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Chronic spontaneous urticaria: update on pathogenesis and therapeutic implications
Paulo Ricardo Criado1, Roberta Fachini Jardim Criado2, Hélio Amante Miot3
1Centro Universitário Faculdade de Medicina do ABC, Santo André, SP, Brazil; Faculdade de Ciências Médicas de Santos (Fundação Lusíada), Santos, SP, Brazil.
Anais Brasileiros De Dermatologia
|August 22, 2025
Summary
Recent advances reveal complex chronic spontaneous urticaria (CSU) pathogenesis involving multiple cells and pathways. Promising new treatments, including immunobiologicals and small molecules, offer hope for managing refractory CSU.
Area of Science:
- Immunology
- Dermatology
- Pharmacology
Background:
- Chronic spontaneous urticaria (CSU) pathogenesis is increasingly understood, highlighting the central role of mast cells alongside other complex cellular interactions.
- Modern CSU therapies aim to address diverse mechanisms, offering improved outcomes for patients with difficult-to-treat disease.
Purpose of the Study:
- To review current concepts and recent advancements in the pathogenesis of chronic spontaneous urticaria (CSU).
- To contextualize emerging and promising therapeutic drug options for the management of chronic spontaneous urticaria.
Main Methods:
- A comprehensive narrative review of scientific literature was performed.
- Articles were systematically searched and selected from the PubMed database, spanning from 1977 to 2024.
Main Results:
- The review prioritized meta-analyses, systematic reviews, and randomized trials, focusing on 138 articles from the last 15 years and clinical trial data.
- Immunobiologicals and small molecules emerged as highly promising therapeutic agents for future chronic spontaneous urticaria treatment regimens.
Conclusions:
- The study provides a review of chronic spontaneous urticaria pathogenesis and discusses promising therapeutic strategies.
- Emerging treatments, particularly immunobiologicals and small molecules, show significant potential for improving the management of chronic spontaneous urticaria.
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