Urticaria Research Articles

Causal Effect Between Gut Microbiota, Gut Bacterial Pathway, and Chronic Spontaneous Urticaria: A Large-Scale Bidirectional Mendelian Randomization Analysis.

To analyze causality between gut microbiota and chronic spontaneous urticaria (CSU) and to investigate the mediating effect of metabolic pathways. We extracted genome-wide association study summary statistics for 211 microbiota taxa from the MiBioGen consortium (N=18 340), 205 microbiota metabolic pathways from the Dutch Microbiome Project (N=7738), and CSU from the FinnGen genomics initiative (N=450). Bidirectional Mendelian randomization (MR) was performed to detect genetic causality between gut microbiota, gut bacterial pathways, and CSU. Sensitivity analyses were performed to validate the robustness of the results. Mediation MR investigated mediators in the association between gut microbiota and CSU. MR analysis suggested that the family Peptococcaceae and its child taxon, the genus Peptococcus, were risk factors for CSU. In addition, the genera Collinsella, Lachnospiraceae UCG004, Ruminococcaceae UCG004, and Sellimonas were also risk factors for CSU, whereas Family XIII UCG001, Lachnospiraceae UCG010, and Methanobrevibacter had protective effects on CSU. As for metabolic pathways, NONMEVIPP-PWY, PWY-5022, and PWY-7221 were positively associated with CSU, although others, such as KDO-NAGLIPASYN-PWY, PWY- 6353, and PWY-7400 presented a suggestive association with CSU. Moreover, PWY-7400 was a mediator in causality between the family Peptococcaceae and CSU. These results were based on nominal significance (P<.05). None of the Bonferroni corrected P values were <.05. Our study confirmed a causal association between gut microbiota and CSU, with the metabolic pathway being a potential mediator. Our findings provide new insights for further mechanistic and clinical studies in CSU.

Dermatological Manifestations of COVID-19: A Comprehensive Review

Background:COVID-19, caused by SARS-CoV-2, manifests in multiple organ systems, including the skin, presenting a range of dermatologic symptoms. Recognizing these cutaneous signs is essential, as they often appear early or alongside respiratory symptoms, aiding in diagnosis and management. Key skin manifestations include pernio-like lesions (COVID toes), maculopapular rashes, urticarial eruptions, vesicular lesions, and vascular-related signs, each potentially valuable for prognostic assessment. Methods:A systematic review of major databases, including PubMed, Google Scholar, Scopus, and Web of Science, was conducted. Studies published between 2015 and 2024 were included, focusing on the prevalence, pathophysiology, and clinical significance of COVID-19-related skin lesions. Selection criteria prioritized case reports, case series, cohort studies, and systematic reviews reporting quantitative data on cutaneous presentations. Main Findings:COVID-19-associated dermatologic symptoms vary in prevalence and severity, with maculopapular rashes and COVID toes being among the most common. Notably, vascular lesions are linked to severe cases and may serve as indicators of coagulopathy or cytokine storms. Cutaneous signs can often precede or appear in the absence of respiratory symptoms, offering clinicians a window for early detection. Histopathological findings reveal immune-mediated mechanisms, suggesting skin lesions could signal systemic inflammation in COVID-19. Conclusion:The diverse skin manifestations of COVID-19 underscore the need for dermatologic assessment in patient care. These findings support the integration of dermatology into COVID-19 care teams, especially for severe cases, where skin signs may correlate with systemic complications. Further research on pathophysiology and long-term effects is essential for advancing diagnostic and prognostic approaches, reinforcing the role of dermatologic indicators in comprehensive COVID-19 management.

Evaluation of Serum Zonulin Level and Intestinal Permeability in Patients with Chronic Spontaneous Urticaria and the Relationship Between Serum Zonulin Level and Disease Severity

Introduction: An emerging hypothesis suggests a potential link between enhanced intestinal permeability and the advancement of chronic spontaneous urticaria (CSU). Objective: This study aimed to investigate the role of intestinal permeability in the etiopathogenesis of CSU by measuring serum zonulin levels, a marker of intestinal permeability, in both CSU patients and control subjects. Additionally, the study sought to explore the correlation between the severity of the illness and zonulin levels. Methods: The study involved 61 patients with CSU and 59 healthy control individuals. For the CSU patients, comprehensive data was collected, encompassing various aspects: age at onset of the condition, duration of the most recent attack, presence of any comorbid conditions, dosage of antihistamines being used, the urticaria activity score, as well as detailed personal and family medical histories. Additionally, demographic information for these patients was also meticulously documented. Result: The study revealed a statistically significant difference in zonulin levels between the CSU patient group and the control group, with a p-value of 0.000 indicating a highly significant disparity. Furthermore, among the CSU patients, those who were presented with angioedema exhibited considerably higher zonulin levels compared to those without angioedema. This variation in zonulin levels based on the presence of angioedema was also statistically significant, with a p-value of 0.023. Conclusion: The observed results suggest that increased intestinal permeability, as indicated by elevated zonulin levels, may play a crucial role in the pathophysiology of both CSU and angioedema. This association highlights the potential significance of intestinal permeability in the development and manifestation of these conditions.

