To evaluate the role and relevance of cytokines IL-17, IL-18, IL-23 and TNF-α and their correlation with disease severity in chronic urticaria

Introduction: The basic event in the pathogenesis of urticaria is inappropriate activation and degranulation of dermal mast cells. Cytokines are soluble polypeptide mediators that play a key role in immunological, inflammatory and reparative host responses including chronic urticaria. Objective: The aim of this study was to evaluate the role and relevance of cytokines interleukin-17 (IL-17), interleukin-18(IL-18), interleukin-23(IL-23) and tumor necrosis factor-alpha (TNF-alpha) and their correlation with disease severity in patients with chronic urticaria. Materials and Methods: A prospective cross-sectional study was conducted to measure the serum concentration of IL-17, IL-18, IL-23 and TNF-alpha in 50 chronic urticaria patients and in 30 healthy controls. Disease activity was assessed by using urticaria activity score (UAS). Results: Serum concentration of IL-17, IL-18, IL-23 and TNF-alpha were significantly higher during the acute episode in chronic urticaria patients as compared with the healthy control subjects (mean: 1.84 +/- 0.81 vs 0.03 +/- 0.02 pg/ml; P < 0.001, 501.41 <plus/minus> 208.98 vs 218.39 +/- 39.83 pg/ml; P < 0.001; 25.57 <plus/minus> 10.79 vs 0.15 +/- 0.14 pg/ml, P < 0.001; and 455.54 <plus/minus> 253.54 vs 8.498 +/- 3.644 pg/ml, P < 0.001, respectively). There was a significant positive correlation between serum levels of IL-17, IL-18, IL-23 and TNF-<alpha> and severity of disease. Conclusion: The serum levels of IL-17, IL-18, IL-23 and TNF-alpha were raised in patients of chronic urticaria and positively correlated with the severity of urticaria.