scholarly journals Cholinergic urticaria: novel aspects of pathogenesis, diagnosis and management

2021 ◽  
Vol 24 (3) ◽  
pp. 211-226
Author(s):  
Elena Yu. Borzova ◽  
Christina Yu. Popova ◽  
Marcin Kurowski ◽  
Maia T. Rukhadze ◽  
Razvigor Darlenski ◽  
...  
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Main Research ◽  
Cholinergic Urticaria ◽  
Chronic Inducible Urticaria ◽  
H1 Antihistamines ◽  
Inducible Urticaria ◽  
Diagnostic Approaches ◽  
Challenge Tests ◽  
Pathophysiologic Mechanisms

Cholinergic urticaria (CholU) is a chronic inducible urticaria, characterised by itchy pinpoint wheals up to 3 mm in diameter, surrounded by a prominent flare, that occur following an exposure to characteristic triggers such as active or passive heating, physical exercise, emotions, hot or spicy foods. Key pathophysiologic mechanisms include immediate hypersensitivity to autologous sweat antigens, functional sweating disorders, impaired acethylcholine metabolism, abnormal skin vascular permeability and disturbed skin innervation. Clinical manifestations of CholU may vary from typical itchy pinpoint urticarial lesions, angioedema to anaphylaxis. Atypical CholU forms include cholinergic pruritus, cholinergic dermographism, cold cholinergic urticaria and persistent cholinergic erythema. The diagnosis of cholinergic urticaria relies on patients history, сlinical manifestations and challenge tests. Treatment options include nonsedating H1 antihistamines in standard or increased doses. The evidence is accumulating for the use of biological treatment with omalizumab in cholinergic urticaria. The prospect of personalized treatment of cholinergic urticaria include autologous sweat desensitization. The main research efforts in ColdU are directed at optimizing diagnostic approaches and developing innovative therapeutic options.

scholarly journals The Use of Omalizumab in Chronic Urticaria: Available Data and Future Aspects of Anti-IgE Treatment

2021 ◽  
Author(s):  
Young-Min Ye
Keyword(s):  
Chronic Urticaria ◽  
Efficacy And Safety ◽  
Chronic Inducible Urticaria ◽  
First Choice ◽  
H1 Antihistamines ◽  
Choice Of Treatment ◽  
Inducible Urticaria ◽  
Disease Modifying ◽  
Impaired Quality

Chronic urticaria (CU) defined as repeatedly occurred itchy wheals and/or angioedema for at least 6 weeks. Due to the unpredictability, recurrent and disabling symptoms, and a considerably impaired quality of life, effective and tolerable treatment for CU patients is crucial. Almost a half of patients with CU are refractory to H1-antihistamines, even though the dose of antihistamines is increased up to 4-fold. Recently treatment modulating IgE levels and activities provides an efficient therapeutic approach. Omalizumab, the only approved anti-IgE treatment for chronic spontaneous urticaria (CSU) patients until now, with a strong evidence of the efficacy and safety, opened a new horizon in the care of the patients whose urticaria is not controlled with antihistamines. Recent international guidelines recommend omalizumab as the first choice of treatment for antihistamine-refractory CSU. However, as it is not curative neither disease-modifying agent, there is a subpopulation of CSU patients responding partly or never to omalizumab. The other things to be solved in the treatment of CU is that clinical evidence is still limited on chronic inducible urticaria (CIndU) and special populations. Thus, a new anti-IgE treatment, ligelizumab is actively evaluated in the efficacy compared with both placebo and omalizumab. Further understandings on the pathogenesis of CU can lead to the development of new mechanism-based therapeutics for CU patients.

scholarly journals Advances in Understanding and Managing Chronic Urticaria

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 177 ◽  
Author(s):  
Yasmin Moolani ◽  
Charles Lynde ◽  
Gordon Sussman
Keyword(s):  
Chronic Urticaria ◽  
Immunoglobulin E ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Fold Increase ◽  
Line Treatment ◽  
Physical Urticaria ◽  
Chronic Inducible Urticaria ◽  
Autoimmune Urticaria ◽  
Inducible Urticaria

There have been recent advances in the classification and management of chronic urticaria. The new term chronic spontaneous urticaria (CSU) has replaced chronic idiopathic urticaria and chronic autoimmune urticaria. In addition, chronic inducible urticaria (CINDU) has replaced physical urticaria and includes other forms of inducible urticaria, such as cholinergic and aquagenic urticaria. Furthermore, novel research has resulted in a new understanding with guidelines being revised in the past year by both the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA2LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO). There are some differences in the recommendations, which will be discussed, but the core updates are common to both groups. The basic treatment for chronic urticaria involves second-generation non-sedating non-impairing H1 antihistamines as first-line treatment. This is followed by up to a 4-fold increase in the licensed dose of these H1 antihistamines. The major therapeutic advance in recent years has been in third-line treatment with omalizumab, a humanized monoclonal anti-immunoglobulin E (anti-IgE) antibody that prevents binding of IgE to the high-affinity IgE receptor. Several multicenter randomized controlled trials have shown safety and efficacy of omalizumab for CSU. There are also some small studies showing efficacy of omalizumab in CINDU. While there were previously many treatment options which were lacking in strong evidence, we are moving into an era where the treatment algorithm for chronic urticaria is simplified and contains more evidence-based, effective, and less toxic treatment options.

Experience with anti – IgE – therapy in children with chronic inducible urticaria: clinical cases.

