[Autoimmunity in chronic urticaria. A historical and current perspective]

Area of Science:

• Immunology
• Dermatology
• Pathogenesis of Urticaria

Background:

• Chronic spontaneous urticaria (CSU) is defined as urticaria lasting over six weeks without identifiable triggers.
• CSU pathogenesis involves mast cell and basophil activation, with potential autoimmune, infectious, or psychological etiologies.
• Autoimmune factors are implicated in up to 40% of CSU cases.

Purpose of the Study:

• To review the multifactorial pathogenesis of chronic spontaneous urticaria.
• To highlight the association between CSU and autoimmune diseases, infections, and stress.
• To emphasize the diagnostic importance of a thorough medical history.

Main Methods:

• Literature review of chronic spontaneous urticaria pathogenesis.
• Analysis of proposed mechanisms including intracellular signaling and autoantibody development.
• Examination of associations with autoimmune thyroid disease, Helicobacter pylori, and psychological stress.

Main Results:

• Two primary pathogenic mechanisms identified: dysregulated intracellular signaling in mast cells/basophils and autoantibodies against FcεRIα or IgE.
• Significant association found between CSU and autoimmune diseases, particularly autoimmune thyroid disease, with higher antithyroid antibody prevalence.
• Helicobacter pylori infection and stress are linked to CSU onset through distinct physiological pathways.

Conclusions:

• CSU pathogenesis is complex, involving immune dysregulation, infections, and stress.
• Autoimmune thyroid disease and H. pylori infection are significant comorbidities.
• Comprehensive medical history remains crucial for diagnosing CSU across different regions.