Pathophysiology and emerging treatments for dermographic, cholinergic and cold urticaria - PubMed
4 hours ago
- #mast cell
- #urticaria
- #emerging treatments
- Chronic inducible urticarias (CIndUs), like symptomatic dermographism, cholinergic urticaria, and cold urticaria, are mast cell-driven conditions triggered by specific stimuli and can persist for years, impacting quality of life.
- Pathophysiology involves diverse mechanisms, including IgE-dependent and IgE-independent mast cell activation pathways, involving receptors such as FcεRI, MRGPRX2, and CHRM3, as well as roles for neuropeptides, autoantibodies, and sweat allergens.
- Many patients do not respond adequately to second-generation H1-antihistamines (sgAHs), the only approved therapy, leading to off-label use of omalizumab for some refractory cases.
- Emerging treatments being investigated in clinical trials target mast cells beyond sgAHs and anti-IgE, including Bruton's tyrosine kinase inhibitors, anti-KIT monoclonal antibodies, MRGPRX2 antagonists, and interleukin-4 receptor alpha chain blockade.
- Improved understanding of CIndU endotypes may enable more personalized, mechanism-based treatment approaches in the future.