2021 ◽  
Author(s):  
Inna Larkova
Keyword(s):  
Clinical Manifestations ◽  
Chronic Spontaneous Urticaria ◽  
Off Label ◽  
Chronic Inducible Urticaria ◽  
Inducible Urticaria ◽  
Clinical Cases

Abstract. Introduction: in children with chronic inducible urticaria, anti-IgE therapy is possible when combined with chronic spontaneous urticaria, otherwise the treatment is considered "off label", since there are no approved recommendations for this category of patients due to insufficient research on the effectiveness, prescription and duration of such treatment Conclusion: Based on clinical cases, the authors present there own experience of successful anti-IgE- therapy of various clinical manifestations of chronic inducible urticaria in children.

Chronic inducible urticaria: A systematic review of treatment options

2018 ◽  
Vol 141 (5) ◽  
pp. 1726-1734 ◽  
Author(s):  
Corinna Dressler ◽  
Ricardo Niklas Werner ◽  
Lisa Eisert ◽  
Torsten Zuberbier ◽  
Alexander Nast ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Options ◽  
Chronic Inducible Urticaria ◽  
Inducible Urticaria

scholarly journals Chronic Spontaneous Urticaria: A Review of Pathological Mechanisms, Diagnosis, Clinical Management, and Treatment

2020 ◽  
pp. 29-39
Author(s):  
Victor Desmond Mandel ◽  
Tatiana Alicandro ◽  
Patrizia Pepe ◽  
Laura Bonzano ◽  
Mario Bruno Guanti ◽  
...  
Keyword(s):  
Clinical Management ◽  
Metabolic Diseases ◽  
Clinical Manifestations ◽  
Sun Exposure ◽  
Sudden Onset ◽  
Chronic Spontaneous Urticaria ◽  
Biological Drugs ◽  
Chronic Inducible Urticaria ◽  
Inducible Urticaria ◽  
New Generation

Urticaria is a poorly understood and underestimated clinical condition characterised by the sudden onset of itchy wheals and/or angioedema, which usually resolve within 24 and 72 hours, respectively. It is generally classified as being acute (lasting <6 weeks) or chronic (continuous or intermittent for ≥6 weeks). Chronic urticaria can be further classified as chronic spontaneous urticaria (CSU) and chronic inducible urticaria, appearing in response to specific eliciting factors, such as heat, cold, or sun exposure, or following the application of pressure. Scientific advances have been made in the understanding of pathological mechanisms and treatment, especially associated with CSU. The exact pathological mechanism of how urticaria develops is still not yet fully understood, but the clinical implications on the patients’ quality of life are severe and have been associated with mental disorders and metabolic diseases. The diagnosis of urticaria is based on medical history and clinical manifestations. The treatment pathway begins with the administration of second-generation, nonsedating, nonimpairing histamine 1 receptor antihistamines and, in case of nonresponse, with new-generation biological drugs. The current review presents an update of the pathological mechanisms, diagnosis, clinical management, and treatment of CSU. It also focusses on the future implications of new-generation drugs and their effects on the clinical practice.

scholarly journals Chronic inducible urticaria: confirmation through challenge tests and response to treatment

2020 ◽  
Vol 18 ◽  
Author(s):  
Amanda Rocha Firmino Pereira ◽  
Antônio Abílio Motta ◽  
Jorge Kalil ◽  
Rosana Câmara Agondi
Keyword(s):  
Response To Treatment ◽  
Chronic Inducible Urticaria ◽  
Inducible Urticaria ◽  
Challenge Tests

Clinical manifestations and diagnostic approaches to the histamine intolerance syndrome in children

2017 ◽  
Vol 81 (1) ◽  
pp. 104-109
Author(s):  
Y.V. Marushko ◽  
◽  
E.D. Moskovenko ◽  
Keyword(s):  
Clinical Manifestations ◽  
Histamine Intolerance ◽  
Diagnostic Approaches

Using Naïve Bayes Algorithm to Estimate the Response to Drug in Lung Cancer Patients

2019 ◽  
Vol 21 (10) ◽  
pp. 734-748 ◽  
Author(s):  
Baoling Guo ◽  
Qiuxiang Zheng
Keyword(s):  
Lung Cancer ◽  
Side Effects ◽  
Cancer Patients ◽  
Drug Response ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Cancer Resistance ◽  
Lung Cancer Patients ◽  
Bayes Algorithm

Aim and Objective: Lung cancer is a highly heterogeneous cancer, due to the significant differences in molecular levels, resulting in different clinical manifestations of lung cancer patients there is a big difference. Including disease characterization, drug response, the risk of recurrence, survival, etc. Method: Clinical patients with lung cancer do not have yet particularly effective treatment options, while patients with lung cancer resistance not only delayed the treatment cycle but also caused strong side effects. Therefore, if we can sum up the abnormalities of functional level from the molecular level, we can scientifically and effectively evaluate the patients' sensitivity to treatment and make the personalized treatment strategies to avoid the side effects caused by over-treatment and improve the prognosis. Result & Conclusion: According to the different sensitivities of lung cancer patients to drug response, this study screened out genes that were significantly associated with drug resistance. The bayes model was used to assess patient resistance.

Effectiveness and tolerability of personalized omalizumab treatment in patients with chronic inducible urticaria

2021 ◽  
Author(s):  
Thomas P. Buters ◽  
Willemijn A.C. van der Velden ◽  
Ismahaan Abdisalaam ◽  
Maurits S. van Maaren ◽  
Martijn B.A. van Doorn
Keyword(s):  
Chronic Inducible Urticaria ◽  
Inducible Urticaria

scholarly journals Clinical manifestations of hereditary angioedema and a systematic review of treatment options

2021 ◽  
Author(s):  
Mattie Rosi‐Schumacher ◽  
Sejal J. Shah ◽  
Timothy Craig ◽  
Neerav Goyal
Keyword(s):  
Systematic Review ◽  
Hereditary Angioedema ◽  
Treatment Options ◽  
Clinical Manifestations
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