Chronic Urticaria: Advances in Understanding of the Disease and Clinical Management

He, Liting; Yi, Wanyu; Huang, Xin; Long, Hai; Lu, Qianjin

doi:10.1007/s12016-021-08886-x

“…[ 6 ] Chronic urticaria has various manifestations, including chronic spontaneous urticaria and chronic inducible urticaria, depending on whether the episodes are triggered by specific stimuli. [ 7 ] Chronic spontaneous urticaria is more common than other forms of chronic urticaria. [ 8 ] Urticaria is a main reason for consultations with an allergist, dermatologist, or general practitioner in Western countries.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of urticaria in China: a population-based study

Li

¹

,

Mao

²

,

Liu

³

et al. 2022

Chinese Medical Journal

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Background: Urticaria is a common skin disease characterized by episodes of wheals, and it has a negative effect on patients' quality of life. Large-scale population-based epidemiological studies of urticaria are scarce in China. The aim of this survey was to determine the prevalence, clinical forms, and risk factors of urticaria in the Chinese population. Methods: This survey was conducted in 35 cities from 31 provinces, autonomous regions, and municipalities of China. Two to three communities in each city were selected in this investigation. Participants completed questionnaires and received dermatological examinations. We analyzed the prevalence, clinical forms, and risk factors of urticaria. Results: In total, 44,875 questionnaires were distributed and 41,041 valid questionnaires were collected (17,563 male and 23,478 female participants). The lifetime prevalence of urticaria was 7.30%, with 8.26% in female and 6.34% in male individuals (P < 0.05). The point prevalence of urticaria was 0.75%, with 0.79% in female and 0.71% in male individuals (P < 0.05). Concomitant angioedema was found in 6.16% of patients. Adults had a higher prevalence of urticaria than adolescents and children. Living in urban areas, exposure to pollutants, an anxious or depressed psychological status, a personal and family history of allergy, thyroid diseases, and Helicobacter pylori infection were associated with a higher prevalence of urticaria. Smoking was correlated with a reduced risk of urticaria. Conclusion: This study demonstrated that the lifetime prevalence of urticaria was 7.30% and the point prevalence was 0.75% in the Chinese population; women had a higher prevalence of urticaria than men. Various factors were correlated with urticaria.

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“…Chronic urticaria is stubborn and difficult to heal, which brings great inconvenience to the patient's life and has a great adverse impact on the patient's physical, mental, and economic conditions [14]. It is clinically believed that the onset of the disease is closely related to the patient's autoimmunity [15,16].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Fangfeng Tongsheng Granule Combined with Levocetirizine in the Treatment of Chronic Urticaria and Its Effect on Serum Complement, IL-4, IgE, and IFN-γ Levels in Patients

