Association between circulating thyroperoxidase (TPO), anti-TPO IgE, anti-TPO IgG, and different clinical outcomes in chronic urticaria: A hypothesis-generating study
{"title":"Association between circulating thyroperoxidase (TPO), anti-TPO IgE, anti-TPO IgG, and different clinical outcomes in chronic urticaria: A hypothesis-generating study","authors":"Juan-Felipe Lopez MD, MSc, PhD(c) , Valentina Bedoya MSc , Julián-Camilo Arango MSc, PhD , Tonny-Williams Naranjo MSc, PhD , Elizabeth Garcia MD, EAC , Jorge Sanchez MD, EAC, MSc, PhD","doi":"10.1016/j.waojou.2025.101116","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>In chronic spontaneous urticaria (CSU), multiple biomarkers have been described, including autoantibodies against thyroperoxidase (TPO). However, the simultaneous analysis of both IgE anti-TPO and IgG anti-TPO alongside blood TPO has not been performed.</div></div><div><h3>Objective</h3><div>We conducted this hypothesis-generating study to evaluate the association between blood TPO, anti-TPO IgE, and anti-TPO IgG and explore their relationships with some clinical variables.</div></div><div><h3>Methods</h3><div>Patients aged 12–80 years with a clinical diagnosis of CSU were included in this study. First, the biomarkers between a CSU group and a non-CSU group were compared (case–control design). Second, the relationship between the biomarkers and clinical characteristics was explored in the CSU group with a twelve-month follow-up.</div></div><div><h3>Results</h3><div>The blood concentration of TPO was higher in the CSU group than in the control group, though this was not statistically significant (median 3.8 ng/mL vs. 13.3 ng/mL <em>p</em> = 0.4). The blood concentration of TPO was not associated with the presence of anti-TPO IgE or IgG. A total of 42 patients (61.2% versus 9.3% in non-CSU group) had anti-TPO IgG (29.4%) or anti-TPO IgE (42.6%) autoantibodies, and 7 patients (10.2%) had both. In the exploratory analysis, anti-TPO IgE and anti-TPO IgG were associated with different clinical clusters.</div></div><div><h3>Conclusion</h3><div>In this hypothesis-generating study, TPO levels do not appear to determine the presence of autoantibodies in patients with CSU. About half of patients with CSU have either an IgE or IgG autoantibody against TPO, but few patients have both, and each autoantibody is associated with a different clinical profile, suggesting that there are perhaps independent CSU mechanisms with a common target. Future studies are required to confirm this hypothesis.</div></div>","PeriodicalId":54295,"journal":{"name":"World Allergy Organization Journal","volume":"18 10","pages":"Article 101116"},"PeriodicalIF":4.3000,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Allergy Organization Journal","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1939455125000936","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
In chronic spontaneous urticaria (CSU), multiple biomarkers have been described, including autoantibodies against thyroperoxidase (TPO). However, the simultaneous analysis of both IgE anti-TPO and IgG anti-TPO alongside blood TPO has not been performed.
Objective
We conducted this hypothesis-generating study to evaluate the association between blood TPO, anti-TPO IgE, and anti-TPO IgG and explore their relationships with some clinical variables.
Methods
Patients aged 12–80 years with a clinical diagnosis of CSU were included in this study. First, the biomarkers between a CSU group and a non-CSU group were compared (case–control design). Second, the relationship between the biomarkers and clinical characteristics was explored in the CSU group with a twelve-month follow-up.
Results
The blood concentration of TPO was higher in the CSU group than in the control group, though this was not statistically significant (median 3.8 ng/mL vs. 13.3 ng/mL p = 0.4). The blood concentration of TPO was not associated with the presence of anti-TPO IgE or IgG. A total of 42 patients (61.2% versus 9.3% in non-CSU group) had anti-TPO IgG (29.4%) or anti-TPO IgE (42.6%) autoantibodies, and 7 patients (10.2%) had both. In the exploratory analysis, anti-TPO IgE and anti-TPO IgG were associated with different clinical clusters.
Conclusion
In this hypothesis-generating study, TPO levels do not appear to determine the presence of autoantibodies in patients with CSU. About half of patients with CSU have either an IgE or IgG autoantibody against TPO, but few patients have both, and each autoantibody is associated with a different clinical profile, suggesting that there are perhaps independent CSU mechanisms with a common target. Future studies are required to confirm this hypothesis.
期刊介绍:
The official pubication of the World Allergy Organization, the World Allergy Organization Journal (WAOjournal) publishes original mechanistic, translational, and clinical research on the topics of allergy, asthma, anaphylaxis, and clincial immunology, as well as reviews, guidelines, and position papers that contribute to the improvement of patient care. WAOjournal publishes research on the growth of allergy prevalence within the scope of single countries, country comparisons, and practical global issues and regulations, or threats to the allergy specialty. The Journal invites the submissions of all authors interested in publishing on current global problems in allergy, asthma, anaphylaxis, and immunology. Of particular interest are the immunological consequences of climate change and the subsequent systematic transformations in food habits and their consequences for the allergy/immunology discipline.