mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2024-26-4-21-26mes-236Research ArticleИММУНОЛОГИЯIMMUNOLOGYСубстанция Р и стресс ассоциированы с развитием хронической крапивницыSubstance P and stress are associated with the development of chronic urticariahttps://orcid.org/0000-0002-3196-8300МикрюковаН. В.MikryukovaN. V.

Микрюкова Наталья Васильевна

Санкт-Петербург

St. Petersburg

natalya@mikryukov.infohttps://orcid.org/0000-0001-8444-9662КалининаН. М.KalininaN. M.

Калинина Наталия Михайловна, д-р мед. наук, профессор

Санкт-Петербург

 

St. Petersburg

doctkalin@mail.ruВсероссийский центр экстренной и радиационной медицины им. А.М. Никифорова МЧС РоссииРоссияNikiforov Russian Center of Emergency and Radiation MedicineRussian FederationВсероссийский центр экстренной и радиационной медицины им. А.М. Никифорова МЧС России; Первый Санкт-Петербургский государственный медицинский университет им. И.П. ПавловаРоссияNikiforov Russian Center of Emergency and Radiation Medicine; First Pavlov State Medical University of St. PetersburgRussian Federation2024211120242642126Copyright © Микрюкова Н.В., Калинина Н.М., 20242024Микрюкова Н.В., Калинина Н.М.Mikryukova N.V., Kalinina N.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/236Введение

Введение. Аллергические заболевания являются актуальной проблемой практического здравоохранения и в последнее десятилетие привлекают все более пристальное внимание врачей различных специальностей. Ведущим звеном в патогенезе стресс-индуцированной крапивницы является нейрогенное иммунное воспаление, сопровождающееся повышением уровня нейропептида субстанции Р (SP).

Цель

Цель. Анализ взаимосвязи между стрессорным фактором и уровнем субстанции Р с последующим обоснованием показателя в качестве биомаркера для оценки клинического течения и прогноза заболевания у пациентов с хронической крапивницей.

Материалы и методы

Материалы и методы. Исследование проведено с участием 165 взрослых в возрасте от 18 до 68 лет. В основную группу были включены 97 пациентов с подтвержденным диагнозом хронической крапивницы (ХК), проходивших лечение в клинике в период с 2018 по 2023 г. Группу сравнения составили 68 практически здоровых лиц, сопоставимых по полу и возрасту с исследуемой группой пациентов. Уровень субстанции Р в сыворотке крови определяли методом иммуноферментного анализа (Infinite F50 Tecan, Австрия) с использованием тест-системы CEA393Hu. Статистическую обработку результатов осуществляли с использованием программного комплекса STATA 18 (StataCorp LLC).

Результаты

Результаты. Отмечалось повышение продукции субстанции P у пациентов с ХК 220,62 пг/мл по отношению к группе сравнения — 96,57 пг/мл, p < 0,001. При анализе логистической регрессии выявлена ассоциация между стрессом, уровнем субстанции Р у пациентов с ХК и установлено, что при увеличении концентрации субстанции Р на 1 пг/мл шанс возникновения ХК увеличивался в 1,02 раза, при наличии стрессовой ситуации в качестве триггера риск развития ХК повышался в 3 раза.

Выводы

Выводы. С помощью построения мультивариантной модели логистической регрессии получены положительные значения параметров модели (с уровнем значимости p ≤ 0,01), указывающие на то, что именно воздействие стресс-фактора и повышение концентрации субстанции Р в крови ассоциировано с увеличением шанса возникновения хронической крапивницы. На основании полученных данных концентрация субстанции Р в крови пациентов с ХК может рассматриваться в качестве потенциального диагностического биомаркера, который можно рекомендовать для расширения панели скрининговых тестов, уточняющих патогенез возникновения заболевания, что позволит улучшить дифференциальную диагностику нозологии и обеспечить раннее выявление пациентов со стресс-индуцированной крапивницей.

Introduction

Introduction. Allergic diseases are a pressing challenge in practical healthcare, attracting increased attention of various medical specialists. The pathogenesis of stress-induced urticaria is driven by neurogenic immune inflammation, accompanied by an increase in the level of neuropeptide substance P (SP).

Objective

Objective. Assessment of the relationship between stress factors and substance P levels with the purpose of justifying the use of SP as a biomarker for assessing the clinical course and prognosis of the disease in patients with chronic urticaria.

Materials and methods

Materials and methods. The study was involved 165 adults aged 18–68 years. The main group included 97 patients with the confirmed diagnosis of chronic urticaria (CU) who were treated in a hospital setting in the period from 2018 to 2023. The comparison group included 68 practically healthy individuals, comparable in gender and age with the study group of patients. The level of substance P in the blood serum was estimated by immunoenzymatic techniques (Infinite F50 Tecan, Austria), using a CEA393Hu test system. Statistical processing of the results was performed using the STATA 18 software package (StataCorp LLC).

Results

Results. An increase in the production of substance P to 220.62 pg/mL in CU patients, compared to 96.57 pg/mL in the reference group (p < 0.001), was observed. The logistic regression revealed an association between stress and substance P levels in CU patients. Thus, an increase in the concentration of substance P by 1 pg/mL led to a 1.02-fold increase in the CU risk. The CU risk increased by 3 times in the presence of a stress situation as a trigger.

Conclusions

Conclusions. The constructed multivariant logistic regression model produced positive values of the model parameters (p ≤ 0.01). This indicates the correlation between the increased blood levels of substance P under the impact of stress factors and the risk of chronic urticaria development. The data obtained suggests that the concentration of substance P in the blood of CU patients can be considered as a potential diagnostic biomarker. This biomarker can be recommended for extending panel screening tests to clarify the pathogenesis of the disease, thus improving the differential diagnosis of the disease and facilitating early detection of patients with stress-induced urticaria.

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The authors declare that there are no conflicts of interest present.