Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study

Kocatürk, Emek; Salameh, Pascale; Saraç, Esra; Ayala, Carolina Elisa Vera; Thomsen, Simon Francis; Zuberbier, Torsten; Ensina, Luis Felipe; Popov, Todor A.; Doorn, Martijn van; Giménez‐Arnau, Ana; Asero, Riccardo; Criado, Paulo Ricardo; Grattan, Clive; Conlon, Niall; Chérrez-Ojeda, Iván; Aarestrup, Fernando Monteiro; Ansari, Zainab; Abri, Salma Al; Ahmad, Mona Al; Hinai, Bushra Al; Al‐Nesf, Maryam; Allenova, Anastasiia; Altrichter, Sabine; Arnaout, Rand; Bartosińska, Joanna; Palitot, Esther Bastos; Bauer, Andrea; Bernstein, Jonathan A.; Bizjak, M; Bonnekoh, Hanna; Bouillet, Laurence; Brzoza, Zenon; Carne, Emily; Purayil, Saleema; Chong-Neto, Herberto José; Christoff, George; Criado, Roberta F. J.; Cvenkel, Klara; Damadoğlu, Ebru; Данилычева, И В; Day, Cascia; Montjoye, Laurence de; Demir, Semra; Ferucci, Silvia Mariel; Fomina, Daria; Kalyoncu, Alı Fuat; Fukunaga, Atsushi; García, Elizabeth; Gelincik, Aslı; Göbel, Joe Hannah; Godse, Kiran; Gonçalo, Margarida; Gotua, Maia; Gugala, Agata; Guillet, Carole; Karakaya, Gül; Kasperska−Zając, Alicja; Katelaris, Constance H.; Khoshkhui, Maryam; Kleinheinz, Andreas; Kołacińska-Flont, Marta; Kolkhir, Pavel; Košnik, Mitja; Krasowska, Dorota; Kumaran, Muthu Sendhil; Kupryś‐Lipińska, Izabela; Kurowski, Marcin; Larenas‐Linnemann, Désirée; Lee, Youngsoo; Campinhos, Fernanda Lugão; Makris, Michael; Gómez, René Maximiliano; Meshkova, Raisa; Moura, Ana; Nasr, Iman; Neisinger, Sophia; Oda, Yoshiko; Kara, Rabia Öztaş; Papapostolou, Niki; Parisi, Claudio Alberto Salvador; Pesqué, David; Peter, Jonny; Petkova, Elena; Ridge, Katie; Rudenko, Michael; Rutkowski, Chris; Saini, Sarbjit S.; Salman, Andaç; Sánchez, Jorge; Şekerel, Bülent Enis; Serpa, Faradiba Sarquis; Dikicier, Bahar Sevimli; Sidiropoulos, Nikitas; Sørensen, Jennifer Astrup; Soria, Angèle; Küçük, Özlem Su; Thalappil, Sherin; Tomaszewska, Katarzyna; Tuncay, Gülseren; Ünal, Derya; Valle, Solange Oliveira Rodrigues; Lindonk, Esmee van; Vestergaard, Christian; Vitchuk, Aleksandr V.; Xepapadaki, Paraskevi; Ye, Young-Min; Zalewska-Janowska, Anna; Sikora, Agnieszka; Zamłyński, Mateusz; Serdotetskova, Sofia A.; Lebedkina, Marina S.; Kuznetsova, Elizaveta V.; Maurer, Marcus

doi:10.1016/j.jaci.2023.07.019

Cited by 10 publications

(1 citation statement)

References 46 publications

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“…The lack of direct link with COVID is also supported by the low infection rate reported in our initial survey as well as by the anti-nucleocapsid data and neutralizing activities against the Omicron (BA.1 and BA.2) variants. Finally, reinfection with SARS-CoV-2 only led to CU exacerbation in a minority of cases (15%) corroborating the data from the UCARE COVAC-CU study who found a rate of COVID-19 vaccination-induced CU exacerbation of 9% (27).…”