Sexual Functions Are Impaired in Males and Females With Chronic Spontaneous and Inducible Urticaria: A Controlled Study

Introduction: Sexual dysfunction (SexD) related to chronic dermatologic diseases in women and men were reported in literature, but there are few reports on effects of chronic urticaria (CU) on male and female sexual functions. Objectives: The aim was to investigate prevalence of SexD in women and erectile dysfunction (ED) caused by 2 different CU subtypes. Methods: Our study included 100 patients with CU (60 chronic spontaneous urticaria ([CSU]) and 40 chronic inducible urticaria [CIndU]) and 60 healthy controls. Urticaria activity score 7, urticaria control test, Dermatology Life Quality Index, Beck-Depression Inventory, International Index of Erectile Function (IIEF), and Female Sexual Function Index (FSFI) were assessed in patients and controls. Results: Patients with CSU and CIndU had a higher prevalence of ED (43%, 50% vs 10%) and female SexD than controls (83%, 70% vs 20%). CSU and CIndU patients both had lower FSFI scores than controls (22.1±5.9 and 19.5±8.9 vs control; 29.7±3.4). The IIEF score in men with CSU correlated with lower sexual function. Patients with CIndU had only impaired scores of erectile and orgasmic functions. We found impairment in quality of life (QoL) and long disease duration in women (r=-0.36, r=-0.37; p&lt;0.05) and that depressive symptoms both in men and women with CU is associated with more impairment in sexual function (r=-0.44, r=-0.47; p&lt;0.001). Conclusions: Sexual function is affected in both female and male patients with CSU and CIndU. Given that sexual life is a crucial aspect of QoL, it should be considered when assessing treatment outcomes and disease control.

Assessing Preferences of Patients with Chronic Spontaneous Urticaria for Injectable Treatment Profiles.

In the context of injectable biologic products approved or in development for chronic spontaneous urticaria (CSU), it is important to capture which treatment attributes matter most to patient and what trade-offs patients are willing to make. The CHOICE-CSU study aimed to quantify patient preferences toward injectable treatment attributes among patients with CSU, inadequately controlled by H1-antihistamines. This was a two-phase cross-sectional patient preference study in adult patients with a diagnosis of CSU, inadequately controlled by H1-antihistamines. A qualitative phase collected patients' insights and relevant treatment attributes that mattered to them, and the outputs were used for the quantitative phase to create the actual injectable treatment profiles with attributes and levels such as: efficacy, safety, and mode of administration. The quantitative phase used discrete choice experiment (DCE) methodology. Eligible patients were asked to make hypothetical choices between 12 treatment profile pairs, created by Sawtooth SoftwareTM. The DCE data were analyzed using hierarchical Bayesian logistic regression models, enabling the quantification of the relative importance of each attribute/level during the decision-making process. A total of 450 respondents participated in the DCE. The key attributes driving respondent preference amongst injectable treatment options were type of administration device (relative importance 18.5%), complete control of urticaria (relative importance 17.4%), and resolution of angioedema (relative importance 16.4%). Keeping all other attributes and levels equal, the predicted choice share was higher for a profile with an auto-injector versus one with a pre-filled syringe (72.9% versus 27.1%). The CHOICE-CSU study is the first study to provide a quantitative assessment of preferences that patients with CSU, inadequately controlled by H1-antihistamines, have for injectable treatment attributes. Symptom-free periods are the most important overriding therapy goal for patients, and patients will accept some inconveniences, such as administration mode, to achieve this. Additionally, when efficacy is equivalent, administration ease of injectable therapies is valued by patients. As new CSU oral treatment options emerge, additional testing of patient preference toward oral treatments will be required.

CT-P39 Compared With Reference Omalizumab in Chronic Spontaneous Urticaria: Results From a Double-Blind, Randomized, Active-Controlled, Phase 3 Study.

