Chronic urticaria in theory and practice. Experience of UCARE-centers for clinicians

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Abstract


Chronic urticaria (CU) is an urgent medical and social problem. The instruments of everyday clinical practice are international and domestic guidelines which briefly reflect modern ideas about various aspects of CU. Recently, a new opportunity has emerged to expand theoretical and practical experience in the management of patients with CU, to carry out educational activities to disseminate modern knowledge about urticaria, to conduct research in the field of studying the pathogenesis, treatment, and prevention of exacerbations of the disease. This opportunity is realized through the centers of excellence for working with such patients (GA2LEN UCARE centers). One of the five Russian centers, have prepared and conducted an online training program “Chronic urticaria: scientific and medical achievements and practical aspects of patient management” at the Federal State Budgetary Institution State Research Center “Institute of Immunology” FMBA of Russia. The event was held by the employees of the Federal State Budgetary Institution State Research Center “Institute of Immunology” of the FMBA of Russia on November, 2020.


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About the authors

Natalia I. Ilyina

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Author for correspondence.
Email: instimmun@yandex.ru
ORCID iD: 0000-0002-3556-969X
SPIN-code: 6715-5650

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Dr. Sci. (Med.), Professor

Inna V. Danilycheva

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: ivdanilycheva@mail.ru
ORCID iD: 0000-0002-8279-2173
SPIN-code: 4547-3948

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Cand. Sci. (Med.)

Irina V. Dorofeeva

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: idorofeeva1@gmail.com
ORCID iD: 0000-0002-4423-1797

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD

Olga G. Elisyutina

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: el-olga@yandex.ru
ORCID iD: 0000-0002-4609-2591
SPIN-code: 9567-1894

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Dr. Sci. (Med.)

Oksana M. Kurbacheva

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: kurbacheva@gmail.com
ORCID iD: 0000-0003-3250-0694
SPIN-code: 5698-6436

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Dr. Sci. (Med.), Professor

Elena A. Latysheva

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: ealat@mail.ru
ORCID iD: 0000-0002-1606-205X
SPIN-code: 2063-7973

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Dr. Sci. (Med.)

Loliana S. Litvin

Novartis Pharma LLC

Email: loliana.litvin@novartis.com
ORCID iD: 0000-0002-2229-1078
SPIN-code: 6105-1370

Russian Federation, Moscow

MD, Cand. Sci. (Med.)

Irina A. Manto

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: irina.manto@yandex.ru
ORCID iD: 0000-0001-6432-394X
SPIN-code: 7944-5159

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Cand. Sci. (Med.)

Evgeniya V. Nazarova

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: evallergo@yandex.ru
ORCID iD: 0000-0003-0380-6205
SPIN-code: 4788-7407

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Cand. Sci. (Med.)

Ksenia S. Pavlova

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: ksenimedical@gmail.com
ORCID iD: 0000-0002-4164-4094
SPIN-code: 7593-0838

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Cand. Sci. (Med.)

Anastasia S. Primak

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: soulcreek.94@mail.ru
ORCID iD: 0000-0003-1309-5101

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD

Elena S. Fedenko

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: efedks@gmail.com
ORCID iD: 0000-0003-3358-5087
SPIN-code: 5012-7242

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Dr. Sci. (Med.), Professor

Rosalia V. Schubelko

National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia

Email: spapharia@gmail.com
ORCID iD: 0000-0001-6993-9831
SPIN-code: 4553-3234

Russian Federation, 24, Kashirskoye shosse, Moscow, 115522

MD, Cand. Sci. (Med.)

