Association between Dehydroepiandrosterone-sulfate and Chronic Urticaria: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 NINGXiao-li ,  ZANGYun-shu , PANMin

Department of Dermatology, Affiliated Hospital of Qingdao University, Qingdao 266003, China;

Corresponding author：

ZANGYun-shu, Email: 13573233611@139.com

Keywords：

Chronic urticaria; Dehydroepiandrosterone-sulfate; Case-control study; Meta-analysis

DOI：

10.7507/1672-2531.20160173

Video：

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Objective To systematically review the association between dehydroepiandrosterone-sulfate (DHEA-S) and chronic urticarial (CU). Methods We searched databases including The Cochrane Library (Issue 3, 2015), PubMed, EMbase, CBM, VIP, CNKI and WanFang Data from inception to January 2016, to collect case-control studies about the association between DHEA-S and CU. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using RevMan 5.3 software. Results A total of 8 papers involving 9 case-control studies were included. The results of meta-analysis showed that DHEA-S might be associated with CU (SMD=-0.93, 95%CI -1.35 to -0.50, P<0.000 01). Subgroup analysis by the difference of measuring methods, indicated that DHEA-S might be associated with CU (ECLIA: SMD=-0.75, 95% CI -1.08 to -0.42, P<0.000 01; ELISA: SMD=-0.59, 95% CI -0.87 to -0.31, P<0.000 1; EIA: SMD=-2. 70, 95% CI -3.30 to -2.10, P<0.000 01). Sensitivity analysis showed that our results were reliable and stable. Conclusion The meta-analysis suggests that DHEA-S might be associated with CU. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.

Citation： NINGXiao-li, ZANGYun-shu, PANMin. Association between Dehydroepiandrosterone-sulfate and Chronic Urticaria: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(10): 1131-1136. doi: 10.7507/1672-2531.20160173 Copy