This study compared the therapeutic equivalence of CT-P39 (an omalizumab biosimilar) and EU-approved reference omalizumab (ref-OMA) in patients with chronic spontaneous urticaria. This double-blind, randomized, active-controlled Phase 3 study (NCT04426890) included two 12-week treatment periods (TPs). In TP1, patients received CT-P39 300 mg, ref-OMA 300 mg, CT-P39 150 mg, or ref-OMA 150 mg. In TP2, patients treated with ref-OMA 300 mg were rerandomized to CT-P39 300 mg or ref-OMA 300 mg; patients initially randomized to CT-P39 300 mg continued this regimen; and patients initially randomized to CT-P39 or ref-OMA 150 mg received 300 mg dosing with the same drug. The primary endpoint for the assessment of therapeutic equivalence of CT-P39 300 mg and ref-OMA 300 mg was changefrom baseline in weekly itch severity score (ISS7) at week 12. In TP1, 619 patients were randomized (CT-P39 300 mg, n = 204; ref-OMA 300 mg, n = 205; CT-P39 150 mg, n = 107; ref-OMA 150 mg, n = 103). Equivalence was demonstrated between CT-P39 300 mg and ref-OMA 300 mg for mean change from baseline in ISS7 at week 12; confidence intervals (CIs) were within predefined equivalence margins: global analysis: treatment difference 0.77, 95% CI -0.37 to 1.90; US analysis: treatment difference 0.70, 90% CI -0.22 to 1.63. The proportion of patients experiencing ≥ 1 treatment-related adverse event was comparable across groups. Secondary efficacy, quality of life, pharmacokinetic, safety, and immunogenicity outcomes were comparable between groups at a given dose level, with no evident impact of switching. Equivalent efficacy was observed between CT-P39 and ref-OMA, with comparable safety also evident.

Chronic Spontaneous Urticaria After New Coronavirus Infection: Clinical Cases

Background. Inefficacy of conventional chronic spontaneous urticaria (CSU) treatments significantly reduces patients’ quality of life. Data on CSU (triggered by new coronavirus infection) prevalence and course in children is very limited.Clinical case description. Authors have presented three clinical cases of CSU onset after the new coronavirus infection. Clinical features of disease and targeted therapy efficacy were evaluated.Conclusion. The course of CSU, potentially triggered by SARS-CoV-2, has its own features, and requires larger research with the study of clinical and laboratory aspects, as well as the immunological mechanisms underlying the disease, with revealing biomarkers indicating disease severity, course, and prognosis.

Navigating Non-Response: Prognosis and Strategies in Chronic Spontaneous Urticaria Management.

Navigating Non-Response: Prognosis and Strategies in Chronic Spontaneous Urticaria Management.

Prescribing practices of corticosteroids in outpatient dermatology department of Injibara General Hospital, north-West Ethiopia, 2024.

Corticosteroids are among the most frequently prescribed drugs in the world because they are extremely effective for the relief of symptoms of many inflammatory and immune disorders and other conditions. Corticosteroids have been a mainstay of pharmacotherapy in dermatological practice. This study aimed to assess prescribing practices of corticosteroids in outpatient dermatology department of Injibara General Hospital, North-West Ethiopia, 2024. A facility-based retrospective cross-sectional study was conducted from September 1 to September 10, 2024, with 422 patient prescriptions issued at the dermatology outpatient department of Injibara General Hospital containing at least one corticosteroid medicine. All patient prescriptions dispensed from the dermatology outpatient department from April to August 2024 containing at least one corticosteroid medicine were included. A structured data collection tool was used to collect data, and Statistical Package for Social Science version 27.1 was used for data analysis. The study population was characterized through descriptive analysis. Female patients accounted 54.2% of the cases recorded, and the most common age group was between 21 and 30 years (26.5%). Atopic dermatitis (15.4%) was the most common skin disorder, followed by papular urticaria (9.97%) and seborrheic dermatitis (8.9%) for which corticosteroids were prescribed. Topical corticosteroids were the most commonly prescribed medications, accounting for 94.1%. The percentage of corticosteroids prescribed by generic name was 82.4%. We found that the percentage of topical corticosteroid prescriptions in fixed drug combinations and extemporaneous prescription was 4.4 and 1.2%, respectively. Mometasone furoate was the most commonly prescribed (34.6%), followed by clobetasol propionate (26.7%). Ointments (53%) followed by creams (40.6%) were the most common formulations of topical corticosteroids issued. In the present study, moderate potency TCS were most commonly prescribed (32.3%), followed by high potency (28.3%), and super high potency (27.6%), respectively. From this study, it can be concluded that atopic dermatitis is the most common skin disease observed in the studied dermatology outpatient where the corticosteroid was indicated. Mometasone furoate and clobetasol propionate were the two most commonly prescribed agents. Prescribing practice of high potent and very high potent topical corticosteroids was found to be considerably high.

