Avaliação da TSLP em pacientes com urticária crônica espontânea tratados com omalizumabe

Abstract

Chronic spontaneous urticaria (CSU) is defined by the presence of recurrent urticaria, angioedema, or both for a period equal to or greater than six weeks. This study evaluated serum thymic stromal lymphopoietin (TSLP) levels in CSU patients treated with omalizumab compared to those treated with second-generation H1 antihistamines (sgHA). This is a quantitative observational study with a cross-sectional component (TSLP measurement at 90 days) and a longitudinal component (clinical evaluation by UAS7 at 0, 3, and 6 months), in which 36 patients of both sexes, aged 12 years or older, diagnosed with CSU at the Urticaria Diagnosis and Treatment Center (UCARE) of the Hospital and Maternity Therezinha de Jesus in Juiz de Fora-MG, were selected between January 2022 and December 2023. Patients were divided into two groups: G1 (control, n = 18), treated with sgAH, and G2 (n = 18), treated with omalizumab. Ninety days after the start of the study, blood samples were collected from all patients for analysis of serum TSLP levels using an enzyme-linked immunosorbent assay (ELISA). Participants in G2 were evaluated quarterly using the Urticaria Activity Scale (UAS7), at baseline and after three and six months. The Shapiro-Wilk test and t-test were used with GraphPad Prism software (version 6.0), with a significance level of p  0.05. From the final sample (N = 29), females predominated (89.7%), and the overall mean age was 40.90  9.05 years, being higher in G2 (omalizumab, 42.13  9.27 years). Comparison of mean serum TSLP levels between G2 (n = 16: 781.63  510.30 pg/mL) and G1 (n = 13: 836.44  439.97 pg/mL) showed no significant difference (p = 0.3811). From a clinical standpoint, the UAS7 of patients treated with omalizumab showed significant reductions in baseline scores for both the first and second trimesters of follow-up. It is concluded that serum TSLP levels were similar between patients treated with omalizumab and those treated with sgAH. Over six months, patients treated with omalizumab showed significant reductions in UAS7 scores, demonstrating a positive clinical impact. These findings demonstrate that, in this study, the clinical efficacy of omalizumab in CSU can occur independently of detectable changes in serum TSLP levels.