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Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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Basophil Activation Test for Allergy Diagnosis
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Urticaria.

Pavel Kolkhir1,2, Ana M Giménez-Arnau3, Kanokvalai Kulthanan4

  • 1Urticaria Center of Reference and Excellence (UCARE), Institute of Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany. pavel.kolkhir@charite.de.

Nature Reviews. Disease Primers
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Summary
This summary is machine-generated.

Urticaria is a common inflammatory skin condition. Effective treatments include antihistamines and omalizumab, with ongoing research into new therapies targeting mast cells and immune pathways.

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Area of Science:

  • Dermatology
  • Immunology
  • Allergy

Background:

  • Urticaria affects up to 20% of the global population, presenting as wheals and/or angioedema due to mast cell degranulation.
  • Acute urticaria (≤6 weeks) is often linked to infections or external triggers, while chronic urticaria (CU, >6 weeks) significantly impacts quality of life and healthcare costs.
  • Chronic urticaria is classified as spontaneous (CSU) or inducible (CIndU), with CSU involving complex autoimmune and inflammatory pathways, and CIndU having specific triggers.

Purpose of the Study:

  • To provide a comprehensive overview of urticaria, encompassing its epidemiology, pathogenesis, diagnosis, and current/novel treatment strategies.
  • To differentiate between acute urticaria, chronic spontaneous urticaria (CSU), and chronic inducible urticaria (CIndU).
  • To highlight the need for further research into disease endotypes, biomarkers, and advanced therapeutic targets.

Main Methods:

  • Clinical diagnosis is primary, supported by tests to rule out differential diagnoses and identify specific triggers or underlying causes.
  • Review of current treatment guidelines, including stepwise approaches with H1 antihistamines, omalizumab, and cyclosporine.
  • Exploration of emerging therapeutic avenues targeting mast cell mediators, signaling pathways, and immune cell receptors.

Main Results:

  • Urticaria diagnosis is primarily clinical, with diagnostic tests aiding in identifying causes or triggers.
  • Current management follows a stepwise approach, prioritizing complete symptom control.
  • Novel treatments are being developed to target specific inflammatory pathways and cellular mechanisms.

Conclusions:

  • Urticaria is a prevalent condition with significant patient impact, requiring effective management strategies.
  • Understanding the distinct pathogenesis of CSU and CIndU is crucial for targeted treatment.
  • Future research directions include defining disease endotypes, discovering biomarkers, and developing innovative therapies for urticaria.