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Advances in the pathogenesis representing definite outcomes in chronic urticaria

Ensina, Luis Felipea,b; Cusato-Ensina, Ana Paulac; Cardona, Ricardod

Current Opinion in Allergy and Clinical Immunology: June 2019 - Volume 19 - Issue 3 - p 193–197
doi: 10.1097/ACI.0000000000000519
OUTCOME MEASURES: Edited by Henry Milgrom and René Maximiliano Gómez

Purpose of review We reviewed in this article, the recent advances in CSU physiopathology and potential clinical and laboratory biomarkers in CSU.

Recent findings In addition to the central role of mast cells in urticaria physiopathology, increased interest in basophils has arisen. Recent data corroborate the autoimmunity pathway as one of the main pathways in mast cell activation. The association of inflammatory cytokines, heat shock proteins and staphylococcal infection with CSU are also reviewed. C-reactive protein, D-dimers, autologous serum skin test, IgE levels and FcεRI expression in basophils have shown their potential as biomarkers for disease duration, activity, severity and/or response to treatment.

Summary A comprehensive understanding of chronic spontaneous urticaria mechanisms is essential to find novel biomarkers and treatments. The use of these biomarkers in clinical practice will guide us in choosing the best treatment option for our patients.

aFederal University of São Paulo

bHospital Sírio-Libanês

cCPAlpha Clinical Research Center, Brazil

dUniversidad de Antioquia, Colombia

Correspondence to Luis Felipe Ensina, MD, PhD, Rua Barata Ribeiro, 490, São Paulo, SP 01308-000, Brazil. Tel: +55 11 3123 5777; e-mail:

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