Effective management of chronic urticaria

Urticaria (also known as welts, hives, weals, wheals or nettle rash) is usually divided into acute and chronic forms, becoming chronic when daily or almost daily wheals continue for 6 weeks or more, although many attacks of acute urticaria settle much more quickly. The most common underlying mechanism is the release of histamine from mast cells with consequent capillary dilatation and tissue oedema. In the UK, approximately 15% of people experience urticaria at some time in their lives and for around 40–50% of people with urticaria, the cause of their condition is unknown. This article will provide an overview of chronic urticaria to include the clinical signs, history, diagnosis and management principles, signposting to current guidance, patient information and further resources.

NOD-like receptor family pyrin domain containing 3 (rs10754558) gene polymorphism in chronic spontaneous urticaria: A pilot case-control study.

Chronic spontaneous urticaria (CSU) is a persistent skin condition with no known cause or trigger. The unpredictability of CSU attacks lowers patients' quality of life. NOD-like receptor pyrin domain containing 3 (NLRP3) gene dysregulation can result in numerous immunological and inflammatory diseases. This case-control study aimed to determine the association between the NLRP3 inflammasome (rs10754558) single nucleotide polymorphism (SNP) and the occurrence, severity and etiology of CSU. Each study group included 62 participants; all were subjected to CSU severity evaluation by the urticaria activity score (UAS), autologous serum skin testing (ASST) and NLRP3 (rs10754558) genotyping. The NLRP3 (rs10754558) CG genotype was the most predominant in both study groups, followed by the CC genotype (41.9%) in the CSU group and the GG genotype (25.8%) in the control group. Most of the CSU group (66.1%) had the C allele, compared to most controls (53.2%) with the G allele. The frequency of NLRP3 (rs10754558) genotypes and alleles did not differ significantly according to the severity of CSU by UAS (P>0.05). The prevalence of the CC genotype was significantly higher among the ASST-positive CSU patients. The C allele elevated the likelihood of positive ASST in CSU patients by 21 times, suggesting the autoimmune theory of CSU. None of the ASST-positive patients had the GG genotype. The NLRP3 inflammasome (rs10754558) C allele may be associated with CSU risk but not severity by UAS. It may also be associated with ASST positivity which suggests a connection between the C-allele and the autoimmune notion of CSU.

Factors associated with quality of life of chronic spontaneous urticaria patients in a Vietnamese population.

Chronic spontaneous urticaria (CSU) is a challenging condition that significantly impacts the affected patients. This study aimed to evaluate the quality of life (QoL) among patients with CSU in Vietnam and identify factors associated with QoL. A cross-sectional study was conducted at the Vietnam National Dermatology and Venereology Hospital from June 2023 to March 2024. A total of 358 CSU patients aged 16 years or older were recruited. Data were collected using a structured questionnaire covering demographic, clinical, and laboratory characteristics. The Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) and the Weekly Urticaria Activity Score (UAS7) were utilized to assess QoL and disease severity. Multivariate Tobit regression models were performed. The CU-Q2oL total score had a mean of 48.67 (SD = 16.90) and a median of 46 (IQR = 35-59). The scores for individual CU-QoL subscales were as follows: pruritus (5.42±2.02), swelling (2.86±1.54), life activities (13.89±6.00), sleep problems (11.12±4.96), limits (6.52±2.66), and looks (8.85±4.09). Higher UAS7 scores were associated with lower QoL, and angioedema in the eyes and lips were associated with increased swelling domain and poorer overall QoL. Longer disease duration was associated with higher pruritus scores, while a history of allergy was related to poorer total QoL, sleep, and looks. Severe itching further degraded sleep quality. Positive Autologous Serum Skin Test (ASST) was correlated with lower overall QoL, particularly in swelling and limits domains. Positive Basophil Histamine Release Assay (BHRA) status was linked to poorer sleep quality domain. CSU significantly impairs the QoL of patients, affecting physical, emotional, and social dimensions. Regular QoL assessments should be integrated into clinical practice to ensure comprehensive and patient-centered treatment strategies.

