Serum concentration of IL-17, IL-23 and TNF-α among patients with chronic spontaneous urticaria: association with disease activity and autologous serum skin test

Background Chronic spontaneous urticaria (CSU) is a common skin disorder, which is considered in a subset of patients to be an autoimmune disorder. T helper 17 (Th17) cells are crucially involved in the pathogenesis of some autoimmune diseases. Objectives Our aim was to test the association of Th17 with CSU. We examined interleukin (IL)-17, IL-23 and tumor necrosis factor-alpha (TNF-alpha) serum levels in CSU patients and studied their association with urticaria activity and autologous serum skin test (ASST). Subjects and methods Serum concentration of IL-17, IL-23 and TNF-alpha were measured in 75 patients with CSU and 30 healthy control subjects. Disease activity was assessed by using urticaria activity score (UAS) as recommended by EAACI/GA(2)LEN/EDF/WAO Guidelines. Results Serum concentration of IL-17, IL-23 and TNF-alpha were significantly higher in CSU patients as compared with the healthy control subjects (mean: 35.51 +/- 31.14 vs. 4.60 +/- 1.38pg/mL; P<0.001, 38.95 +/- 27.82 vs. 9.87 +/- 4.62pg/mL; P>0.001 and 17.93 +/- 6.05 vs. 6.87 +/- 3.73pg/mL; P=0.004, respectively). There were significant positive correlation between serum IL-17, IL-23, TNF-alpha and disease activity assessed by cumulative UAS for 7days before blood sampling. The Serum concentration of IL-17, IL-23 and TNF-alpha were also significantly higher in ASST positive patients than in ASST negative patients. Conclusion Our results showed high serum levels of IL-17, IL-23 and TNF-alpha among CSU patients which may highlight a functional role of these cytokines in the pathogenesis of this important and common skin disease. It also may provide the rationale for new treatment strategies in chronic urticaria.