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\begin{document}

\title{INFLAMMATORY CYTOKINE LEVELS AND CHANGES DURING OMALIZUMAB TREATMENT IN
CHRONIC SPONTANEOUS URTICARIA}



\author[1]{Selcen Hoşgören-Tekin}%
\author[2]{İrem Peker Eyüboğlu}%
\author[2]{Mustafa Akkiprik}%
\author[3]{Ana Giménez Arnau}%
\author[1]{Andac Salman}%
\affil[1]{Marmara Universitesi Egitim ve Arastirma Hastanesi}%
\affil[2]{Marmara Universitesi Tip Fakultesi}%
\affil[3]{Universitat Pompeu Fabra - Campus del Mar}%


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  \date{May 24, 2024}


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\begin{abstract}
\textbf{Introduction:} While several studies have examined the role of T
cells and related cytokines in the development of chronic spontaneous
urticaria (CSU), there is a limited amount of research focusing on the
changes in cytokine levels during omalizumab treatment. The primary
objective of this study was to investigate the inflammatory cytokine
profile (including IL-4, IL-5, IL-10, IL-13, IL-17, IL-31, IL-33, and
TNF\selectlanguage{greek}α\selectlanguage{english}) among CSU patients undergoing to omalizumab treatment.
\textbf{Materials and Methods:} Plasma levels of cytokines were measured
using ELISA. Measurements were taken before CSU treatment, at the 3rd
and 6th months of omalizumab treatment, and once in the control group.
The severity of the patients' disease was assessed using the weekly
Urticaria Activity Score(UAS7), and disease control was evaluated using
the Urticaria Control Test(UCT). \textbf{Results:} Thirty-one CSU
patients and 56 age- and gender-matched healthy controls were included.
Plasma levels of IL-4 and IL-33 were significantly lower in patients
with CSU compared to healthy controls (p=0.001; p=0.038, respectively).
During omalizumab treatment, IL-4 levels showed a significant increase
in the 3rd month compared to baseline (p=0.01), and IL-5 levels
significantly decreased in the 6th month compared to both the 3rd month
and baseline (6th month vs baseline; p=0.006, 6th month vs 3rd month;
p=0.001). \textbf{Discussion:} One potential mechanism of action for
omalizumab may involve its regulatory effects on type 2 inflammatory
cytokines in CSU patients. This finding partially explains the efficacy
of anti-IL-4/13 treatments in chronic spontaneous urticaria. Further
investigations on drugs targeting type 2 inflammatory cytokines in CSU
are warranted.%
\end{abstract}%



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\verb`Table 1. Clinical and laboratory findings of the patient group..docx`  available at \url{https://authorea.com/users/698789/articles/686417-inflammatory-cytokine-levels-and-changes-during-omalizumab-treatment-in-chronic-spontaneous-urticaria}

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\verb`Table 2. Cytokine levels in study groups..docx`  available at \url{https://authorea.com/users/698789/articles/686417-inflammatory-cytokine-levels-and-changes-during-omalizumab-treatment-in-chronic-spontaneous-urticaria}

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\verb`Table 3. Cytokine levels in early and late responders..docx`  available at \url{https://authorea.com/users/698789/articles/686417-inflammatory-cytokine-levels-and-changes-during-omalizumab-treatment-in-chronic-spontaneous-urticaria}

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