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Clinical Reviews in Allergy & Immunology

, Volume 54, Issue 1, pp 88–101 | Cite as

Urticaria and Angioedema: an Update on Classification and Pathogenesis

  • Susanne Radonjic-HoesliEmail author
  • Kathrin Scherer Hofmeier
  • Sara Micaletto
  • Peter Schmid-Grendelmeier
  • Andreas Bircher
  • Dagmar SimonEmail author
Article

Abstract

Urticaria is a common, mast cell-driven disease presenting with wheals or angioedema or both. In the last years, urticaria has increasingly attracted notice to clinicians and researchers, last but not least inspired by the approval of omalizumab, an anti-IgE antibody, for urticaria treatment. There is wide consensus on the clinical classification based on duration and elicitation. However, the pathogenesis is incompletely understood. This review summarizes current guidelines for the management and novel insights in the pathogenesis of urticaria with special focus on their impact on clinical praxis. The classification of urticaria subgroups is mainly based on clinical criteria: acute and chronic urticaria (CU). Chronic urticaria comprises both chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU) that includes physical and non-physical urticarias. Recent research focused on characterizing the role of cells and mediators involved in the pathogenesis of urticaria, identifying the mechanisms of mast cell activation, and investigating underlying autoimmune processes in chronic spontaneous urticarial. Currently, non-sedating antihistamines and omalizumab, an antiimmunoglobulin E antibody, are recommended for the therapy of chronic urticaria, as both exhibit a favorable efficacy and safety profile. Novel therapeutic strategies aim at specifically targeting cells and mediators involved in the pathogenesis of urticaria.

Keywords

Angioedema Mast cell Histamine Omalizumab Urticaria 

Abbreviations

ACE

Angiotensin converting enzyme

ACU

Acquired cold urticaria

AE

Angioedema

AIU

Autoimmune urticaria

ASST

Autologous serum skin test

ChU

Cholinergic urticaria

CIndU

Chronic indicible urticaria

CRTH2

Chemoattractant receptor–homologous molecule expressed on TH2 cells

CU

Chronic urticaria

CSU

Chronic spontaneous urticaria

DPU

Delayed pressure urticaria

Ig

Immunoglobuline

IL

Interleukin

PG

Prostaglandin

SU

Solar urticaria

TNF

Tumor necrosis factor

TPO

Thyroperoxidase

UAS

Urticaria activity score

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Funding

None.

Research Involving Human Participants and/or Animals

Not applicable.

Ethical Approval and Informed Consent

Not applicable.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Dermatology, InselspitalBern University Hospital, University of BernBernSwitzerland
  2. 2.Department of Dermatology, Allergy UnitUniversity Hospital BaselBaselSwitzerland
  3. 3.Department of Dermatology and AllergyUniversity Hospital ZurichZurichSwitzerland

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