Advances in the pathogenesis representing definite outcomes in chronic urticaria

Curr Opin Allergy Clin Immunol. 2019 Jun;19(3):193-197. doi: 10.1097/ACI.0000000000000519.


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.

Publication types

  • Review

MeSH terms

  • Autoimmunity
  • Biomarkers / metabolism*
  • C-Reactive Protein / metabolism
  • Chronic Disease
  • Cytokines / metabolism
  • HSP70 Heat-Shock Proteins / immunology
  • Humans
  • Immunoglobulin E / metabolism
  • Inflammation / immunology
  • Inflammation / metabolism
  • Iodide Peroxidase / immunology
  • Mast Cells / immunology
  • Staphylococcal Infections / metabolism
  • Urticaria / immunology*
  • Urticaria / metabolism
  • Urticaria / microbiology
  • Urticaria / therapy


  • Biomarkers
  • Cytokines
  • HSP70 Heat-Shock Proteins
  • Hspa14 protein, human
  • Immunoglobulin E
  • C-Reactive Protein
  • Iodide Peroxidase