Emerging Therapies in Chronic Spontaneous Urticaria

Min, Taek Ki; Saini, Sarbjit S.

doi:10.4168/aair.2019.11.4.470

Cited by 25 publications

(26 citation statements)

References 90 publications

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“…Urticaria is a common skin disease, and various factors are known to be associated with the onset and/or the aggravation of urticaria. Recent development of biologics, such as omalizumab, humanized monoclonal antibody against IgE, have largely improved its treatment [38,39]. However, many patients still do not benefit from or tolerate such therapies, and the molecular mechanism of wheal formation in urticaria is poorly understood [1,2,5].…”

Section: Discussionmentioning

confidence: 99%

A single reaction-diffusion equation for the multifarious eruptions of urticaria

et al. 2020

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Urticaria is a common skin disorder characterized by the rapid appearance and disappearance of local skin edema and flares with itching. It is characterized by various macroscopic skin eruptions unique to patients and/or subtypes of urticaria with respect to shape, size, color, and/or duration of eruptions. Nevertheless, the mechanism underlying multifarious eruptions in urticaria is largely unknown. The eruptions are believed to be evoked by histamine release from mast cells in the skin. However, the majority of visible characteristics of urticaria cannot be explained by a simple injection of histamine to the skin. To explain the multifarious eruptions of urticaria, we developed a single reaction-diffusion model suggesting the self-activation and self-inhibition regulation of histamine release from mast cells. Using the model, we found that various geometrical shapes of eruptions typically observed in patients can be explained by the model parameters and randomness or strength of the initial stimuli to mast cells. Furthermore, we verified that the wheal-expanding speed of urticaria, which is shown to be much smaller than that of the intradermal injection experimental system may be explained by our model and a simple diffusion equation. Our study suggests that the simple reaction-diffusion dynamics, including the independent self-activating and-inhibitory regulation of histamine release, may account for the essential mechanism underlying the formation of multifarious eruptions in urticaria.

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Section: Discussionmentioning

confidence: 99%

A single reaction-diffusion equation for the multifarious eruptions of urticaria

et al. 2020

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“…Therefore, unmet clinical needs remain in patients with H 1 -antihistamine-refractory CU and the addition of leukotriene receptor antagonists (LTRAs), immunomodulating agents (such as omalizumab, cyclosporine, dapsone, and methotrexate), and phototherapy has been evaluated and included in guidelines for the treatment of this patient group. 1 7 8 15 16 …”

Section: Introductionmentioning

confidence: 99%

The KAAACI/KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children: Part 2. Management of H1-Antihistamine-Refractory Chronic Urticaria

Choi

Lee

Song

et al. 2020

Allergy Asthma Immunol Res

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Quite a few patients with chronic spontaneous urticaria (CSU) are refractory to H 1 -antihistamines, even though the dose of H 1 -antihistamines is increased up to 4-fold. CSU that is not controlled with H 1 -antihistamines results in increased disease burden. Several immunomodulators have been used to manage these patients. The guidelines reported herein are connected to Part 1 of the KAAACI/KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children, and aimed to provide evidence-based recommendations for the management of H 1 -antihistamine-refractory CSU. Part 2 focuses on the more commonly used additional treatment options for refractory CSU, including omalizumab, cyclosporine, leukotriene receptor antagonist, dapsone, methotrexate, and phototherapy. The evidence to support their efficacy, dosing, safety, and selection of these agents is systematically reviewed. To date, for patients with refractory CSU, the methodologically sound data to evaluate the use of omalizumab has been growing; however, the evidence of other immunomodulators and phototherapy is still insufficient. Therefore, an individualized stepwise approach with a goal of achieving complete symptom control and minimizing side effects can be recommended. Larger controlled studies are needed to elevate the level of evidence to select a rational therapeutic agent for patients with refractory CSU.

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“…2 Causes of chronic urticaria are physical insults, allergens, hereditary urticaria, autoimmune causes, and idiopathic causes. 3 Idiopathic causes of chronic urticaria often cause a diagnostic dilemma. 80-90% of chronic urticaria cases are idiopathic .4 Basophils and mast cells are the main cells leading to clinical manifestations.…”

Section: Introductionmentioning

confidence: 99%

“…80-90% of chronic urticaria cases are idiopathic .4 Basophils and mast cells are the main cells leading to clinical manifestations. 3 These cells secrete inflammatory mediators like histamine, serotonin, leukotrienes, prostaglandins, cytokines, chemokines, and other pro-inflammatory mediators. 3 This secretion leads to dilatation of blood vessels, exudation of tissue fluid, and increased vascular permeability.…”

Section: Introductionmentioning

confidence: 99%

“…3 These cells secrete inflammatory mediators like histamine, serotonin, leukotrienes, prostaglandins, cytokines, chemokines, and other pro-inflammatory mediators. 3 This secretion leads to dilatation of blood vessels, exudation of tissue fluid, and increased vascular permeability. 2 The main pharmacologic treatment modalities for chronic idiopathic urticaria are H1 antihistamines, H2 antihistamines, leukotriene antagonists, and corticosteroids.…”

Section: Introductionmentioning

confidence: 99%

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Chronic urticaria in a two year old child: a diagnostic dilemma

Suresh¹,

Chandran²

2020

Int J Contemp Pediatr

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A 2 year old child presented with history of recurrent urticaria for 2 months. The cause was initially idiopathic. On close questioning about diet and observation it was found that mother started using a coriander based masala powder 2 months back and it was found that the child was allergic to coriander. Chronic urticaria should be dealt with extreme caution and careful elicitation of history for the offending agent should be taken in a case of urticaria which poses as a diagnostic dilemma.

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Emerging Therapies in Chronic Spontaneous Urticaria

Cited by 25 publications

References 90 publications

A single reaction-diffusion equation for the multifarious eruptions of urticaria

A single reaction-diffusion equation for the multifarious eruptions of urticaria

The KAAACI/KDA Evidence-Based Practice Guidelines for Chronic Spontaneous Urticaria in Korean Adults and Children: Part 2. Management of H1-Antihistamine-Refractory Chronic Urticaria

Chronic urticaria in a two year old child: a diagnostic dilemma

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