Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press86210.36691/RJA862ArticlesСтатьиTreatment of urticaria: today and tomorrowЛечение крапивницы: сегодня и завтра (Часть I)BorzovaElena YuБорзоваЕ Ю

Norfolk and Norwich University Hospital

Университетская больница Норфолка и Норвича

elena.borzova@nnuh.nhs.ukGrattanClive EHГраттанК EH

Norfolk and Norwich University Hospital

Университетская больница Норфолка и Норвича

Norfolk and Norwich University HospitalУниверситетская больница Норфолка и Норвича1510201075NO05 (2010)№05 (2010)31610032020Copyright ©; 2009, Pharmarus Print MediaCopyright ©; 2009, Фармарус Принт Медиа2009Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/862

Urticaria is a common disorder with diverse clinical presentations. Correct recognition of the different clinical patterns helps clinical assessment and treatment. The management of urticaria involves recognition of relevant disease associations, treatment of any identifiable external causes including infection, avoidance of drug, food and physical triggers and the appropriate use of pharmacological therapies. These can be divided into first, second and third-line approaches. The choice of treatment will be influenced by many factors including drug-licensing, safety, pattern of disease, its severity, pharmaco-economic considerations and patient preference. Possible new therapeutic approaches on the horizon include new H1 antihistamines, H4 receptor antagonists, a histidine decarboxylase inhibitor under development and biological agents that target histamine-releasing autoantibody production and function.

Крапивница - распространенное заболевание, характеризующееся возникновением на коже зудящих волдырей. Точная диагностика разных патофизиологических форм может помочь в выборе наиболее эффективного метода лечения. Ведение больных подразумевает устранение любых выявленных внешних причин заболевания, в том числе инфекций, исключение провоцирующих факторов (медикаментов, продуктов питания и физических триггеров) и эффективное использование лекарственных средств. Лечение больных крапивницей можно подразделить на терапию первой, второй и третьей линий. На выбор метода лечения влияет много факторов, включая лицензионный статус лекарств, их безопасность, клиническую картину и тяжесть заболевания, предпочтения пациента. Возможные новые методы лечения включают новые Н^антигистаминные препараты, антагонисты Н4-рецепторов, разрабатываемый ингибитор гис-тидин-декарбоксилазы и биологические препараты, воздействующие на образование и функцию гиста-минолиберирующих аутоантител