1.	中华医学会皮肤性病学分会免疫学组. 中国荨麻疹诊疗指南(2014版). 中华皮肤科杂志, 2014, 47(7): 514-516.
2.	Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy, 2009, 64(10): 1427-1443.
3.	Zhong H, Song Z, Chen W, et al. Chronic urticaria in Chinese population: a hospital-base dmuhicenter epidemiological study. Allergy, 2013, 69(3): 359-364.
4.	Kasperska-Zajac A, Brzoza Z, Rogala B. Sex hormones and urticaria. J Dermatol Sci, 2008, 52(2): 79-86.
5.	Kasperska-Zajac A, Brzoza Z, Rogala B. Dehydroepiandrosterone and Dehydroepiandrosterone Sulphate in Atopic Allergy and Chronic Urticaria. Inflammation, 2008, 31(3): 141-145.
6.	Kasperska-Zajac A. Does dehydroepiandrosterone Influence the expression of urticaria?-a mini review. Inflammation, 2011, 34(5): 362-366.
7.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
8.	Zeng X, Zhang Y, Kwong JS, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med, 2015, 8(1): 2-10.
9.	Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range and the size of a sample. MC Med Res Methodol, 2005, 5: 13.
10.	文进, 李幼平. Meta分析中效应尺度指标的选择. 中国循证医学杂志, 2007, 7(8): 606-613.
11.	Kasperska-Zajac A, Brzoza Z, Rogala B. Serum concentration of dehydroepian-drosterone sulphate in female patients with chronic idiopathic urticaria. J Dermatol Sci, 2006, 41(1): 80-81.
12.	Kasperska-Zajac A, Brzoza Z, Rogala B. Lower serum concentration of dehydroepiandrosterone sulphate in patients suffering from chronic idiopathic urticaria. Allergy, 2006, 61(12): 1489-1490.
13.	Kasperska-Zajac A, Brzoza Z, Rogala B. Circulating concentration of dehydroepiandrosterone sulfate(DHEA-S) in women suffering from chronic idiopathic urticaria in relation to their pre- or post-menopausal status. Maturities, 2007(3), 58: 211-215.
14.	Kasperska-Zajac A, Brzoza Z, Rogala B. Plasma concentration of interleukin6 (IL-6), and its relationship with circulating concentration of dehydroepiandrosteronesulfate (DHEA-S) in patients with chronic idiopathic urticaria. Cytokine, 2007, 39(2): 142-146.
15.	Brzoza Z, Kasperska-Zajac A, Rogala B. Serum prolactin concentration and its relationship with dehydroepiandrosterone sulfate concentration in chronic urticaria patients with positive and negative response to autologous serum skin test. Allergy, 2007, 62(5): 566-567.
16.	叶有兴, 陈明春. 慢性荨麻疹患者血清去氢表雄酮和硫酸去氢表雄酮水平的测定及临床意义. 广州: 中山大学, 2008.
17.	Sabry MK, Farres MN, Melek NA, et al. Prolactinand Dehydroepiandrosterone Sulfate: Are They Related to the Severity of Chronic Urticaria? Arch Med Res, 2013, 44(1): 21-26.
18.	Ucmak D, Akkurt M, Ucmak F, et al. Investigation of dermatology life quality index and serum prolactin and serum dehydroepiandrosterone sulphate levels in patients with chronic urticaria. Asian Pac J Allergy Immunol, 2014, 32(4): 293-299.
19.	Pawlikowski M. Adrenal cortex-the next biological clock. Neuro Endocrinol, 2005, 26(3): 193-195.
20.	Rook GA, Hernandez-Pando R, Lightman SL. Hormones, peripherally activated prohormones and regulation of the Th1/Th2 balance. Immunol Today, 1994, 15(7): 301-303.
21.	Kroboth PD, Salek FS, PittengerAL, et al. DHEA and DHEA-S: a review. J Clin Pharmacol, 1999, 39(4): 327-348.
22.	Burger HG, Dudley EC, Cui J, et al. A prospective longitudinal study of serum testosteernoe, dehydroepiandrosterone sulphate and sex hormone binding globulin levels through the menopause transition. J Clin Endocrinol Metab, 2000, 85(8): 2832-2938.
23.	Burger HG. Androgen production in women. Fertill Steril, 2002, 77(Suppl4): S3-S5.
24.	Laaughlin GA, Barrett-connor E. Sexual dimorphism in the influence of advanced aging on adrenal hormone levels: The Rancho Bernardo Study. J Clin Endocrinol Metab, 2000, 85(10): 3561-3568.
25.	Straub RH, Schuld A, Mullington J, et al. The endotoxin-induced increase of cytokines is followed by an increase of cortisol relative to dehydroepiandrosterone (DHEA) in healthy male subjects. J Endocrinol, 2002, 175(2): 467-474.
26.	Schwartz KE. Autoimmunity, dehydroepiandrosterone (DHEA), and stress. J Adoles Health, 2002, 30(4 Suppl): 37-43.
27.	Pastore S, Berti I, Longo G. Autoimmune chronic urticaria: transferability of autologous serum skin test. Eur J Pediatrics, 2013, 172(4): 569-569.
28.	Mizota K,Yoshida A, Uchida H, et al. Novel type of Gq/11protein-coupled neurosteroid receptor sensitive to endocrine disrupting chemicals in mast cell line (RBL-2H3). Br J Pharmacol, 2005, 145(4): 545-550.
29.	Brzoza Z, Kasperska-Zajac A, Badura-Brzoza K, et al. Decline in dehydroepiandrosterone sulphate observed in chronic urticaria is associated with psycho-logical istress. Psychosom Med, 2008, 70(6): 723-728.
30.	Murakami K, Nakagawa T, Yamashiro G, et al. Adrenal steroids in serum during danazol therapy, taking into account cross-reactions between danazol metabolites and serum androgens. Endocrine Journal, 1993, 40(6): 659-664.
31.	Ceuppens JL, Stevens E, Rijon M. Danazol treatment in chronic urticaria and delayed pressure urticaria: effect on protease inhibitors. Allergie und Immunologie, 1985, 17(1): 46-51.

