Autoimmune Theories of Chronic Spontaneous Urticaria

Abstract

Urticaria (hives) is a highly prevalent skin disorder that can occur with or without associated angioedema. Chronic spontaneous urticaria (CSU) is a condition which persists for more than 6 weeks in duration and occurs in the absence of an identifiable provoking factor. CSU results from pathogenic activation of mast cells and basophils, which gives rise to the release of proinflammatory mediators that support the generation of urticaria. Several theories have been put forth regarding the pathogenesis of CSU with much evidence pointing toward a potential autoimmune etiology in up to 50% of patients with this condition. In this review, we highlight the evidence surrounding the autoimmune pathogenesis of chronic urticaria including recent data which suggests that CSU may involve contributions from both immunoglobin G (IgG)-specific and immunoglobulin E (IgE)-specific autoantibodies against a vast array of antigens that can span beyond those found on the surface of mast cells and basophils.

The pseudoallergen receptor MRGPRX2 on peripheral blood basophils and eosinophils: Expression and function

“…Nevertheless, at the moment, most data indicating MRGPRX‐mediated anaphylactoid reactions are derived from mouse models or cell lines . Recently, human skin mast cell MRGPRX2 upregulation has been demonstrated in severe chronic spontaneous urticaria, a disease in which the role of specific IgE against allergens is negligible and against autoallergens debated . Not only mast cells, but also basophils and eosinophils are increasingly regarded as potent effector cells in chronic urticaria.…”

Recurrent spontaneous clearance of psoriasis during exacerbations of concomitant chronic spontaneous urticaria

“…Mast cell (MC) activation is one of the earliest morphological changes in developing both psoriatic lesions 3 and CSU. 4 Moreover, induction of the Koebner reaction in healthy-looking skin of patients with psoriasis is associated with an increase in MC numbers, which peaks with the appearance of psoriatic plaques. 5 Compared to CSU, psoriasis is considered to be a Th1-driven disease characterized by the infiltration of several T-cell subsets, dendritic cells, neutrophils, natural killer T cells, and MCs.…”

Secondary Analysis of Microarray Data Reveals Immune-Related Key Genes and Pathways in Chronic Spontaneous Urticaria

“…As an immune-mediated in ammatory disease, CSU is closely related to autoimmune process and systemic in ammatory response. The autoimmunity theory and Th1/Th2 cell imbalance hypothesis related to its pathogenesis have been discussed most in the past [6,7]. In order to better understand its pathogenesis, this article explores from the molecular level.…”