Efficacy of autologous whole blood or serum therapy for chronic spontaneous urticaria: A systematic review and meta-analysis
The Journal of dermatological treatment. 2019;:1-28
BACKGROUND Chronic spontaneous urticaria (CSU) is chronic wheals without identifiable exogenous stimuli. Autologous whole blood (AWB) injection and autologous serum therapy (AST) are alternative therapies for CSU that induce tolerance to circulating histamine-releasing factors. OBJECTIVE We elucidated currently available evidence for the efficacy and safety of AWB therapy and AST for CSU. METHODS We systematically searched four databases for eligible studies to perform meta-analysis. The primary outcome was the efficacy of AST or AWB therapy, and the secondary outcome was improvement after intervention based on the autologous serum skin test (ASST) status of patients. RESULTS Eight clinical trials, including four randomized controlled trials and 529 CSU patients, were identified. AST was not more effective than the placebo treatment in alleviating CSU symptoms at the end of treatment (P = 0.161), and AWB injection was also not more effective in response rates than the placebo at the end of follow-up (P = 0.099). Furthermore, the efficacy of AST or AWB injection for CSU and the ASST status were not significantly related. No remarkable adverse events were recorded during therapy. CONCLUSIONS Our meta-analysis suggested that AWB therapy and AST are not significantly more effective in alleviating CSU symptoms than the placebo treatment.
The influence of a partially HLA-matched blood transfusion on the disease activity of rheumatoid arthritis
OBJECTIVE Based on the immunosuppressive effects of blood transfusions in organ transplantation, we determined the effect of a blood transfusion on disease activity of rheumatoid arthritis (RA). METHOD In this double-blind pilot study, 40 patients with active RA were randomly assigned to receive a HLA-DRB1-matched blood transfusion (n = 30) or placebo (n = 10). Disease activity was scored according to the American College of Rheumatology response criteria during 6 months of follow-up. RESULTS After 1 month and 6 months, respectively, 6 and 16% of patients fulfilled the response criteria in the blood transfusion group compared to none and 30%, respectively, in the placebo group. Following correction for the increase in haemoglobin levels, a majority of the response parameters in the blood transfusion group showed significant improvement compared to the placebo group. CONCLUSION A DRB1-matched blood transfusion shows improvement of symptoms in several RA patients. Additional studies are required to identify blood transfusion regimens that enhance the potential for therapeutic responses.