The association of chronic spontaneous urticaria (CSU) with anxiety and depression: a nationwide cohort study

Bitan, Dana Tzur; Berzin, Daniella; Cohen, Arnon D

doi:10.1007/s00403-020-02064-3

Cited by 22 publications

(14 citation statements)

References 41 publications

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“…Yu et al (66) found that the altered metabolic activity of the purine cycle is also linked with allergic asthma (66). Furthermore, lower levels of xanthine in the cerebrospinal fluid are associated with depression, which may partly explain the high prevalence of depression in CSU patients (67). Our data also showed an interesting correlation between xanthine and the time since diagnosis of CSU, although it needs further validation in a larger sample size.…”

Section: Discussionsupporting

confidence: 56%

Abnormalities in Gut Microbiota and Metabolism in Patients With Chronic Spontaneous Urticaria

Wang

et al. 2021

Front. Immunol.

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BackgroundIncreasing evidence suggests that the gut microbiome plays a role in the pathogenesis of allergy and autoimmunity. The association between abnormalities in the gut microbiota and chronic spontaneous urticaria (CSU) remains largely undefined.MethodsFecal samples were obtained from 39 patients with CSU and 40 healthy controls (HCs). 16S ribosomal RNA (rRNA) gene sequencing (39 patients with CSU and 40 HCs) and untargeted metabolomics (12 patients with CSU and 12 HCs) were performed to analyze the compositional and metabolic alterations of the gut microbiome in CSU patients and HCs.ResultsThe 16S rRNA gene sequencing results showed a significant difference in the β-diversity of the gut microbiota, presented as the Jaccard distance, between CSU patients and HCs. No significant differences were found in the α-diversity of the gut microbiota between patients and HCs. At the phylum level, the major bacteria in the gut microbiome of patients with CSU were Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria. At the genus level, Lactobacillus, Turicibacter, and Lachnobacterium were significantly increased and Phascolarctobacterium was decreased in patients with CSU. PICRUSt and correlation analysis indicated that Lactobacillus, Turicibacter, and Phascolarctobacterium were positively related to G protein-coupled receptors. Metabolomic analysis showed that α-mangostin and glycyrrhizic acid were upregulated and that 3-indolepropionic acid, xanthine, and isobutyric acid were downregulated in patients with CSU. Correlation analysis between the intestinal microbiota and metabolites suggested that there was a positive correlation between Lachnobacterium and α-mangostin.ConclusionsThis study suggests that disturbances in the gut microbiome composition and metabolites and their crosstalk or interaction may participate in the pathogenesis of CSU.

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Section: Discussionsupporting

confidence: 56%

Abnormalities in Gut Microbiota and Metabolism in Patients With Chronic Spontaneous Urticaria

Wang

et al. 2021

Front. Immunol.

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“…Our study observed a prevalence of 39.8% ( n = 49), comparable data in a range of 38–54% in contrast to other clinical reports ( 31 , 32 ). On the other hand, mental comorbidities have been associated with CU ( 12 , 33 , 34 ), a finding corroborated in our study. More than a third of the patients evaluated reported symptoms related to anxiety and exacerbations associated with stress.…”

Section: Discussionsupporting

confidence: 91%

Multicentric and Observational Study of Omalizumab for Chronic Spontaneous Urticaria in Real-Life in Colombia

