A Comprehensive Approach to Urticaria: From Clinical Presentation to Modern Biological Treatments Through Pathogenesis

Folci, Marco; Ramponi, Giacomo; Brunetta, Enrico

doi:10.1007/5584_2020_612

Cited by 5 publications

(9 citation statements)

References 175 publications

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“…Urticaria is often idiopathic but can be triggered by infection with viruses, bacteria, and parasites, medications (such as nonsteroidal anti-inflammatory drugs and narcotics), food (such as tree nuts and shellfish), and insect stings or bites. Approximately 20% of people develop urticaria over their lifetime, with two-thirds experiencing acute urticaria, defined as lasting less than 6 weeks . Urticaria is considered chronic if it recurs over a duration of 6 weeks or longer …”

Section: Discussionmentioning

confidence: 99%

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Urticaria 12 Days After COVID-19 mRNA Booster Vaccination

Wolfson

Freeman

Blumenthal

2022

JAMA

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A healthy 27-year-old woman received a COVID-19 mRNA booster vaccine (Moderna) on December 7, 2021. She had not experienced adverse effects after the first 2 vaccine doses on January 17 and February 5, 2021. Twelve days after the booster vaccination, she developed pruritic wheals on her face and bilateral, transient eyelid swelling. Over the next week, a pruritic rash spread over her neck, chest, trunk, and arms; each lesion faded without scarring within 24 hours. She did not experience lip, tongue, or neck swelling; shortness of breath; wheezing; chest pain; or palpitations. Application of pressure to her forearm in a circular motion using a pen cap elicited wheal and flare lesions (Figure, left panel). On physical examination, performed 17 days after the onset of rash, her vital signs were normal. She had no tongue, lip, or throat swelling, and her lungs were clear to auscultation bilaterally. Wheal and flare lesions developed on her upper eyelids during the examination and resolved after approximately 30 minutes (Figure, right panel). Light pressure applied to her skin with a tongue depressor elicited wheal and flare lesions within 3 to 5 minutes.The patient had no history of atopy, urticaria, angioedema, or food or drug allergy and no recent infections. She took no prescription medications and reported no recent use of over-the-counter medications, including nonsteroidal anti-inflammatory drugs. She had no recent travel, exposure to animals, or use of new personal care products.

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Section: Discussionmentioning

confidence: 99%

“…Approximately 20% of people develop urticaria over their lifetime, with two-thirds experiencing acute urticaria, defined as lasting less than 6 weeks. 6 Urticaria is considered chronic if it recurs over a duration of 6 weeks or longer. 1 Urticaria can occur spontaneously or may be induced by specific triggers.…”

Section: Discussionmentioning

confidence: 99%

Urticaria 12 Days After COVID-19 mRNA Booster Vaccination

Wolfson

Freeman

Blumenthal

2022

JAMA

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“…Association with other infectious organisms such as those causing cystitis and tonsillitis has also been reported. Ingestion of food additives such as colorings (azo and non-azo dyes), anti-oxidants, preservatives (nitrates and nitrites), and aspartame (an artificial sweetener) can also cause urticaria [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Role of the Skin Prick Test in Urticaria Patients

Lote¹,

Gupta²,

Poulose³

et al. 2022

Cureus

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BackgroundUrticaria, a vascular reaction of the skin, is marked by the transient appearance of erythematous papules or plaques (wheals) of varying sizes that are blanchable and associated with severe pruritus which lasts from a few hours to days. The etiological factors for urticaria include food, drugs, bacterial foci, pollen, fungi, dust, worms, physical stimuli, stress, anxiety, insect stings, etc. Skin prick tests (SPTs) represent the cheapest and most effective method to diagnose immunoglobulin E-mediated type 1 allergic reactions such as urticaria. A history suggestive of clinical sensitivity supported by a positive test strongly implicates the allergen in the disease process. In this study, we aimed to detect the common allergens and correlate the findings of SPTs with various epidemiological characteristics of urticaria patients. MethodologyA total of 100 patients with urticaria were included in this study. After receiving written and informed consent from patients, SPTs using a battery of 45 allergens were performed. ResultsIn our study, SPT positivity was seen in 88 (88%) patients. The highest sensitization was noted toward Dermatophagoides pteronyssinus (house dust mite) (30%), followed by D. farinae, Cynodon dactylon, and peanuts (each comprising 24%), and Ailanthus excelsa (20%). ConclusionsFinding the causative allergen in urticaria is often a difficult and long-drawn process, both for the physician and the patient. Our study identified an allergen in 88% of patients with urticaria, thereby showing that the SPT is a cost-effective, easy, and reliable tool for diagnosing and guiding treatments in urticaria patients.

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“…Two major groups of immune signals influence the production of IgE, which triggers an antigen response: (1) activation and differentiation of CD4 naive T cell to T helper type 2 (Th2) cells by the signals and (2) the cytokines and co-stimulatory molecules secreted by Th2 cells, which stimulate T follicular helper cells-induced immunoglobulin B cells class switch directed to IgE production [3]. Such antigen characteristics like concentration and localization of the encounter (namely, tissue, mucosa, circulation) can also impact Th2 cell induction.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Transcriptional Activity of Immune Response Genes in the Blood of Patients with Acute Urticaria

Petruk

Kamyshna

Shkilna

et al. 2022

Open Access Maced J Med Sci

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OBJECTIVE: Alterations in the transcriptional activity of some immunoregulatory genes can play a key in the pathogenesis of acute urticarial (AU). Minimally-invasive markers of the transcriptional activity of immune response genes are essential not only for predicting the severity and activity of the disease but also as a potential target for therapy. METHODS: In our research, we applied a pathway-specific polymerase chain reaction PCR array (Human Innate and Adaptive Immune Responses RT2 Profiler PCR Array, QIAGEN, Germany) to detect and verify innate and adaptive immune responses pathway-focused genes expression in patients suffering from AU and control group. RESULTS: The AU development was accompanied by an increase in the transcriptional activity of genes for a number of costimulation molecules such as CD40, CD40LG, CD80 (B7-1), and C-reactive protein and myeloperoxidase genes either. Under AU conditions, transcriptional induction of genes of several cytokines was also observed: Interferon gamma, interleukin (IL4), IL5, IL17A, tumor necrosis factor, and also chemokine CXCL8. This process was also accompanied by an increase in the transcriptional activity of the RAR-related orphan receptor C Th17 differentiation regulator, the NLRP3 inflammasome genes, and the NFKB1 transcription factor. Such changes occurred against the background of transcriptional repression of the FOXP3 gene and the Treg-dependent suppressor cytokine IL10. The expression of other studied genes did not differ significantly from the controls. CONCLUSIONS: The development of acute urticaria led to the transcriptional activation of pro-inflammatory signaling against the background of a deficiency of the suppressor link. Detected changes in gene expression can be important for targeted therapy.

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A Comprehensive Approach to Urticaria: From Clinical Presentation to Modern Biological Treatments Through Pathogenesis

Cited by 5 publications

References 175 publications

Urticaria 12 Days After COVID-19 mRNA Booster Vaccination

Urticaria 12 Days After COVID-19 mRNA Booster Vaccination

Role of the Skin Prick Test in Urticaria Patients

Analysis of the Transcriptional Activity of Immune Response Genes in the Blood of Patients with Acute Urticaria

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