Chinese Journal of Dermatology ›› 2023, Vol. 56 ›› Issue (2): 184-187.doi: 10.35541/cjd.20210377

• Reviews • Previous Articles    

Autologous serum skin test: immunological mechanisms and its associations with clinical features and prognosis of chronic spontaneous urticaria

Yu Miao1,2, Song Xiaoting1, Liu Bo1, Liao Shuanglu1, Luan Tingting1,2, Zhao Zuotao1   

  1. 1Department of Dermatology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, National Clinical Research Center for Skin and Immune Diseases, Beijing 100034, China; 2Peking University School of Nursing, Beijing 100191, China
  • Received:2021-05-12 Revised:2021-12-25 Online:2023-02-15 Published:2023-02-01
  • Contact: Zhao Zuotao

Abstract: 【Abstract】 Autologous serum skin test (ASST) is commonly used as a screening test to assess immune subtypes of chronic spontaneous urticaria (CSU) in clinical practice, but its immunological mechanisms and associations with clinical features and prognosis of CSU are not yet clear. Studies have shown that positive ASST is associated with increased immunoglobulin G autoantibodies, decreased eosinophil and basophil counts, increased CD63 expression on basophils, and changes in circulating inflammatory cytokine levels in CSU patients, but not associated with age, disease duration, and personal or family history of CSU patients, and may be a predictor of severity of chronic urticaria. ASST-positive patients may respond poorly to second-generation H1 antihistamines, slowly to omalizumab, but respond well to cyclosporine and autologous whole blood/serum injections. This review summarizes the immunological and clinical characteristics of ASST-positive patients, and discusses the predictive value of positive ASST for the efficacy of different treatment regimens.

Key words: Urticaria, Chronic spontaneous urticaria, Autologous serum skin test, Immunoglobulin G, Omalizumab