Section: Discussionsupporting

confidence: 82%

Features of chronic urticaria after COVID-19 mRNA vaccine, a real-life cohort study

Muller,

Foglierini,

Pescosolido

et al. 2024

Preprint

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Background New onsets of chronic urticaria (CU) have been reported after repeated immunizations, mainly with the Moderna mRNA-1273 vaccine (Spikevax) Objective This study aims to evaluate patients with CU after COVID-19 mRNA vaccination. The contribution of SARS-Cov2 infection, atopy and IgE against the vaccine was analyzed. Methods We monitored the features of patients who developed CU after vaccination in the Canton of Vaud through two surveys conducted in 2022 and 2023. Fifty individuals with CU underwent blood tests, and their results were compared with individuals without a history of urticaria (N=135). The presence of anti-vaccine IgE was detected with basophil activation tests (BAT). We assessed anti-SARS-Cov2 humoral response, and the presence of IgEs against common respiratory allergens (Phadiatop) as a surrogate for atopy. Results Post-vaccination CU occurred after a median interval of 10 days and significantly more after the Spikevax booster, affecting middle-aged individuals (median 41, 66% females). In 2023, CU was still active in 53% of the cases. Inducible forms of CU, primarily dermographism, were reported in 54% (2022) and 61% (2023) of the cases. BAT positivity was not specific to CU, anti-nucleocapsid positivity, or atopy but was significantly associated with higher anti-spike neutralizing activities and younger age. Four CU patients tolerated an additional dose of mRNA vaccine with no disease exacerbation/recurrence. Conclusion The Spikevax booster induced anti-vaccine IgE independently of CU, the latter being not directly associated with COVID-19 infection nor atopy. The tolerance to a new booster in 4/4 patients suggests that the Spikevax vaccine indirectly triggered CU in predisposed individuals.

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Section: Discussionsupporting

confidence: 82%

Features of chronic urticaria after COVID-19 mRNA vaccine, a real-life cohort study

Muller,

Foglierini,

Pescosolido

et al. 2024

Preprint

View full text Add to dashboard Cite

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Low risk of urticaria exacerbation following COVID-19 vaccination

2023

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Psychological Stress and Urticaria: Pathophysiologic and Therapeutic Updates

Xiang,

Türk,

Ojeda

et al. 2024

Curr Treat Options Allergy

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Purpose of review The goal of this review is to examine the relationship between psychological stress and chronic urticaria (CU), focusing on the underlying mechanisms and potential therapeutic interventions. The paper seeks to answer how stress exacerbates CU and the neuro-immunological pathways involved, providing insight into improving therapeutic strategies by considering the psychological dimensions of the disease. Recent findings Recent studies highlight the significant role of stress in aggravating CU through the dysregulation of the hypothalamic-pituitary-adrenal axis and neurogenic inflammation. Increased levels of neuropeptides like substance P and calcitonin gene-related peptide, as well as upregulated expression of the MRGPRX2 receptor, are implicated in the neuro-immune interactions that worsen CU symptoms. Additionally, psychological distress has been linked to poorer disease outcomes, with stress management strategies and psychopharmacological interventions showing promise in reducing disease severity. Summary This review concludes that stress significantly contributes to the exacerbation of CU through neuro-immune pathways, suggesting the need for holistic treatment approaches. Addressing both the physical and psychological aspects of CU may improve disease management and patient outcomes. Future research should focus on further elucidating the connection between stress and CU and developing targeted therapies that integrate stress reduction techniques into standard care.

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Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study

Cited by 10 publications

References 46 publications

Features of chronic urticaria after COVID-19 mRNA vaccine, a real-life cohort study

Features of chronic urticaria after COVID-19 mRNA vaccine, a real-life cohort study

Low risk of urticaria exacerbation following COVID-19 vaccination

Psychological Stress and Urticaria: Pathophysiologic and Therapeutic Updates

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