References

  1. Fricke J, Ávila G, Keller T, et al. Prevalence of chronic urticaria in children and adults across the globe: Systematic review with meta-analysis. Allergy. 2020;75(2):423–432. doi: 10.1111/all.14037
  2. Gonçalo M, Gimenéz-Arnau A, Al-Ahmad M, et al. The global burden of chronic urticaria for the patient and society. Br J Dermatol. 2021;184(2):226–236. doi: 10.1111/bjd.19561
  3. Danilycheva IV, Ilina NI, Luss LV, et al. Russian Federal clinical recomendations on chronic urticaria diagnostics and treatment. Russian Journal of Allergy. 2016;(1):38–46. (In Russ).
  4. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73(7):1393–1414. doi: 10.1111/all.13397
  5. Maurer M, Metz M, Bindslev-Jensen C, et al. Definition, aims, and implementation of GA(2) LEN Urticaria Centers of Reference and Excellence. Allergy. 2016;71(8):1210–1218. doi: 10.1111/all.12901
  6. Kocatürk E. Treatment patterns and outcomes in patients with chronic urticaria during pregnancy: Results of the PREG-CU study, a UCARE project. Oral presentation. GA²LEN GLOBAL URTICARIA FORUM 2020. Available from: www.globalurticariaforum.org
  7. Weller K, Giménez-Arnau A, Grattan C, et al. CURE Investigators. The Chronic Urticaria Registry: rationale, methods and initial implementation. J Eur Acad Dermatol Venereol. 2021;35(3):721–729. doi: 10.1111/jdv.16947
  8. Allergology and clinical immunology. Clinical recommendations. Ed. by R.M. Khaitov, N.I. Ilyina. Moscow: GEOTAR-Media; 2019. 352 p. (Series “Clinical recommendations”). (In Russ).
  9. Antia C, Baquerizo K, Korman A, et al. Urticaria: A comprehensive review: Epidemiology, diagnosis, and work-up. J Am Acad Dermatol. 2018;79(4):599–614. doi: 10.1016/j.jaad.2018.01.020
  10. Bernstein JA, Lang DM, Khan DA, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol. 2014;133(5):1270–1277. doi: 10.1016/j.jaci.2014.02.036
  11. Maurer M, Weller K, Bindslev-Jensen C, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA²LEN task force report. Allergy. 2011;66(3):317–330. doi: 10.1111/j.1398-9995.2010.02496.x
  12. Maurer M, Eyerich K, Eyerich S, et al. Urticaria: collegium internationale allergologicum (CIA) update 2020. Int Arch Allergy Immunol. 2020;181(5):321–333. doi: 10.1159/000507218
  13. Schmetzer O, Lakin E, Topal FA, et al. IL-24 is a common and specific autoantigen of IgE in patients with chronic spontaneous urticaria. J Allergy Clin Immunol. 2018;142(3):876–882. doi: 10.1016/j.jaci.2017.10.035
  14. Altrichter S, Peter HJ, Pisarevskaja D, et al. IgE mediated autoallergy against thyroid peroxidase--a novel pathomechanism of chronic spontaneous urticaria? PLoS One. 2011;6(4):e14794. doi: 10.1371/journal.pone.0014794
  15. Hatada Y, Kashiwakura J, Hayama K, et al. Significantly high levels of anti-dsDNA immunoglobulin E in sera and the ability of dsDNA to induce the degranulation of basophils from chronic urticaria patients. Int Arch Allergy Immunol. 2013;161(Suppl 2):154–158. doi: 10.1159/000350388
  16. Cugno M, Asero R, Ferrucci S, et al. Elevated IgE to tissue factor and thyroglobulin are abated by omalizumab in chronic spontaneous urticaria. Allergy. 2018;73(12):2408–2411. doi: 10.1111/all.13587
  17. Bracken SJ, Abraham S, MacLeod AS. Autoimmune theories of chronic spontaneous urticaria. Front Immunol. 2019;10:627. doi: 10.3389/fimmu.2019.00627
  18. Sánchez J, Sánchez A, Cardona R. Causal relationship between anti-TPO IgE and chronic urticaria by in vitro and in vivo tests. Allergy Asthma Immunol Res. 2019;11(1):29–42. doi: 10.4168/aair.2019.11.1.29
