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- Presentation
Chronic Urticaria: What's New
Description
The session on chronic urticaria highlighted the importance of dermatology in managing this skin disease, advocating for a more prominent role for dermatologists, especially in the U.S. with the introduction of new therapies like dupilumab. The discussion included the contributions of late experts in the field, such as Marcus Mauer. Key speakers delved into the pathophysiology of mast cells, emphasizing their role in chronic spontaneous urticaria and exploring autoimmune mechanisms triggered by IgE and other factors. Advances in molecular biology reveal a complex interplay involving IL-33's influence on itch and mast cell activation, suggesting pathways through which systemic inflammation can exacerbate symptoms. Research involving mast cells and basophils highlighted their differences, their roles in urticaria, and the potential for innovative therapeutics targeting these cells. Discussions pointed to emerging treatments that could improve patient outcomes by selectively inhibiting key signaling pathways and components involved in mast cell and basophil activation. Overall, the forum aimed to enhance understanding and therapeutic strategies for chronic urticaria, emphasizing ongoing research and collaboration among experts.
View moreConclusions
- Chronic spontaneous urticaria (CSU) is characterized by the presence of hives for more than six weeks, including angioedema.
- Dermatology needs to reclaim the management of CSU from allergists since it is fundamentally a skin disease.
- New therapies, such as dupilumab, show promise in bringing chronic urticaria back into dermatological focus.
- The pathophysiology of CSU involves complex interactions between inflammatory stimuli, mast cells, and autoallergens.
- IL-33 plays a significant role in enhancing histaminergic itch, suggesting it as a potential therapeutic target.
- Basophils and mast cells interact in ways that can influence chronic itch and urticaria, offering new avenues for treatment.
- MRGPRX2 represents a novel target in CSU therapies that could help in alleviating symptoms related to mast cell activation.
- Histamine receptor H4R is a promising target for new therapies in conditions like cholinergic urticaria and CSU.
- Research indicates that autoimmunity and systemic inflammation may contribute to chronic urticaria progression and treatment resistance.
- Omalizumab (anti-IgE) is effective in managing chronic urticaria symptoms, even in patients who initially respond poorly to antihistamines.
- Kim BS, et al. The Role of Mast Cells and Basophils in Urticaria. AAD Annual Meeting 2025.
- Netchiporouk E, et al. CSU and CINDU in Children. AAD Annual Meeting 2025.
- Giménez-Arnau AM, et al. Biomarkers to Predict Response to Treatment in CSU. AAD Annual Meeting 2025.
- Metz M, et al. Marcus Legacy and New Meds in the Pipeline. AAD Annual Meeting 2025.
- Trier J, Ver Heul A. Mast Cells are the Highest Expressers of IL-33R in the Skin. J Allergy Clin Immunol 2023.
- Wang F, et al. Atopic Dermatitis is Associated with Circulating Basophil Activation. Cell 2021.
- Auyeung K, et al. Response to Omalizumab (anti-lgE mAb). J Dermatol Treatment 2024.
- Grekowitz E, Metz M, et al. Targeting Histamine Receptor 4 in Cholinergic Urticaria. Br J Dermatol 2024.
- Abreu R, Kim BS. MRGPRX2 as a New Target in CSU. Immunol Allerg Clin 2021.