Biomarkers In Chronic Spontaneous Urticaria: Current Targets And Clinical Implications
Hereditary alpha tryptasemia (H αT) is a genetic trait that results from increased TPSAB1 copy number encoding alpha-tryptase and is characterized by elevated basal serum tryptase (BST) levels of ≥8ng/mL with variably expressed clinical symptoms (1). In addition to multisystem complaints involving gastrointestinal, connective t issue, and neurologic systems, many individuals with HαT report symptoms associated with mast cell activation such as chronic spontaneous urticaria (CsU) and less commonly allergic asthma.
Oral H1-antihistamines (AHs) are the most commonly used therapy to treat allergic rhinitis and chronic urticaria. Older, first-generation AHs (e.g. diphenhydramine, hydroxyzine) have significant and common side e...
Angioedema consists in a localized swelling of deep dermis, subcutaneous or submucosal tissues due to an extravasation of fluid into the interstitium. It could be divided into histaminergic angioedema, typically accompanied by pruritus and/or urticaria, and bradykinin angioedema. In bradykinin-mediated endotype, angioedema results from the generation of bradykinin, triggering an increase of vascular permeability. These forms are not associated with urticaria, do not respond to epinephrine, antihistamines or glucocorticoids and frequently affects the gastrointestinal mucosa1.
Chronic spontaneous urticaria (CSU) is often associated with organ specific autoimmunity but is rarely caused by food allergy. Colourings and preservatives in pre-packaged foods, so called pseudoallergens, hav...
CONCLUSION: A similar approach to that used for peanut OIT can be taken for non-peanut foods, and for multiple foods simultaneously. High baseline allergy test results are not a contraindication to OIT. PMID: 31494236 [PubMed - as supplied by publisher]
CONCLUSION: The development of new treatments for CSU will importantly lead to improved options for patients and may assist with improving our understanding of disease pathophysiology. PMID: 31494233 [PubMed - as supplied by publisher]
To review the published literature on current and new treatments for chronic spontaneous urticaria (CSU) and to provide guidance on the potential use of these therapeutics.
Alpha-gal allergy is associated with immunoglobulin E (IgE) antibodies to galactose- α-1,3-galactose (alpha-gal), a carbohydrate found in beef, pork, and lamb. First described in the adult population in 2009 by Commins et al., this syndrome is associated with delayed anaphylaxis, angioedema, and urticaria with symptom onset 3 to 6 hours after eating red meat.1,2,3 Bites from ticks, namely the Lone Star Tick (Amblyomma americanum) in the United States, are associated with production of IgE antibodies to alpha-gal, resulting in an immune system primed to react to foods containing the antigen in patients who previously ...
Chronic urticaria (CU) is a common, heterogeneous and debilitating disease. Antihistamines and omalizumab are the mainstay therapies of CU. Additional treatment options are needed. Here, we review the off and beyond label use of licensed drugs, novel treatments that are currently under development, and promising new targets.
Aspirin is first-line treatment in coronary artery disease (CAD) patients, but in patients with acute coronary syndrome (ACS) or who require dual antiplatelet therapy after myocardial revascularization, aspirin therapy becomes critical and time-sensitive1. Approximately 1.5% of CAD patients report aspirin allergy2. Most reactions are considered non-immunologic, related to aspirin ’s inhibition of cyclo-oxygenase causing allergic-like symptoms3. A subset of patients has aspirin exacerbated respiratory disease (AERD) or chronic idiopathic urticaria (CIU) exacerbated by aspirin.