Autologous serum therapy in chronic spontaneous urticaria: useful in both ASST positive and negative patients


  • Vijayalakshmi Talwar Consultant Dermatologist, Dr. Venu Skin Clinic, Bellary, India
  • Puspha Bhaskar Consultant Dermatologist, Bellary, India



Chronic urticaria, Autologous serum skin test, Autologous serum therapy, Urticaria activity score, Autoimmune urticaria, High affinity IgE receptors


Background: Chronic urticaria is a common disorder that affects 0.1% of the population. Point prevalence is between 0.5 and 1.0% for chronic spontaneous urticaria. Functional IgG antibodies against IgE or high-affinity IgE receptors can be detected in 25-30% of patients with chronic spontaneous urticaria. Autologous serum therapy is a novel and cost-effective therapy. The aim of the study was to evaluate Autologous serum therapy's (AST) efficacy in chronic urticaria patients.

Methods: 106 patients with chronic urticaria were enrolled. Patients were categorized into two groups based on autologous serum skin therapy- ASST positive and ASST negative. Intramuscular injection of 0.05 ml/kg of autologous serum was injected every week for up to 9 weeks. Urticaria activity scoring (UAS) questionnaire was used to quantify the symptoms before the therapy and at nine weeks.

Results: Significant improvement in urticaria activity score was noted in both groups of the patients from the baseline and at nine weeks. (UAS reduced from 15.3 to 10.8 in ASST positive patients, and in ASST negative patients, UAS decreased from 16.2 to 10.1).  

Conclusions: Both ASST positive and ASST negative patients showed significant improvement at nine weeks after starting autologous serum therapy. AST can be an effective modality for both patients.


Humphreys F. Major landmarks in the history of urticarial disorders. Int J Dermatol. 1997;36(10):793-6.

Griffiths CEM, Barker JNWN. In: Griffiths C, Baker J, Bleiker T, Chalmers R, Creamer D, eds. Urticaria. Rook's textbook of Dermatology. 9th ed. United Kingdom: John Wiley and Sons; 2016: 1-18.

Maurer M, Weller K, Jensen C, Arnau A, Bousquet PJ, Bousquet J, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report. Allergy. 2011;66(3):317-30.

Konstantinou GN, Asero R, Maurer M, Sabroe RA, Grendelmeier P, Grattan CE. EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria. Allergy. 2009;64(9):1256-68.

Hide M, Francis DM, Grattan CE, Hakimi J, Kochan JP, Greaves MW. Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria. N Engl J Med. 1993;328(22):1599-604.

Iqbal K, Bhargava K, Skov PS, Falkencrone S, Grattan CE. A positive serum basophil histamine release assay is a marker for ciclosporin-responsiveness in patients with chronic spontaneous urticaria. Clin Transl Allergy. 2012;2(1):19.

Grattan CE, Wallington TB, Warin RP, Kennedy CT, Bradfield JW. A serological mediator in chronic idiopathic urticaria--a clinical, immunological and histological evaluation. Br J Dermatol. 1986;114(5):583-90.

Sabroe RA, Grattan CE, Francis DM, Barr RM, Kobza BA, Greaves MW. The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. Br J Dermatol. 1999;140(3):446-52.

Majid I, Shah S, Hassan A, Aleem S, Aziz K. How Effective is Autologous Serum Therapy in Chronic Autoimmune Urticaria. Indian J Dermatol. 2015;60(1):102.

Debbarman P, Sil A, Datta PK, Bandyopadhyay D, Das NK. Autologous serum therapy in chronic urticaria: a promising complement to antihistamines. Indian J Dermatol. 2014;59(4):375-82.

Zuberbier T, Asero R, Jensen C, Canonica G, Church MK, Arnau A, et al. EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy. 2009;64(10):1417-26.

George M, Balachandran C, Prabhu S. Chronic idiopathic urticaria: comparison of clinical features with positive autologous serum skin test. Indian J Dermatol Venereol Leprol. 2008;74(2):105-8.

Godse KV. Autologous serum skin test in chronic idiopathic urticaria. Indian J Dermatol Venereol Leprol. 2004;70(5):283-4.

Staubach P, Onnen K, Vonend A, Metz M, Siebenhaar F, Tschentscher I, et al. Autologous whole blood injections to patients with chronic urticaria and a positive autologous serum skin test: a placebo-controlled trial. Dermatology. 2006;212(2):150-9.

Bajaj AK, Saraswat A, Upadhyay A, Damisetty R, Dhar S. Autologous serum therapy in chronic urticaria: old wine in a new bottle. Indian J Dermatol Venereol Leprol. 2008;74(2):109-13.

Godse KV, Nadkarni N, Patil S, Mehta A. Subcutaneous Autologous Serum Therapy in Chronic Spontaneous Urticaria. Indian J Dermatol. 2017;62(5):505-7.






Original Research Articles