Investigating the association of atopy and aeroallergen
sensitization and chronic spontaneous urticaria

Esmaeilzadeh, Hossein; Eskandarisani, Mehrdad; Nabavizadeh, Hesamodin; Alyasin, Soheila; Vali, Mouhebat; Mortazavi, Negar

doi:10.5114/ada.2022.113805

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…The positive sensitization rate of patients with CU to various allergens according to the skin prick test (SPT) or serum-specific IgE test ranged from 17.2–95.83% ( Table 1 ), which was significantly higher than that of healthy individuals ( 13 – 33 ). Among the allergens identified in patients with CU, house dust mites (HDM) are often the most common ( 13 , 14 , 16 , 26 , 29 ), followed by weed (mugwort and ragweed) and tree pollen, cereal pollen, cockroaches, weeds, cat hair, rat, and Candida albicans and mixed molds ( 17 , 19 , 21 , 22 , 31 , 32 ). In addition, an association between CU and Anisakis simplex (As) sensitization has been reported, and the sensitization rates to pollen, dander, and mold in patients with CU with sensitization to As (CU/As+) were significantly higher than those in patients without As sensitization (CU/As-) ( 18 ).…”

Section: High Prevalence Of Atopy In Cumentioning

confidence: 99%

Atopy in chronic urticaria: an important yet overlooked issue

Chen,

Yang,

et al. 2024

Front. Immunol.

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Chronic urticaria (CU) is one of the most common dermatological diseases and has a significant impact on the quality of life of patients. However, the pathogenesis of this disease remains unclear. Autoimmunity in chronic spontaneous urticaria (CSU) has received considerable attention and has been studied previously. Atopy is an important characteristic of CU; however, it has not been fully recognized. Atopy predisposes individuals to immune responses to allergens, leading to type 2 inflammation and immunoglobulin E (IgE) overproduction. Compared with healthy individuals, patients with CU have a higher proportion of atopy, and an atopic background is correlated with the clinical characteristics of CU. The total IgE levels in patients with CU is significantly higher than those in healthy individuals. Although its level is not higher than that in classic allergic diseases, it is closely related to CU. Exogenous allergens, auto-allergens, and specific IgEs, which are closely related to atopy, have been reported, and their roles in CU pathogenesis are also being studied. Local and systemic atopic inflammation is present in patients with CU. This review summarizes the current knowledge regarding atopy and CU, speculating that there are CU subtypes, such as atopic CSU or atopic chronic inducible urticaria (CIndU) and that atopy may be involved in the pathogenesis of CU. These findings provide a new perspective for a comprehensive understanding of the clinical features of CU and further research regarding its pathogenesis.

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Section: High Prevalence Of Atopy In Cumentioning

confidence: 99%

Atopy in chronic urticaria: an important yet overlooked issue

Chen,

Yang,

et al. 2024

Front. Immunol.

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“…Studies have found that the prevalence of IgE sensitization to various allergens, tested by skin prick test (SPT) or serum-specific IgE, in CU patients ranges from 17.2% to 95.83% (as shown in Table 1), all significantly higher than the healthy population . Among the allergens found in CU, house dust mites (HDM) are often the most common 10,11,13,22,25 , followed by grass (mugwort and ragweed) and trees pollen, cereal pollen, cockroach, weeds, cat hair, rat, Candida albicans and mixed molds have also been reported significantly increased in CU 14,16,18,19,26,28 , and an association of CU with sensitization to Anisakis simplex has also been described 15 . Studies have also found that multiple allergens IgE sensitization is more common than single allergen IgE sensitization, and sensitization to one allergen may predispose to sensitization to other allergens in CU 15,31 .…”

Section: High Prevalence Of Atopy In Cumentioning

confidence: 99%

Atopy in Chronic Urticaria: An Important yet Overlooked Issue

Chen

Yang

et al. 2023

Preprint

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Chronic urticaria (CU) is a common clinical disease that seriously affects the quality of life of patients, but its pathogenesis is still not fully understood. The autoimmunity of chronic spontaneous urticaria (CSU) has been highly concerned and intensively studied in the past. Atopy is also one of the important characteristics of CU, but it has not been fully recognized. Atopy is a predisposition to respond immunologically to allergens, leading to type 2 inflammation and overproduction of immunoglobulin E (IgE). Compared with the healthy population, patients with CU have a higher proportion of atopy, and atopic background is correlated with the clinical characteristics of CU. The total IgE level of CU patients is significantly higher than that of healthy people. Although it is not higher than that of classic allergic diseases, its level is also closely related to CU. Exogenous allergens, autoallergens and their specific IgE, which are closely related to atopy, have been gradually discovered in CU, and their roles in the pathogenesis of CU are also being studied. Atopic inflammation is equally present in CU, both locally and systemically. This review summarizes up-to-date knowledge regarding atopy and CU, and speculates that atopic CSU or atopic CIndU indeed exists, providing a fresh perspective for comprehensively understanding the clinical characteristics of CU and further studying its pathogenesis.

