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Total IgE as a Marker for Chronic Spontaneous Urticaria
Sabine Altrichter1, Jie Shen Fok1,2,3, Qingqing Jiao1,4
1Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Total immunoglobulin E (IgE) levels can indicate chronic spontaneous urticaria (CSU) activity and treatment response. Measuring total IgE is recommended for diagnosing and managing CSU patients.
Area of Science:
- Immunology
- Dermatology
- Allergy
Background:
- Immunoglobulin E (IgE) and its receptor (FcɛRI) are key in chronic spontaneous urticaria (CSU) pathophysiology.
- Total IgE may serve as a marker for CSU disease activity, endotypes, and treatment outcomes.
Purpose of the Study:
- To review the evidence supporting the inclusion of total IgE in the diagnostic workup of CSU patients.
- To evaluate total IgE as a potential biomarker in CSU.
Main Methods:
- A systematic literature search was conducted on PubMed using terms 'chronic urticaria' and 'total IgE'.
- 141 publications were screened by title and abstract for inclusion in the review.
Main Results:
- Elevated total IgE levels were observed in up to 50% of CSU patients; normal or low levels also occurred.
- High total IgE correlated with high disease activity, longer duration, better response to omalizumab, and quicker relapse.
- Low total IgE suggested autoimmune CSU (Type IIb), poor omalizumab response, and potential benefit from cyclosporine.
Conclusions:
- Total IgE is a valuable marker for assessing CSU.
- Routine assessment of total IgE is recommended in the diagnostic workup of CSU patients.
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