Research and Medical Studies on Cholinergic Urticaria
Post by: Duper on November 16, 2008, 06:08:44 PM
Hey guys, I recently started college and have access to a ton of research databases. I do not know if you guys have tried this in the past, but there are some articles available about the successful treatment of Cholinergic Urticaria. By law, I’m not allowed to upload these files to share with you guys; but if you guys have some sort of access, I highly suggest you try looking up Cholinergic Urticaria. However, if you don’t have any access, you can private message me your email addresses.
A few of the articles I’ve found interesting:
Successful treatment of cholinergic urticaria with anti-immunoglobulin E therapy. Authors:
Metz, M.
Allergy; Feb2008, Vol. 63 Issue 2, p247-249, 3p, 1 graph
Severe cholinergic urticaria successfully treated with
scopolamine butylbromide in addition to
antihistamines
Authors: H. Ujiie, T. Shimizu, K. Natsuga, K. Arita, K. Tomizawa,* and
H. Shimizu
Departments of Dermatology, Hokkaido University Graduate School of
Medicine, Sapporo, Japan
Successful Treatment of Disabling Cholinergic Urticaria
LCDR JeffH. Feinberg, MC(FS) USN*; CDR Charles B. Toner, MC USNf
Stay well, guys. I’ll make sure to follow up if you want the abstracts or if I find some more articles.
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Title: Re: Research
Post by: HivesGuy on November 17, 2008, 06:25:25 PM
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Hey Duper,
Thanks for the great info. I have came across many of those article excerpts as well while doing some research online. I am not sure if I would do any of them, as they seem like they could have potential side effects, but they are interesting to consider. It is always interesting to see what treatments are being given, and new experiements or research into cholinergic urticaria.
I hope your college semester goes great, and you don’t get bogged down or stressed with Cholinergic Urticaria attacks. Good luck to you!
Thanks again for posting the excerpt and article titles, and take care.
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Title: My Story, Potential Therapies, and Researching for a Cure
Post by: nowash on January 22, 2011, 07:51:27 PM
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Hi guys, new guy here. I found this site not too long ago but didn’t post anything since I felt I had nothing to contribute. I’ve spent this past month, Christmas break from school, researching, trying to find some information that could help cure my hives. Now break is over and I have no time to research. Even though I haven’t cured myself yet, maybe the information I have will help some of you. I’m just a junior physics major in college, so keep in mind I am no doctor. However I think PubMed has enough information and we have enough will to beat this dissase. I have had hives all my life, or rather, as long as I can remember; I am 22 now.
There are many factors that can make my hives worse or better. I get them when I get too hot and sweat, but they’re at their worst when I am embarrassed (not with general everyday stress, though). They’re also worse when the environment I’m in is dry; I’ve noticed some improvement after moving to Houston. The summer seems to be worse if I’m not outside everyday, but if I am, I am better than during the winter. Typically, I get most of my attacks when I exercise. I also get asthma when I exercise. I find it hard to breath and speak in Houston most of the time, as my throat feels tight, which I feel might be caused by post-nasal drip. Other related disorders are my numerous food insensitivities. All grains and legumes give me a rash across my face as well as acne, Coffee, chocolate, and some spices give me hives and acne. Sage, Cinnamon, Coriander, Cumin and Rosemary seem to make my hives worse. I avoid highly glycemic foods for my acne. If my hives get too bad, through exercise or whatever, I feel extremely nauseous.
So in order to control my breakouts I used to take an antihistamine, claritin (loratadine). This seemed to help my hives, but made other things worse. I stopped taking it because I felt it disrupted my thinking, memory problems and coordination problems, which might be due to its anticholinergic properties. I also stopped taking it because it seemed to make me fatigued, even though I could still function. My liver enzymes were high while taking the medication as well. I was only taking the recommended dose at the time. Eventually I got to the point where I didn’t feel like buying the medication anymore and stopped taking it. I pushed through the attacks.
Now, since I developed all these food insensitivities (which I feel is caused by the hives) and with the hives on top of it, my life has become so boring and limited with what I can do that I decided to spend all my free time researching the condition to try to find a way to cure it.
So what do we know about cholinergic urticaria (Cholinergic Urticaria)?