urticariaangioedemaurticarial vasculitistreatmentantihistaminesantileukotrienesimmunotherapyperspectivesкрапивницаангиоотекуртикарный васкулитлечениеантигистаминные препаратыантилейкотриеновые препаратыиммунотерапияперспективыGrattan C.E. The urticaria spectrum: recognition of clinical patterns can help management. Clin. Exp. Dermatol. 2004, v. 29 (3), p. 217-221.Barlow R.J., Warburton F., Watson K., Black A.K. et al. Diagnosis and incidence of delayed pressure urticaria in patients with chronic urticaria. J. Am. Acad. Dermatol. 1993, v. 29 (6), p. 954-958.Shinkai K., McCalmont T.H., Leslie K.S. Cryopyrin-associated periodic syndromes. Clin. Exp. Dermatol., in press.Grattan C.E. Autoimmune urticaria. Immunol. Allergy Clin. North. Am. 2004, v. 24 (2), p. 163-181 (3), p. 63-69.O'Donnell B.F., Francis D.M., Swana G.T., Seed P.T. et al. Thyroid autoimmunity in chronic urticaria. Br. J. Dermatol. 2005, v. 153 (2), p. 331-335.Dreskin S.C., Andrews K.Y. The thyroid and urticaria. Curr. Opin. Allergy Clin. Immunol. 2005, v. 5 (5), p. 408-412.Doutre M.S. Chronic urticaria and thyroid auto-immunity. Clin. Rev. Allergy Immunol. 2006, v. 30 (1), p. 31-37.Kaplan A.P. Chronic urticaria: pathogenesis and treatment. J. Allergy Clin. Immunol. 2004, v. 114 (3), p. 465-474.Asero R., Orsatti A., Tedeschi A., Lorini M. Autoimmune chronic urticaria associated with type 1 diabetes and Graves' disease. J. Allergy Clin. Immunol. 2005, v. 115 (5), p. 1088-1089.Bar-Sela S., Reshef T., Mekori Y.A. IgE antithyroid microsomal antibodies in a patient with chronic urticaria. J. Allergy Clin. Immunol. 1999, v. 103 (6), p. 1216-1217.Toubi E., Kessel A., Avshovich N., Bamberger et al. Clinical and laboratory parameters in predicting chronic urticaria duration: a prospective study of 139 patients. Allergy. 2004, v. 59 (8), p. 869-873.Henderson C.A., Highet A.S. Urticaria associated with thyrotoxicosis. Clin. Exp. Dermatol. 1995, v. 20 (2), p. 173-174.Rumbyrt J.S., Katz J.L., Schocket A.L. Resolution of chronic urticaria in patients with thyroid autoimmunity. J. Allergy Clin. Immunol. 1995, v. 96 (6 Pt 1), p. 901-905.Baskan E.B., Tunali S., Turker T., Saricaoglu H. Comparison of short- and long-term cyclosporine A therapy in chronic idiopathic urticaria. J. Dermatolog. Treat. 2004, v. 15 (3), p. 164-168.Heymann W.R. Acquired angioedema. J. Am. Acad. Dermatol. 1997, v. 36 (4), p. 611-615.Caminiti L., Passalacqua G., Magazzu G., Comisi F. et al. Chronic urticaria and associated coeliac disease in children: a case-control study. Pediatr. Allergy Immunol. 2005, v. 16 (5), p. 428-432.Zuberbier T. Acute urticaria. In: Urticaria and angioedema. Greaves M.W., Kaplan A.P. (Ed), Marcel Dekker, New York, USA. 2004, p. 141-148.Wedi B., Kapp A. Chronic urticaria: assessment of current treatment. Expert. Rev. Clin. Immunol. 2005, v. 1 (3), p. 459-473.Federman D.G., Kirsner R.S., Moriarty J.P., Concato J. The effect of antibiotic therapy for patients infected with Helicobacter pylori who have chronic urticaria. J. Am. Acad. Dermatol. 2003, v. 49 (5), p. 861-864.Grattan C.E. Aspirin sensitivity and urticaria. Clin. Exp. Dermatol. 2003, v. 28 (2), p. 123-127.Simons E. H1-antihistamines: more relevant than ever in the treatment of allergic disorders. J. Allergy Clin. Immunol. 2003, v. 112, р. 42-52.Simons F.E., Silver N.A., Gu X., Simons K.J. Skin concentrations of H1-receptor antagonists. J. Allergy Clin. Immunol. 2001, v. 107 (3), p. 526-530.Church M.K. Histamine receptors, inverse agonism, and allergy. Allergy Clin. Immunol. Int. 2004, v. 16, p. 112-116.Holgate S.T., Canonica G.W., Simons F.E. et al. Consensus Group on New-Generation Antihistamines. Consensus Group on New-Generation Antihistamines (CONGA): present status and recommendations. Clin. Exp. Allergy. 