  19. Staubach P, Vonend A, Burow G, et al. Patients with chronic urticaria exhibit increased rates of sensitisation to Candida albicans, but not to common moulds. Mycoses. 2009;52(4):334–338. doi: 10.1111/j.1439-0507.2008.01601.x
  20. Altrichter S, Fok JS, Jiao Q, et al. Total IgE as a marker for chronic spontaneous urticaria. Allergy Asthma Immunol Res. 2021;13(2):206–218. doi: 10.4168/aair.2021.13.2.206
  21. Ferrer M, Kinét JP, Kaplan AP. Comparative studies of functional and binding assays for IgG anti-Fc(epsilon)RIalpha (alpha-subunit) in chronic urticaria. J Allergy Clin Immunol. 1998;101(5):672–676. doi: 10.1016/s0091-6749(98)70176-9
  22. Maurer M, Metz M, Brehler R, et al. Omalizumab treatment in patients with chronic inducible urticaria: A systematic review of published evidence. J Allergy Clin Immunol. 2018;141(2):638–649. doi: 10.1016/j.jaci.2017.06.032
  23. Konstantinou GN, Asero R, Maurer M, et al. EAACI/GA(2)LEN task force consensus report: the autologous serum skin test in urticaria. Allergy. 2009;64(9):1256–1268. doi: 10.1111/j.1398-9995.2009.02132.x
  24. Kolkhir P, Borzova E, Grattan C, et al. Autoimmune comorbidity in chronic spontaneous urticaria: A systematic review. Autoimmun Rev. 2017;16(12):1196–1208. doi: 10.1016/j.autrev.2017.10.003
  25. Netchiporouk E, Sasseville D, Moreau L, et al. Evaluating comorbidities, natural history, and predictors of early resolution in a cohort of children with chronic urticaria. JAMA Dermatol. 2017;153(12):1236–1242. doi: 10.1001/jamadermatol.2017.3182
  26. Silpa-archa N, Kulthanan K, Pinkaew S. Physical urticaria: prevalence, type and natural course in a tropical country. J Eur Acad Dermatol Venereol. 2011;25(10):1194–1199. doi: 10.1111/j.1468-3083.2010.03951.x
  27. Maurer M, Abuzakouk M, Bérard F, et al. The burden of chronic spontaneous urticaria is substantial: Real-world evidence from ASSURE-CSU. Allergy. 2017;72(12):2005–2016. doi: 10.1111/all.13209
  28. Trevisonno J, Balram B, Netchiporouk E, Ben-Shoshan M. Physical urticaria: Review on classification, triggers and management with special focus on prevalence including a meta-analysis. Postgrad Med. 2015;127(6):565–570. doi: 10.1080/00325481.2015.1045817
  29. Weller K, Groffik A, Church MK, et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. 2014. Vol. 133, N 5. P. 1365–1372.
  30. Folci M, Heffler E, Canonica GW, et al. Cutting edge: biomarkers for chronic spontaneous urticaria. J Immunol Res. 2018;2018:5615109. doi: 10.1155/2018/5615109
  31. Guillén-Aguinaga S, Jáuregui Presa I, Aguinaga-Ontoso E, et al. Updosing nonsedating antihistamines in patients with chronic spontaneous urticaria: a systematic review and meta-analysis. Br J Dermatol. 2016;175(6):1153–1165. doi: 10.1111/bjd.14768
  32. Conlon NP, Edgar JD. Adherence to best practice guidelines in chronic spontaneous urticaria (CSU) improves patient outcome. Eur J Dermatol. 2014;24(3):385–386. doi: 10.1684/ejd.2014.2323
  33. Kaplan AP, Giménez-Arnau AM, Saini SS. Mechanisms of action that contribute to efficacy of omalizumab in chronic spontaneous urticaria. Allergy. 2017;72(4):519–533. doi: 10.1111/all.13083
  34. MacGlashan DW, Bochner BS, Adelman DC, et al. Down-regulation of Fc(epsilon)RI expression on human basophils during in vivo treatment of atopic patients with anti-IgE antibody. J Immunol. 1997;158(3):1438–1445
  35. Beck LA, Marcotte GV, MacGlashan D, et al. Omalizumab-induced reductions in mast cell Fce psilon RI expression and function. J Allergy Clin Immunol. 2004;114(3):527–530. doi: 10.1016/j.jaci.2004.06.032
  36. MacGlashan DJ, Xia HZ, Schwartz LB, Gong J. IgE-regulated loss, not IgE-regulated synthesis, controls expression of FcepsilonRI in human basophils. J Leukoc Biol. 2001;70(2):207–218