-According to a group of researchers, there are two distinct subtypes of Cholinergic Urticaria: patients that react to their own serum and patients that react to their own sweat (Fukunaga et al.). *Saran wrap technique (see below)*
-Another group took biopsies of a 33-year old Japanese man’s skin and noted hyperkeratinization (excess dead skin) blocking the sweat gland ducts. This man had symptoms similar to Cholinergic Urticaria and hypohydrosis. They hypothesize that this occlusion of the sweat gland causes sweat to leak out into surrounding tissue leading to an immune response (Chinuki et al.). https://www.ncbi.nlm.nih.gov/pubmed/21103837
-It is IgE-mediated and several cases have gone into remission with omazilumab (monoclonal IgE-antibodies).
-Antihistamines help.
-Mast cell stabilizers help (Cromolyn, Ketotifen)
-Anticholinergics help.
-Corticosteroids help.
-Beta-blockers help (maybe this is more adrenergic urticaria).
-The disease can go into remission.
Don’t forget any other similar condition, such as adrenergic urticaria and miliaria.
So we have many ways to attack this theoretically. The dream would be to induce immune tolerance to the antigen (if it’s not a mechanical mechanism). Some things I have thought of and/or tried:
Antihistamines (duh):
-Benadryl (also anticholinergic?)
-Loratadine (also anticholinergic)
-Cetirizine
-Fexofenadine
-Vitamin C (don’t know the mechanism)
-and many others
Mast Cell Stabilizers:
-Cromolyn (Gastrocrom)
-Ketotifen
-Chondroiten Sulfate
-Feverfew (parthenolide)
-Noni (damancanthol?)
-Quercetin (also COX inhibitor, watch kidneys)
-Genistein,from soy isoflavones (spleen tyrosine kinase (syk) inhibitor, part of the intracellular signalling response in allergic reactions)
-Piceatannol, metabolite of reservatrol (approx. 15% metabolized) (syk inhibitor)
-some others I can’t remember
Keratolytics (removes dead skin cell blockage):
-Salicylic acid bath
-Sulfur bath
-Vinegar bath
-Aspirin mask etc.
Immunosuppressants/regulators:
-Corticosteroids (prednisone, etc.)
-Methotrexate (chemotherapy)
-Calcineurin inhibitors (cyclosporine, etc.)
-mTOR inhibitors (rapamycin, reservatrol?, fasting? etc.)
-Ultraviolet radiation (+ psoralen, present in celery?, parsley?)
-Vitamin D3 (promotes nTreg cells)
-Fish oil (lessons overall inflammation due to competition with arachidonic acid)
-Madagascar Periwinkle (dangerous,like chemotherapy)
-Cordyceps? (cordycepin? analogue to adenosine)
Immunomodulatory:
-Probiotics (Toll-like receptor ligands)
-Infection/sickness
-Matrine (from sophora flos) (immunotolerogenic?)
-Sublingual immunotherapy (yes, with your own sweat)
-Autohematherapy?
-IVIg
IgE inhibitor:
-Omalizumab
-Syk inhibitors?
-Trifoliate Orange? (Naringenin, hesperetin and ponciretin?) (one user was cured from this, many of the substances can be found in other citrus fruit peels)
Niche:
-Belimumab (in clinical testing for lupus, disrupts B cell activation and thus stopping Ig generation?)
There are possibly others that I cannot remember. Some of these I have tried and alot I have not. The things I have tried that I think helped are:
-Fish oil (helps, no practical way to overdose, might as well take it)
-Vitamin D3 (taken with fish oil)
-Ultraviolet radiation (sunbathing, can’t wait for summer to really try it)
-Chondroiten Sulfate (w/ glucosamine)
-Quercetin
-Antihistamines (Loratadine and Cetirizine)
-Vinegar bath
-Probiotics (for sure)
The things I have tried that I’m not sure about are:
-Vitamin C
-Reservatrol
-Feverfew
-Noni
-Cordyceps
The things I want to try but haven’t yet are:
-Sunbathing during the summer
-IP6
-Omalizumab
-Fexofenadine
-Ketotifen
-Matrine (if I can find it)
-Genistein (worried about the phytoestrogens though)
-Sublingual immunotherapy
If you guys want references just ask. I remember how most of them work (or how researchers think most of them work), however I wouldn’t know any side effects. I’m not a doctor, so take my suggestions with a grain of salt. Consult your doctor if you want to take any medication. Any medication you take is at your own risk.