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“…Recently, sensitization to aeroallergens has been considered a possible factor contributing to development of CSU. Esmaeilzadeh et al [1] mention that in CSU, the frequency of urticaria episodes fluctuates throughout the days and seasons, suggesting a possible contribute of aeroallergen sensitization to the development of CSU. Refaat et al [2] published a study including 200 patients with CSU, also supporting that sensitization to aeroallergens, namely mites, should be considered as a probable cause of CSU development.…”

Section: Introductionmentioning

confidence: 99%

Atopy and Response to Omalizumab Treatment in Chronic Spontaneous Urticaria

Costa,

Esteves Caldeira,

Paulino

et al. 2023

Int Arch Allergy Immunol

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Introduction: The possible influence of sensitization to aeroallergens on omalizumab response in chronic spontaneous urticaria (CSU) has been insufficiently investigated. This study’s aim was to investigate atopy’s influence on omalizumab response in CSU patients. Method: Retrospective study of CSU patients followed at a Portuguese Urticaria Center of Reference and Excellence (UCARE), treated with omalizumab for at least 6 months, between 2015 and 2022. At T0, all patients underwent quantification of specific immunoglobulin E (IgE) for total extract of most prevalent aeroallergens (ImmunoCAP Thermo Fisher Scientific®) and were divided in 2 groups, according to their response to omalizumab during the first 16 weeks of treatment: responders (R) (UAS7 <7) versus partial (PR) (UAS7 = 7–15) and nonresponders (UAS7 >15). R were further classified as fast (FR) (4–6 weeks) and slow responders (SR) (12–16 weeks). Total serum IgE, circulating eosinophil, and basophil counts were compared between groups at T0. p < 0.05 was considered statistically significant (SPSS® v25.0). Results: Ninety-six patients (80% female) were studied, mean age 49 ± 14 years. Median CSU duration pre-omalizumab was 3 (0.6–20) years and mean omalizumab treatment duration was 3.7 ± 2.3 years. 38 (40%) had concomitant chronic inducible urticaria and 72 (75%) angioedema. Based on positive results of the specific IgE assay, 35 patients (36%) were considered atopic. Most patients (n = 30; 86%) were sensitized to house dust mites (HDM) (Dermatophagoides farinae = 28, Dermatophagoides pteronyssinus = 27, Blomia tropicalis = 19, Lepidoglyphus destructor = 17), followed by pollens (n = 12; 34%) (mixture of grasses = 10, Olea europaea = 7, Parietaria officinalis = 6), epithelia (n = 9; 26%) (dog = 8, cat = 7), and fungi (Alternaria alternata = 4; 11%). Eight patients (23%) were monosensitized to HDM and 4 (11%) to pollens. No significant association was found between aeroallergen sensitization and CSU duration, concomitant chronic inducible urticaria, or angioedema. Atopic patients featured significantly higher levels of baseline total serum IgE than nonatopic (469 vs. 94 U/mL, respectively; p = 0.0009). Mean baseline counts of eosinophils and basophils were not significantly different between atopic and non-atopic, respectively: eosinophils (128 vs. 121/mm3) and basophils (26 vs. 28/mm3). Regarding response to omalizumab, most patients (58; 60%) were responders: FR – 46 (79%); SR – 12 (21%). There was no significant association between aeroallergen sensitization and omalizumab response or speed of response. Conclusions: As far as we know, this is the first study exploring the influence of atopy sensitization pattern on omalizumab response in CSU. According to our results, presence of atopy/sensitization pattern does not influence omalizumab response in CSU patients.

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Investigating the association of atopy and aeroallergen sensitization and chronic spontaneous urticaria

Cited by 4 publications

References 13 publications

Atopy in chronic urticaria: an important yet overlooked issue

Atopy in chronic urticaria: an important yet overlooked issue

Atopy in Chronic Urticaria: An Important yet Overlooked Issue

Atopy and Response to Omalizumab Treatment in Chronic Spontaneous Urticaria

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