  37. Saini SS, Bindslev-Jensen C, Maurer M, et al. Efficacy and safety of omalizumab in patients with chronic idiopathic/spontaneous urticaria who remain symptomatic on H1 antihistamines: a randomized, placebo-controlled study. J Invest Dermatol. 2015;135(1):67–75. doi: 10.1038/jid.2014.306
  38. Gericke J, Metz M, Ohanyan T, et al. Serum autoreactivity predicts time to response to omalizumab therapy in chronic spontaneous urticaria. J Allergy Clin Immunol. 2017;139(3):1059–1061.e1. doi: 10.1016/j.jaci.2016.07.047
  39. Eggel A, Baravalle G, Hobi G, et al Accelerated dissociation of IgE-FcεRI complexes by disruptive inhibitors actively desensitizes allergic effector cells. J Allergy Clin Immunol. 2014;133(6):1709–1719.e8. doi: 10.1016/j.jaci.2014.02.005
  40. Serrano-Candelas E, Martinez-Aranguren R, Valero A, et al. Comparable actions of omalizumab on mast cells and basophils. Clin Exp Allergy. 2016;46(1):92–102. doi: 10.1111/cea.12668
  41. Jacques P, Lavoie A, Bédard PM, et al. Chronic idiopathic urticaria: profiles of skin mast cell histamine release during active disease and remission. J Allergy Clin Immunol. 1992;89(6):1139–1143. doi: 10.1016/0091-6749(92)90297-f
  42. Bédard PM, Brunet C, Pelletier G, Hébert J. Increased compound 48/80 induced local histamine release from nonlesional skin of patients with chronic urticaria. J Allergy Clin Immunol. 1986;78(6):1121–1125. doi: 10.1016/0091-6749(86)90260-5
  43. Noga O, Hanf G, Brachmann I, et al. Effect of omalizumab treatment on peripheral eosinophil and T-lymphocyte function in patients with allergic asthma. J Allergy Clin Immunol. 2006;117(6):1493–1499. doi: 10.1016/j.jaci.2006.02.028
  44. Maurer M, Altrichter S, Bieber T, et al. Efficacy and safety of omalizumab in patients with chronic urticaria who exhibit IgE against thyroperoxidase. J Allergy Clin Immunol. 2011;128(1):202–209.e5. doi: 10.1016/j.jaci.2011.04.038
  45. Saini S, Rosen KE, Hsieh HJ, et al. A randomized, placebo-controlled, dose-ranging study of single-dose omalizumab in patients with H1-antihistamine-refractory chronic idiopathic urticaria. J Allergy Clin Immunol. 2011;128(3):567–573.e1. doi: 10.1016/j.jaci.2011.06.010
  46. Maurer M, Rosén K, Hsieh HJ, et al. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med. 2013;368(10):924–935. doi: 10.1056/NEJMoa1215372
  47. Kaplan A, Ledford D, Ashby M, et al. Omalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy. J Allergy Clin Immunol. 2013;132(1):101–109. doi: 10.1016/j.jaci.2013.05.013
  48. Zhao ZT, Ji CM, Yu WJ, et al. Omalizumab for the treatment of chronic spontaneous urticaria: A meta-analysis of randomized clinical trials. J Allergy Clin Immunol. 2016;137(6):1742–1750.e4. doi: 10.1016/j.jaci.2015.12.1342
  49. Tharp MD, Bernstein JA, Kavati A, et al. Benefits and harms of omalizumab treatment in adolescent and adult patients with chronic idiopathic (Spontaneous) urticaria: a meta-analysis of “Real-world” evidence. JAMA Dermatol. 2019;155(1):29–38. doi: 10.1001/jamadermatol.2018.3447
  50. Asero R, Canonica GW, Cristaudo A, et al. Critical appraisal of the unmet needs in the treatment of chronic spontaneous urticaria with omalizumab: an Italian perspective. Curr Opin Allergy Clin Immunol. 201717(6):453–459. doi: 10.1097/ACI.0000000000000404.
  51. Casale TB, Murphy TR, Holden M, et al. Impact of omalizumab on patient-reported outcomes in chronic idiopathic urticaria: Results from a randomized study (XTEND-CIU). J Allergy Clin Immunol Pract. 2019;7(7):2487–2490.e1. doi: 10.1016/j.jaip.2019.04.020