Gut microbial alteration in chronic spontaneous urticaria unresponsive to second generation antihistamines and its correlation with disease characteristics- a cross-sectional case-control study.

Gut microbial involvement has been speculated in chronic spontaneous urticaria (CSU). The aim of the study was to compare the gut microbiome composition and diversity in CSU patients uncontrolled with second-generation antihistamines (sgAHs) and healthy individuals, as well as to explore any association between gut microbiome and disease characteristics. A cross-sectional case-control study including 20 CSU patients unresponsive to standard doses of sgAHs, and 15 age-and-sex matched healthy controls was conducted. Clinico-demographic profile, laboratory investigations and stool analysis were conducted in all study participants. 16S RNA gene sequencing and DNA isolation was performed for all stool samples, followed by bioinformatic analysis. The CSU patients (mean age 39.5±9.3, M:F 1:4) and healthy controls (mean age 35±13, M:F 1:2) were statistically comparable. The median (IQR) duration of CSU was 42months (7-81). Concomitant angioedema and concomitant symptomatic dermographism were present in 30% and 20% CSU patients, respectively. At inclusion, 60% patients were receiving add-on omalizumab, while the remaining 40% were on up-dosed sgAHs. Stool microbial analysis revealed increased diversity and higher microbial richness in CSU patients compared with healthy individuals. CSU patients showed reduced load of short-chain fatty acid (SCFA) producing microbiota and increased load of opportunistic pathogens. The Firmicutes/Bacteroides (F/B) ratio was higher in CSU patients. Among CSU patients, higher Bacteroides and reduced Firmicutes count were associated with higher disease activity and poor control; however, there was no link with the type of therapy. Gut microbial dysbiosis is seen in CSU and is linked with disease control.

Predictive cytokines of omalizumab in the treatment of chronic spontaneous urticaria

BackgroundOmalizumab, an anti-IgE biological agent, is commonly prescribed as a second-line therapy for Chronic Spontaneous Urticaria (CSU). However, there is a lack of biomarkers to predict which CSU patients will respond favorably to omalizumab. ObjectiveOur study aims to identify cytokine markers associated with the efficacy of omalizumab in treating CSU. MethodsWe conducted a prospective study, enrolling antihistamine-resistant CSU patients from Tongji Hospital between Feburary and August 2023. All patients received a 16-week course of omalizumab (300 mg, administered every 4 weeks). Following 16 weeks of omalizumab treatment, patients were categorized into responder group and non-responder groups based on their UAS7 scores at the 16th week, using a cut-off value of 7. Serum total IgE (TIgE) and cytokine levels were measured at baseline and at the 16th week. ResultsA total of 59 patients were enrolled in the study, 46 (78.0 %) responded positively to omalizumab. The responder group had lower UAS7 and DLQI scores at 4 and 16 weeks compared to their baseline and the non-responder group. There was no statistical difference in baseline TIgE levels between the two groups, but TIgE significantly increased in both groups after 16 weeks of omalizumab treatment. The responder group had higher baseline levels of IL-2, IL-13, IL-31, and IL-33 than the non-responder group. After 16 weeks of omalizumab treatment, the levels of IL-5, IL-31, and IL-33 were higher in the responder group than in the non-responder group. The AUC of baseline IL-2, IL-13, IL-31, and IL-33 in predicting responses to omalizumab were 0.8250, 0.8125, 0.7938, and 0.7813 (all P < 0.05), and the cut-off value were 154.5 pg/ml, 41.5 pg/ml, 100.8 pg/ml and 3330 pg/ml respectively. ConclusionCSU patients with high levels of IL-2, IL-13, IL-31, and IL-33 may potentially benefit from omalizumab treatment.

The association of parental age at delivery with childhood allergic disease and the modified effect of breastfeeding.