* In this study the researchers used saran wrap taped to the patients skin in order to collect his sweat. If you want to make sure if you’re allergic to your own sweat or not you can collect the sweat like this and then touch it to a nonreacting part of your body.
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Title: Re: My Story, Potential Therapies, and Researching for a Cure
Post by: HivesGuy on January 23, 2011, 06:34:20 AM
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Hello nowash,
Wow, what an amazing post. I can tell you have really put a lot of effort into that research, so thank so much for posting. It was a very interesting read and I agree with so many points you made, and I really enjoyed it.
I can relate to a lot of what you say. I seem to get that post nasal drip a lot too. I also have a lot of food intolerances, which is odd because in my whole life I have never had a single allergy to anything (aside from poison ivy). Now I can’t keep my body under control. I truly feel as if I am a prisoner in my own flesh.
It is interesting that you are studying physics. Science has always fascinated me, and I have always enjoyed all of the science classes I took in school & college.
Anyway, I do think that those studies are all interesting, and I have read them at various points in the past as well. I think that the autoimmune thing is probably the most likely at this point in my opinion. It is interesting how you made the connection that sweat leaking out could have caused this autoimmunity (from the hyperkeratization). A lot of us also seem to have Keratosis Pilaris, which supports that idea that we have some type of excessive skin cell production. It is interesting to consider that it could have had something to do with Cholinergic Urticaria being initiated.
I have tried a few of those remedies for the KP, such as applying vinegar, and also scrubbing my skin with an abrasive pad. Nothing ever seemed to work in that regard, and actually made my skin more itchy feeling. But I find it interesting how it could have a hand in this.
Your posts on immunity reminded me of a post I read the other day on AOL. A guy was allergic to his own semen. When he ejaculated, he would get really sore down there for a while. They said he had been doing an immunotherapy, where they diluted his semen with water and injected it into his body. They said over time he was getting less reactive to it. I will try to look up that source later and maybe post it on the blog.
It would be wonderful if there was a safe and affordable immunotherapy for us, where we did something similar. Perhaps that could be a treatment in the future.
Anyway, thanks again for the great thought-provoking post and welcome!
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Title: Re: My Story, Potential Therapies, and Researching for a Cure
Post by: nowash on January 23, 2011, 04:21:57 PM
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Hey thanks, HivesGuy!
Just saw your blog post about the immunotherapy and thought you would be interested in this link (dunno if you’ve seen it or not):
Quote
Arerugi. 2007 Jan;56(1):54-7.
[Cholinergic urticaria successfully treated by immunotherapy with partially purified sweat antigen].
[Article in Japanese]
Tanaka T, Ishii K, Suzuki H, Kameyoshi Y, Hide M.
Department of Dermatology, Graduate School of Biomedical Sciences, Hiroshima University. toshikun@hiroshima-u.ac.jp
Abstract
A 24-years-old man was referred to our University Hospital because of one and a half-year history of disabling symptoms related to physical exertion. Multiple small round-shaped wheals with severe itch were induced by exercise, warmth and psychological stress. These symptoms were resistant to histamine H1-receptor antagonists. Similar eruptions were induced by sauna-bathing, and skin test with autologous sweat showed a flare and wheal reaction. Incubation of his peripheral-blood leukocytes with partially purified sweat antigen evoked marked histamine release, indicating that he has been IgE-sensitized to an antigen(s) in human sweat. Specific immunotherapy using partially purified sweat antigen was performed every other week. Both pruritus and wheals improved gradually, and the reactivity of his peripheral blood leukocytes against sweat antigen decreased as immunotherapy was proceeded. Specific immunotherapy using sweat antigen may be valuable for patients with cholinergic urticaria with type I hypersensitivity to sweat antigen(s).
