Immunological signature of chronic spontaneous urticaria (Review)

Dobrican,Carmen-Teodora; Muntean,Ioana Adriana; Pintea,Irena; Petricău,Carina; Deleanu,Diana-Mihaela; Filip,Gabriela Adriana

doi:10.3892/etm.2022.11309

Immunological signature of chronic spontaneous urticaria (Review)

Authors:
- Carmen-Teodora Dobrican
- Ioana Adriana Muntean
- Irena Pintea
- Carina Petricău
- Diana-Mihaela Deleanu
- Gabriela Adriana Filip
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Affiliations: Discipline of Allergology and Immunology, Department of Functional Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400162 Cluj‑Napoca, Romania, Discipline of Physiology, Department of Functional Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400162 Cluj‑Napoca, Romania
Published online on: April 8, 2022 https://doi.org/10.3892/etm.2022.11309
Article Number: 381
Copyright: © Dobrican et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Chronic urticaria (CU) is a condition characterized by intensely pruritic, edematous, erythematous papules lasting for more than 6 weeks. Over half of the cases have concomitant swelling of deeper tissues, known as angioedema. The socio‑economic burden of the disease is significant. Unfortunately, patients with severe CU, refractory to conventional treatment, have limited and expensive therapeutic options. The pathogenesis of CU is not yet completely understood. Therefore, elucidating the pathophysiological mechanisms involved would potentially identify new therapeutic targets. It has been accepted in recent years that mast cells and their activation, followed by excessive degranulation represent the key pathophysiological events in chronic spontaneous urticaria (CSU). The triggering events and the complexity of the effector mechanisms, however, remain intensely debated topics with conflicting studies. One pathogenetic mechanism incriminated in chronic spontaneous urticaria is the response mediated by the high‑affinity receptor for IgE (FcεRI) expressed on mast cells. Increasing recognition of chronic spontaneous urticaria as an autoimmune disease linked to the cytokine‑chemokine network imbalance resulting from alteration of innate immune response is another pathogenetic explanation. It is likely that these different pathological mechanisms are more interconnected, both acting synergistically, rather than separately, to produce the clinical expression of CU. The discovery and understanding of pathogenic mechanisms represent the premise for the development of safe and effective immunomodulators and targeted biological treatment for severe, refractory CU.

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