et al. 2022

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BackgroundAlthough chronic urticaria (CU) is a common, cause of medical consulting both in general practitioners and allergist specialists worldwide, there is little information about its behavior and management in Latin America. Currently, national and international guidelines recommend using Omalizumab for cases refractory to management with antihistamines. Despite advances in the knowledge of Omalizumab for the management of CU, although there are few studies in underdeveloped countries, there are many studies evaluating the impact of Omalizumab treatment. There is not clinical information related with CSU-Omalizumab in patient settled in the Caribbean area. This research aims to evaluate the management of CU with Omalizumab in a real-life scenario in Colombia.MethodologyWe conducted an observational, descriptive, and retrospective study with patient recruitment between 2014 and 2017 of individuals diagnosed with Chronic Urticaria (CU) treating allergology specialists in five Colombian cities. We included patients with CU who failed to achieve disease control after treatment for 4 weeks with fourfold doses of second-generation H1-antihistamines, as recommended by the EAACI/GA2LEN/EDF/WAO guidelines and who received treatment with Omalizumab.ResultsWe included 123 patients, 73.1% (n = 90) were women. The mean age was 47.1 years (Standard Deviation, SD: 16.2). The median of the total months of disease evolution was 30 (IQR = 13–58). 81.3 % (n = 100) of patients were diagnosed with chronic spontaneous urticarial (CSU). 4.8% (n = 6) had inducible CU (CIndU), and 13.8% (n = 17) reported mixed urticaria (spontaneous CU with at least one inducible component). Regarding emotional factors, 34.9% (n = 43) of subjects indicated anxiety symptoms, 34.1% (n = 42) had exacerbations associated with stress, and 14.6% (n = 18) manifested episodes of sadness. The percentage of patients with CSU controlled according to medical criteria at 3 months with Omalizumab were 80% (n = 80/100) and at 6 months 87% (n = 87/100). The frequency of adverse events was 29.2% (n = 36), with headache being the most frequent adverse event.ConclusionsThis real-life study with Omalizumab at CU describes percentages of effectiveness and safety similar to those observed in pivotal and real-life studies conducted in other regions around the world.

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“…10 It is estimated that 35-60% of patients with CU have psychiatric comorbidities. 17 In children, social anxiety disorder and depression appear to be the most frequent, 18 and in an SR focusing on children with CSU, the authors describe only one publication reporting psychiatric comorbidities in 70.4%. 15 In the present analysis, there was a psychiatric illness in nearly 10% of patients.…”

Section: Discussionmentioning

confidence: 99%

Pediatric chronic urticaria: Clinical and laboratory characteristics and factors linked to remission

Sandoval‐Ruballos

Domínguez

Landazuri

et al. 2023

Pediatric Allergy Immunology

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Background Chronic urticaria (CU) is defined as the occurrence of wheals/angioedema for ≥6 consecutive weeks. Until now, guidelines and publications addressing CU have focused mainly on adults. As a result, evidence and guidance in the pediatric population are scarce. Methods This study aims to describe clinical and laboratory findings in pediatric CU and to determine factors associated with remission. Results 185 patients, 54% female, median age at onset of 8.8 years. Angioedema was present in almost half. The most common type of CU was chronic spontaneous urticaria (CSU) in 74%. At least one atopic comorbidity was found in almost a third (35%). In addition, 8% had an autoimmune disorder (exclusively in CSU) and 9% had a psychiatric condition. Basopenia was found in 67% and was more frequently associated with CSU. The basophil activation test (BAT) was positive in 40%. With regard to remission, being of male sex, angioedema absence, the absence of physical triggers, and eosinophil counts >0.51 × 109/L were associated with shorter CU duration. Conclusion Atopy is a common condition in pediatric CU. CSU is the most common type. Autoimmune comorbidities and basopenia were significantly more common in CSU. In addition, ours is one of the few studies, assessing BAT utility in the pediatric population, being positive in a relevant percentage (40%). BAT positivity was more frequent in CSU. Our results suggest that the absence of angioedema and physical triggers, male sex, and eosinophil counts >0.51 × 109/L appear to be associated with a better prognosis in terms of remission.

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The association of chronic spontaneous urticaria (CSU) with anxiety and depression: a nationwide cohort study

Cited by 22 publications

References 41 publications

Abnormalities in Gut Microbiota and Metabolism in Patients With Chronic Spontaneous Urticaria

Abnormalities in Gut Microbiota and Metabolism in Patients With Chronic Spontaneous Urticaria

Multicentric and Observational Study of Omalizumab for Chronic Spontaneous Urticaria in Real-Life in Colombia

Pediatric chronic urticaria: Clinical and laboratory characteristics and factors linked to remission

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