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Markers for the involvement of endothelial cells and the coagulation system in chronic urticaria: A systematic review
Yora Mostmans1,2, Katleen De Smedt3, Bertrand Richert2
1Department of Immunology-Allergology, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium.
Insights
This review identifies key biomarkers indicating endothelial cell (EC) dysfunction in chronic urticaria (CU). Findings highlight specific markers in skin and serum, confirming vascular involvement in CU pathogenesis.
Area of Science:
- Immunology
- Dermatology
- Vascular Biology
Background:
- Chronic urticaria (CU) is a mast cell-driven inflammatory condition.
- Endothelial cells (ECs) play a significant role in CU pathogenesis.
- Systematic review of EC dysfunction markers in CU is lacking.
Purpose of the Study:
- To systematically review and categorize published markers of endothelial cell (dys)function in chronic urticaria.
- To identify reliable biomarkers for EC dysfunction in CU skin and serum.
- To consolidate evidence for vascular involvement in CU.
Main Methods:
- Comprehensive literature search of PubMed, Cochrane Library, Web of Science, and SCOPUS.
- Used Mesh terms: CU AND pathogenesis AND (vasculopathy OR microangiopathy OR ECs OR marker).
- Selected 79 articles and categorized identified biomarkers based on EC function.
Main Results:
- Upregulated biomarkers in CU skin include adhesion molecules, tissue factor (TF), and P-selectin.
- Reliable serum biomarkers in CU patients are F1+2 (coagulation), D-dimers (fibrinolysis), and MMP-9 (vascular permeability).
- Emerging biomarkers include endostatin, heat shock proteins, cleaved high molecular weight kininogen, and adipokines.
Conclusions:
- This review confirms EC dysfunction in CU, affecting cell survival, vascular structure, and coagulation/fibrinolysis.
- Identified biomarkers provide insights into CU pathophysiology.
- Evidence supports significant vascular involvement in chronic urticaria.
Abstract:
Chronic urticaria (CU) is a chronic inflammatory mast cell-driven disorder. Endothelial cells (ECs) contribute importantly to key features of CU. Several markers of EC (dys)function in CU have been reported, but have not yet been systematically reviewed. In this study, we systematically reviewed and categorized all published markers of EC functions in CU through a comprehensive search in Pubmed, The Cochrane Library, Web of Science, and SCOPUS using the following Mesh terms: CU AND pathogenesis AND (vasculopathy OR microangiopathy OR ECs OR marker). In total, 79 articles were selected and the identified biomarkers were categorized according to EC (dys)function in CU. The most frequent and consistently reported upregulated biomarkers in CU skin were adhesion molecules, TF, and P-selectin. The most frequently reported upregulated and reliable biomarkers in sera of CU patients were F1+2 for coagulation cascade involvement, D-dimers for fibrinolysis, and MMP-9 for vascular permeability. Emerging biomarkers described in the selected articles were endostatin, heat shock proteins, cleaved high molecular weight kininogen, and adipokines. This systematic review contributes to the pool of growing evidence for vascular involvement in CU where EC dysfunction is present in different aspects of cell survival, maintenance of vascular structure, and coagulation/fibrinolysis balance.
