU-. Different urticaria phenotypes are associated with distinct serum cytokine levels.