Childhood allergic diseases are a global concern; quite limited studies have examined the impacts of parental age at delivery. This study aimed to explore the association between separate and combined parental age at delivery and childhood allergic diseases and whether adequate breastfeeding could modify this association. This cross-sectional study sampled 15,976 children from Shanghai, China. The International Study of Asthma and Allergies in Childhood questionnaire was adopted to evaluate allergic diseases. Multivariate logistic regression models were used to examine the association of parental age and exclusive breastfeeding with allergic diseases. The prevalence of allergic rhinitis, asthma, food allergy, drug allergy, urticaria, and eczema was 21.2%, 14.2%, 8.7%, 3.9%, 15.6%, and 35.5%, respectively. Either of parental age at delivery ≥25 years could increase the risk of allergic diseases in most cases, where paternal age showed a stronger effect. The risk was further elevated when parental age were both ≥25 years (OR ranged from 1.266 to 1.541, all p < .05 except for drug allergy). Breastfeeding >6 months was inversely associated with all types of allergic diseases and involved in attenuating the risk caused by parental age ≥25 years. These findings were generally validated by sensitivity examination as well as stratified analyses. Parental age at delivery ≥25 years was a risk factor for most childhood allergic diseases. Breastfeeding >6 months applied to modifying the risk chalked up to parental age. These findings are significant given the rising age of parents and increasing prevalence of childhood allergic diseases.

Effects of micronutrients and macronutrients on risk of allergic disease in the European population: a Mendelian randomization study

ABSTRACT Background: Regional lifestyles influence allergic disease risks, with dietary factors being crucial. However, observational studies on micro- and macronutrient impacts are inconsistent. Methods: We used a two-sample Mendelian randomization (MR) design with the inverse variance weighted (IVW) method and sensitivity analyses to evaluate the effects of various micronutrients (e.g. zinc, selenium, phosphorus) and macronutrient intake on allergic diseases. Results: Zinc was inversely associated with allergic asthma (OR = 0.856, p = 0.014) and atopic dermatitis (OR = 0.918, p = 0.039). Selenium was inversely associated with allergic rhinitis (OR = 0.863, p = 0.037). Phosphorus was linked to an increased risk of allergic urticaria (OR = 4.396, p = 0.0025). Other nutrients showed no significant associations. Conclusion: Certain micronutrients, like zinc, selenium, and phosphorus, may play significant roles in allergic disease development, warranting further research to confirm these findings.

Is Omalizumab Alone an Effective Treatment for Patients with Chronic Spontaneous Urticaria?

Is Omalizumab Alone an Effective Treatment for Patients with Chronic Spontaneous Urticaria?

Persistent urticarial eruption preceding systemic features of adult-onset Still's disease: A case report.

Adult-onset Still's disease (AOSD) is a rare autoinflammatory systemic disorder classically characterised by inflammatory polyarthritis, daily fevers and a transient asymptomatic salmon-pink maculopapular rash that typically arises with the onset of fevers. We report a case of AOSD presenting with a severely pruritic urticarial eruption starting 6 weeks prior to the onset of fever and arthritis and complicated by macrophage activation syndrome. This case highlights the importance of early recognition of diverse cutaneous manifestations of AOSD to facilitate timely diagnosis and treatment to improve disease outcomes.

Exploring the Impact of IL-33 Gene Polymorphism (rs1929992) on Susceptibility to Chronic Spontaneous Urticaria and Its Association with Serum Interleukin-33 Levels.

Urticaria is a debilitating skin condition affecting up to 20% of the global population, characterized by erythematous, maculopapular lesions and significant quality of life impairment. This study focused on the role of interleukin 33 (IL-33) and its polymorphisms, particularly SNP rs1929992, in chronic spontaneous urticaria (CSU). Using demographic, clinical, and laboratory data from CSU patients and controls, we estimated allele and genotype frequencies, Hardy-Weinberg equilibrium condition, and serum IL-33 levels, using unconditional binomial logistic regression for association analysis. Results revealed that CSU patients had significantly higher frequencies of the minor allele of IL-33 rs1929992 compared to controls (31.25% vs. 17.35%, p = 0.024), and carriers of the GA genotype exhibited increased odds of CSU (adjusted OR = 2.208, p ≤ 0.001). Additionally, serum IL-33 levels were markedly elevated in CSU patients, particularly those with the GA genotype. The findings suggest that the IL-33 SNP is associated with an increased susceptibility to CSU, emphasizing its potential as a diagnostic and therapeutic biomarker. This study underscores the genetic and immunological underpinnings of CSU, paving the way for personalized treatment approaches.

Orticaria cronica spontanea

Chronic spontaneous urticaria (CSU) is a condition characterized by the daily occurrence of wheals, with or without angioedema, persisting for more than six weeks, without any identifiable triggering factor. CSU is caused by the abnormal activation of mast cells and basophils and the release of histamine, resulting in itching and skin lesions that can significantly impact patients' quality of life. Diagnosis is primarily based on clinical observation and the exclusion of other conditions, while standard treatment involves the use of second-generation antihistamines, with the addition of omalizumab for more resistant cases.