Xu

¹

,

Li

²

,

Wang

³

2022

Evidence-Based Complementary and Alternative Medicine

0

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Objectives. To investigate the efficacy of Fangfeng Tongsheng granule combined with levocetirizine in the treatment of chronic urticaria and its effect on serum complement, interleukin (IL)-4, immunoglobulin E (IgE), and interferon-γ (IFN-γ) levels in patients. Methods. A total of 98 patients with chronic urticaria who were admitted to our hospital from July 2021 to March 2022 were selected and divided into random odd-even numbers. The odd numbers were included in the observation group, with a total of 49 cases, and they were treated with Fangfeng Tongsheng granule combined with levocetirizine; the even numbers were included in the control group, with a total of 49 cases and were treated with levocetirizine alone. The two groups of patients were treated continuously for 4 weeks, and the clinical efficacy of the two groups was observed. Before treatment, 2 weeks and 4 weeks after treatment, evaluate the clinical symptom scores of patients such as itching, flushing, wheal, edema, observe the improvement of clinical symptoms of patients, and the changes in Dermatology Life Quality Index (DLQI). Serum complement C3, C4, T lymphocyte subsets CD3+, CD4+, CD8+ levels and CD4+/CD8+ ratio, IL-4, IgE, and IFN-γ levels and the occurrence of adverse reactions in the two groups were calculated and observed. All patients were followed up for 2 months after treatment to observe the recurrence of patients. Results. The scores of clinical symptoms such as wheal, itching, flushing, edema, and attack frequency in the observation group at each time point after treatment were lower than those in the control group (F times were 725.365, 851.521, 936.411, 3943.136, and 2226.147, all P < 0.05 (F between-group were 40.642, 102.124, 188.523, 259.291, and 23.92, P < 0.05 ); the total effective rate of the observation group was 93.88% (46/49), which was significantly higher than that of the control group, 73.47% (36/49) (χ2 = 7.470, P = 0.006 ). The DLQI scores of the observation group at each time point after treatment were lower than those of the control group (F time was 282.214, P < 0.05 ; F between-group was 6.546, P < 0.05 ). There was no significant difference in serum C4 levels between the two groups at each time point (F time was 1.225, P > 0.05 ; F between-group was 0.408, P > 0.05 ); serum complement C3, CD3+, and CD4+/the ratio of CD8+ and IFN-γ were higher than those in the control group (F time was 407.352, 107.823, 32.941, and 2354.147, P < 0.05 ; F between-group was 40.941, 24.710, 54.982, and 264.921, P < 0.05 ); the observation group at each time after treatment the levels of IgE and IL-4 were lower than those of the control group (F time were 373.124 and 395.612, P < 0.05 ; F between-group were 21.802 and 62.591, P < 0.05 ). The incidence of adverse reactions in the observation group was 12.24% (6/49) compared with 10.20% (5/49) in the control group, which had no significant difference (χ2 = 0.102, P = 0.749 ). Both groups were followed up for 2 months after treatment. The recurrence rate in the observation group was 12.24% (6/49), which was lower than that in the control group, which was 32.65% (16/49) (χ2 = 5.861, P = 0.015 ). Conclusion. The application of Fangfeng Tongsheng granules combined with levocetirizine in patients with chronic urticaria can effectively improve the clinical symptoms of patients, improve clinical efficacy, reduce the impact of the disease on life, improve the immune status of patients, and reduce the risk of recurrence.

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“…It is notorious that the release of granules and the discharge of histamine from MCs are involved in the genesis of urticaria [ 72 , 73 ]. VD has been suggested for this therapy and for the one concerning other allergic pathology [ 74 , 75 ], as MCs own the VDR capable of blocking degranulation of compounds provoked by IgE [ 76 ].…”

Section: Vitamin D and Mast Cells: Effects On Allergiesmentioning

confidence: 99%

Mast Cells and Vitamin D Status: A Clinical and Biological Link in the Onset of Allergy and Bone Diseases

Murdaca

¹

,

Allegra

²

,

Tonacci

³

et al. 2022

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The immune system is made up by an extremely composite group of cells, whose regulated and harmonious activity is fundamental to maintain health. The mast cells are an essential effector of inflammatory response which is characterized by a massive release of mediators accumulated in cytoplasmic secretory granules. However, beyond the effects on immune response, mast cells can modify bone metabolism and are capable of intervening in the genesis of pathologies such as osteoporosis and osteopenia. Vitamin D is recognized to induce changes in bone metabolism, but it is also able to influence immune response, suppressing mast cell activation and IgE synthesis from B cells and increasing the number of dendritic cells and IL-10-generating regulatory T cells. Vitamin D deficit has been reported to worsen sensitization and allergic manifestations in several different experimental models. However, in clinical situations, contradictory findings have been described concerning the correlation between allergy and vitamin D deficit. The aim of this review was to analyze the close relationships between mast cells and vitamin D, which contribute, through the activation of different molecular or cellular activation pathways, to the determination of bone pathologies and the onset of allergic diseases.

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Chronic Urticaria: Advances in Understanding of the Disease and Clinical Management

Cited by 35 publications

References 193 publications

Epidemiology of urticaria in China: a population-based study

Epidemiology of urticaria in China: a population-based study

Efficacy of Fangfeng Tongsheng Granule Combined with Levocetirizine in the Treatment of Chronic Urticaria and Its Effect on Serum Complement, IL-4, IgE, and IFN-γ Levels in Patients

Mast Cells and Vitamin D Status: A Clinical and Biological Link in the Onset of Allergy and Bone Diseases

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