PMID: 17272959 [PubMed – indexed for MEDLINE]
They most likely used the sweat antigen and injected it like an allergy shot (I can’t read the whole article). That is what they usually mean by specific immunotherapy, although there are other techniques. You can achieve the same thing (immune tolerance) by sticking antigen underneath your tongue (sublingual immunotherapy), in your nose, or ingesting it; all are known to provoke what they call oral tolerance. IIRC, in oral tolerance, dendritic cells then take the antigen to the nearest lymph node and present them to T-cells to suppress an immune response. They aren’t too clear on how tolerance or suppression of a specific response to an antigen works in vivo in humans, but they’ve done tons of studies on mice and in vitro human cells.
Dendritic cells (DCs) are the main cells that also start the immune responses as well, so there is a paradox in the sense that the same cell can either give immunity or invoke tolerance. There are subtypes of DCs based on what proteins they express either on their outer-membrane or intra-cellularly, IIRC. Vitamin D3 has been know to promote tolerogenic DCs, as well as regulatory T-cells and has been considered as an adjuvant to sublingual immunotherapy.
I mentioned the researchers’ method of using Saran Wrap to give people an idea of how they might be able to collect their own sweat in case they wanted to try sublingual immunotherapy themselves. I know it sounds gross, eating your own sweat, but if its a potential cure, why not? I will try it myself, eventually, if any other treatments don’t work.
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Title: Re: My Story, Potential Therapies, and Researching for a Cure
Post by: HivesGuy on January 23, 2011, 04:31:14 PM
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Thanks for reposting that nowash. Ah, I see now. Wow. It says it did help the guy, but I just wonder how he ended up. I wonder if it ever went away completely, or if it got worse over time. Very interesting, and very exciting all at the same time.
It is an interesting idea about the saran wrap. The only problem with for me is–right now I literally am not sweating a drop. I wore a sauna suit all day one day (which is similar to saran wrap) and painted my living room walls. I even did some pushups. After hours and a few minor hives attacks, I took off the sauna suit, and my skin was as dry as a bone.
But that is interesing. Heck, at this point I would inject it, stick it under my tongue, snort it in my nose, bathe in my sweat, or whatever it took to eliminate my hives. Thanks for posting all of that great info.
It seems I have read over it on the web in the past, but it didn’t really seem feasible. But now it seems a lot more realistic after putting some things into perspective. I would love it if they did a big trial on us or something doing this.
Thanks again!
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Title: Re: My Story, Potential Therapies, and Researching for a Cure
Post by: mody on February 04, 2011, 04:58:44 PM
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thank you for the great efforts & satisfactory explanations
only have cholinergic urticaria 2 or 3 monh ago
just wanna ask if you have tried Omalizumab, is very promsing
i noticed that my sweat has decreased progressively over the previous month, & i used to sweat heavily if any minor heat (ooh!! i missed those days). now only just feel moist but no active sweat perhaps because of avoidance of heat & sun. my question is that is it beneficial to induce sweating regularly by exposure to hot conditions or exercise & pass through the horrible pain, or it would just self torture.
now just starting to increase the room temp gradually & trying to leave in a relatively hot environment perhaps my body will adapt again.
i do not know what to do next, may be i would try skin Keratolytics
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Title: Re: My Story, Potential Therapies, and Researching for a Cure
Post by: LookMaNoHives on February 04, 2011, 07:37:08 PM
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This is an excellent post! Thanks for all of the information! If anyone has questions about the side effects of the drugs, I am a pharmacy student so I could help as much as I can! The new therapy ideas are very interesting and my pathophysiology class these past two weeks have specifically been talking about the immune system and immunopathologies!
I was also wondering how long ago you took Claritan? The symptoms you described aren’t exactly consistent with the OTC Claritan, but in some people I’m sure it is possible. They claim its completely non-drowsy. But if it bothers you that much, it stays in your system for 24 hours so you could take it at night and by the morning the adverse effects would be significantly decreased if not completely gone and you would still have antihistamine protecting you. I am currently taking cyproheptadine which is a first generation antihistamine. It’s like taking Benadryl. I had to take it 3 times a day and I would practically pass out during my pharmacy classes. However, after a couple weeks I stopped feeling tired completely. They also had me taking Claritan and Xyzal at the same time which is kind of bad on your liver and didn’t help me at all. Keep us updated on what works for you. I’m thinking about the sun therapy too! I just got cholinergic urticaria starting last September so I hope this works!