  52. Vadasz Z, Tal Y, Rotem M, et al. Israeli Forum for investigating and treating Chronic Spontaneous Urticaria (CSU). Omalizumab for severe chronic spontaneous urticaria: Real-life experiences of 280 patients. J Allergy Clin Immunol Pract. 2017;5(6):1743–1745. doi: 10.1016/j.jaip.2017.08.035
  53. Staubach P, Metz M, Chapman-Rothe N, et al. Effect of omalizumab on angioedema in H1-antihistamine-resistant chronic spontaneous urticaria patients: results from X-ACT, a randomized controlled trial. Allergy. 2016;71(8):1135–1144. doi: 10.1111/all.12870
  54. Metz M, Vadasz Z, Kocatürk E, Giménez-Arnau AM. Omalizumab updosing in chronic spontaneous urticaria: an overview of real-world evidence. Clin Rev Allergy Immunol. 2020;59(1):38–45. doi: 10.1007/s12016-020-08794-6
  55. Türk M, Carneiro-Leão L, Kolkhir P, et al. How to treat patients with chronic spontaneous urticaria with omalizumab: questions and answers. J Allergy Clin Immunol Pract. 2020;8(1):113–124. doi: 10.1016/j.jaip.2019.07.021
  56. Kulthanan K, Tuchinda P, Likitwattananurak C, et al. Does omalizumab modify a course of recalcitrant chronic spontaneous urticaria? A retrospective study in Asian patients. J Dermatol. 2018;45(1):17–23. doi: 10.1111/1346-8138.14081
  57. Maurer M, Giménez-Arnau A, Ensina LF, et al. Chronic urticaria treatment patterns and changes in quality of life: AWARE study 2-year results. World Allergy Organ J. 2020;13(9):100460. doi: 10.1016/j.waojou.2020.100460
  58. Kocatürk E, Maurer M, Metz M, Grattan C. Looking forward to new targeted treatments for chronic spontaneous urticaria. Clin Transl Allergy. 2017;7:1. doi: 10.1186/s13601-016-0139-2
  59. Arm JP, Bottoli I, Skerjanec A, et al. Pharmacokinetics, pharmacodynamics and safety of QGE031 (ligelizumab), a novel high-affinity anti-IgE antibody, in atopic subjects. Clin Exp Allergy. 2014;44(11):1371–1385. doi: 10.1111/cea.12400
  60. Gasser P, Tarchevskaya SS, Guntern P, et al. The mechanistic and functional profile of the therapeutic anti-IgE antibody ligelizumab differs from omalizumab. Nat Commun. 2020;11(1):165. doi: 10.1038/s41467-019-13815-w
  61. Angst D, Gessier F, Janser P, et al. Discovery of LOU064 (Remibrutinib), a Potent and Highly Selective Covalent Inhibitor of Bruton’s Tyrosine Kinase. J Med Chem. 2020;63(10):5102–5118. doi: 10.1021/acs.jmedchem.9b01916
  62. Nutku E, Aizawa H, Hudson SA, Bochner BS. Ligation of Siglec-8: a selective mechanism for induction of human eosinophil apoptosis. Blood. 2003;101(12):5014–5020. doi: 10.1182/blood-2002-10-3058
  63. Yokoi H, Choi OH, Hubbard W, et al. Inhibition of FcepsilonRI-dependent mediator release and calcium flux from human mast cells by sialic acid-binding immunoglobulin-like lectin 8 engagement. J Allergy Clin Immunol. 2008;121(2):499–505.e1. doi: 10.1016/j.jaci.2007.10.004

Supplementary files

Supplementary Files Action
1.
Fig.1. Information for patients with urticaria about the upcoming International Urticaria Day educational event.

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2.
Fig. 2. International Urticaria Day Announcement. (https://urticariaday.org/urticaria-day-2020/urticaria/).

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3.
Fig. 3. Studied mechanisms of mast cell and basophil activation in CSU (adapted from [12]).

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4.
Fig. 4. Determination of urticaria symptom control (UCT-test) [29].

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5.
Fig. 5. Algorithm for drug treatment of patients with chronic urticaria [4].

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