Differential MicroRNA Expression in Chronic Spontaneous Urticaria in Relation to Treatment Response

Area of Science:

• Immunology
• Dermatology
• Genetics

Background:

• Chronic spontaneous urticaria (CSU) is a mast cell-driven skin disorder with complex immune dysregulation.
• MicroRNAs (miRNAs) are key post-transcriptional regulators implicated in various diseases, including CSU.
• Understanding miRNA roles in CSU pathogenesis and treatment response is crucial for therapeutic advancements.

Purpose of the Study:

• To investigate differentially expressed serum miRNAs in CSU patients.
• To identify serum miRNA signatures associated with treatment response to H₁-antihistamines (H1AHs) and omalizumab.
• To explore the potential mechanistic links between miRNAs and CSU treatment outcomes.

Main Methods:

• Serum samples from 30 CSU patients and 10 healthy controls were analyzed.
• Serum miRNA profiling was performed using the Affymetrix GeneChip® miRNA 4.0 Array.
• Bioinformatic analyses were conducted to identify differentially expressed miRNAs, predict target genes, and assess pathway enrichment.

Main Results:

• Eighteen miRNAs were differentially expressed between CSU patients and controls (10 upregulated, 8 downregulated).
• Twenty-three miRNAs were downregulated in H1AH nonresponders compared to responders.
• Four miRNAs (hsa-miR-503-5p, hsa-miR-1282, hsa-miR-93-5p, hsa-miR-638) were reduced in complete responders to omalizumab.
• hsa-miR-93-5p and its target CCND1 were associated with both H1AH nonresponsiveness and omalizumab response.

Conclusions:

• Distinct serum miRNA profiles are associated with treatment responses in CSU.
• MiR-93-5p, with network targets including MYC, CCND1, and HSPA8, highlights shared pathways in H1AH refractoriness and omalizumab responsiveness.
• These findings provide mechanistic insights into CSU pathogenesis and support personalized treatment strategies.