1. 中华医学会皮肤性病学分会免疫学组. 中国荨麻疹诊疗指南(2014版). 中华皮肤科杂志, 2014, 47(7): 514-516.
2. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy, 2009, 64(10): 1427-1443.
3. Zhong H, Song Z, Chen W, et al. Chronic urticaria in Chinese population: a hospital-base dmuhicenter epidemiological study. Allergy, 2013, 69(3): 359-364.
4. Kasperska-Zajac A, Brzoza Z, Rogala B. Sex hormones and urticaria. J Dermatol Sci, 2008, 52(2): 79-86.
5. Kasperska-Zajac A, Brzoza Z, Rogala B. Dehydroepiandrosterone and Dehydroepiandrosterone Sulphate in Atopic Allergy and Chronic Urticaria. Inflammation, 2008, 31(3): 141-145.
6. Kasperska-Zajac A. Does dehydroepiandrosterone Influence the expression of urticaria?-a mini review. Inflammation, 2011, 34(5): 362-366.
7. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
8. Zeng X, Zhang Y, Kwong JS, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med, 2015, 8(1): 2-10.
9. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range and the size of a sample. MC Med Res Methodol, 2005, 5: 13.
10. 文进, 李幼平. Meta分析中效应尺度指标的选择. 中国循证医学杂志, 2007, 7(8): 606-613.
11. Kasperska-Zajac A, Brzoza Z, Rogala B. Serum concentration of dehydroepian-drosterone sulphate in female patients with chronic idiopathic urticaria. J Dermatol Sci, 2006, 41(1): 80-81.
12. Kasperska-Zajac A, Brzoza Z, Rogala B. Lower serum concentration of dehydroepiandrosterone sulphate in patients suffering from chronic idiopathic urticaria. Allergy, 2006, 61(12): 1489-1490.
13. Kasperska-Zajac A, Brzoza Z, Rogala B. Circulating concentration of dehydroepiandrosterone sulfate(DHEA-S) in women suffering from chronic idiopathic urticaria in relation to their pre- or post-menopausal status. Maturities, 2007(3), 58: 211-215.
14. Kasperska-Zajac A, Brzoza Z, Rogala B. Plasma concentration of interleukin6 (IL-6), and its relationship with circulating concentration of dehydroepiandrosteronesulfate (DHEA-S) in patients with chronic idiopathic urticaria. Cytokine, 2007, 39(2): 142-146.
15. Brzoza Z, Kasperska-Zajac A, Rogala B. Serum prolactin concentration and its relationship with dehydroepiandrosterone sulfate concentration in chronic urticaria patients with positive and negative response to autologous serum skin test. Allergy, 2007, 62(5): 566-567.
16. 叶有兴, 陈明春. 慢性荨麻疹患者血清去氢表雄酮和硫酸去氢表雄酮水平的测定及临床意义. 广州: 中山大学, 2008.
17. Sabry MK, Farres MN, Melek NA, et al. Prolactinand Dehydroepiandrosterone Sulfate: Are They Related to the Severity of Chronic Urticaria? Arch Med Res, 2013, 44(1): 21-26.
18. Ucmak D, Akkurt M, Ucmak F, et al. Investigation of dermatology life quality index and serum prolactin and serum dehydroepiandrosterone sulphate levels in patients with chronic urticaria. Asian Pac J Allergy Immunol, 2014, 32(4): 293-299.
19. Pawlikowski M. Adrenal cortex-the next biological clock. Neuro Endocrinol, 2005, 26(3): 193-195.
20. Rook GA, Hernandez-Pando R, Lightman SL. Hormones, peripherally activated prohormones and regulation of the Th1/Th2 balance. Immunol Today, 1994, 15(7): 301-303.
21. Kroboth PD, Salek FS, PittengerAL, et al. DHEA and DHEA-S: a review. J Clin Pharmacol, 1999, 39(4): 327-348.
22. Burger HG, Dudley EC, Cui J, et al. A prospective longitudinal study of serum testosteernoe, dehydroepiandrosterone sulphate and sex hormone binding globulin levels through the menopause transition. J Clin Endocrinol Metab, 2000, 85(8): 2832-2938.
23. Burger HG. Androgen production in women. Fertill Steril, 2002, 77(Suppl4): S3-S5.
24. Laaughlin GA, Barrett-connor E. Sexual dimorphism in the influence of advanced aging on adrenal hormone levels: The Rancho Bernardo Study. J Clin Endocrinol Metab, 2000, 85(10): 3561-3568.
25. Straub RH, Schuld A, Mullington J, et al. The endotoxin-induced increase of cytokines is followed by an increase of cortisol relative to dehydroepiandrosterone (DHEA) in healthy male subjects. J Endocrinol, 2002, 175(2): 467-474.
26. Schwartz KE. Autoimmunity, dehydroepiandrosterone (DHEA), and stress. J Adoles Health, 2002, 30(4 Suppl): 37-43.
27. Pastore S, Berti I, Longo G. Autoimmune chronic urticaria: transferability of autologous serum skin test. Eur J Pediatrics, 2013, 172(4): 569-569.
28. Mizota K,Yoshida A, Uchida H, et al. Novel type of Gq/11protein-coupled neurosteroid receptor sensitive to endocrine disrupting chemicals in mast cell line (RBL-2H3). Br J Pharmacol, 2005, 145(4): 545-550.
29. Brzoza Z, Kasperska-Zajac A, Badura-Brzoza K, et al. Decline in dehydroepiandrosterone sulphate observed in chronic urticaria is associated with psycho-logical istress. Psychosom Med, 2008, 70(6): 723-728.
30. Murakami K, Nakagawa T, Yamashiro G, et al. Adrenal steroids in serum during danazol therapy, taking into account cross-reactions between danazol metabolites and serum androgens. Endocrine Journal, 1993, 40(6): 659-664.
31. Ceuppens JL, Stevens E, Rijon M. Danazol treatment in chronic urticaria and delayed pressure urticaria: effect on protease inhibitors. Allergie und Immunologie, 1985, 17(1): 46-51.

Chinese Journal of Evidence-Based Medicine

Association between Dehydroepiandrosterone-sulfate and Chronic Urticaria: A Meta-analysis

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