2003, v. 33 (9), p. 1305-1324.Simons F.E. Advances in H1-antihistamines. N. Engl. J. Med. 2004, v. 351 (21), p. 2203-2217.Qidwai J.C., Watson G.S., Weiler J.M. Sedation, cognition, and antihistamines.Curr. Allergy Asthma Rep. 2002, v. 2 (3), p. 216-222.Casale T.B., Blaiss M.S., Gelfand E., Gilmore T. et al. Antihistamine Impairment Roundtable. First do no harm: managing antihistamine impairment in patients with allergic rhinitis. J. Allergy Clin. Immunol. 2003, v. 111 (5), p. 835-842.Greaves M.W. The immunopharmacology of skin inflammation: the future is already here! Br. J. Dermatol. 2000, v. 143 (1), p. 47-52.Monroe E. Review of H1-antihistamines in the treatment of chronic idiopathic urticaria. Cutis. 2005, v. 76 (2), p. 118-126.Timmerman H. Factors involved in the absence of sedative effects by the second generation antihistamines. Allergy. 2000, v. 55, p. 5-10.Juhlin L. Inhibition of cold urticaria by desloratadine. J. Dermatol. Treat. 2004, v. 15 (1), p. 51-59.Kawashima M., Harada S., Tango T. Review of fexofenadine in the treatment of chronic idiopathic urticaria. Int. J. Dermatol. 2002, v. 41 (10), p. 701-706.Simons F.E., Simons K.J. Clinical pharmacology of H1-antihistamines. Clin. Allergy Immunol. 2002, v. 17, p. 141-178.Molimard M., Diquet B., Benedetti M.S. Comparison of pharmacokinetics and metabolism of desloratadine, fexofenadine, levocetirizine and mizolastine in humans. Fundam. Clin. Pharmacol. 2004, v. 18 (4), p. 399-411.Gillard M., Benedetti M.S., Chatelain P., Baltes E. Histamine H1-receptor occupancy and pharmacodynamics of second generation H1-antihistamines. Inflamm. Res. 2005, v. 54 (9), p. 367-369.Golightly L.K., Greos L.S. Second generation antihistamines. Actions and efficacy in the management of allergic disorders. Drugs. 2005, v. 63, p. 341-384.Grattan C., Powell S., Humphreys F. British Association of Dermatologists. Management and diagnostic guidelines for urticaria and angio-oedema. Br. J. Dermatol. 2001, v. 144 (4), p. 708-714.Ellis A.K., Day J.H. Second- and third-generation antihista-mines in the treatment of urticaria. Dermatologie Therapy. 2000, v. 13 (4), p. 327-336.Zuberbier T., Bindslev-Jensen C., Canonica W. et al. EAACI/GA-2LEN/EDF. EAACI/GA2LEN/EDF guideline: management of urticaria. Allergy. 2006, v. 61 (3), p. 321-331.Tharp M.D. The clinical efficacy of antihistamines in skin. Allergy, 2000, v. 55, p. 11-16.Benedetti M.S. Gillard M., Baltes E. Estimation of Receptor Occupancy When Is This Relevant for the Efficacy of an H1-antihistamine? Allergy Clin. Immunol. Int. 2006, v. 18 (3), p. 131-133.Dunford P.J., Williams K.N., Desai P.J., Karlsson L. et al. Histamine H4-receptor antagonists are superior to traditional antihistamines in the attenuation of experimental pruritus. J. Allergy Clin. Immunol. 2007, v. 119 (1), p. 176-183.Simons F.E., Silver N.A., Gu X., Simons K.J. Clinical pharmacology of H1-antihistamines in the skin. J. Allergy Clin. Immunol. 2002, v. 110 (5), p. 777-783.Simons F.E., Murray H.E., Simons K.J. Quantitation of H1-receptor in skin and serum. J. Allergy Clin. Immunol. 1995, v. 95 (3), p. 759-764.Hermes B., Prochazka A.K., Haas N., Jurgovsky K. et al. Upregulation of TNF-alpha and IL-3 expression in lesional and uninvolved skin in different types of urticaria. J. Allergy Clin. Immunol. 1999, v. 103 (2 Pt 1), p. 307-314.Simons F.E.R. Mizolastine: antihistaminic activity from preclinical data to clinical evaluation. Clin. Exp. Allergy. 1999, v. 29, p. 3-8.Caproni M., Volpi W., Giomi B., Torchia D. et al. Cellular adhesion molecules in chronic urticaria: modulation of serum levels occurs during levocetirizine treatment. Br. J. Dermatol. 2006, v. 155 (6), p. 1270-1274.Kapp A., Wedi B. Chronic urticaria: clinical aspects and focus on a new antihistamine, levocetirizine. J. Drugs Dermatol. 2004, v. 3 (6), p. 632-639.Vena G.A., Cassano N., D'Agento V., Milani M. Clobetasol propionate 0,05% in a novel foam formulation is safe and effective in the short-term treatment of patients with delayed pressure urticaria: a randomized, double-blind, placebo-controlled trial. Br. J. Dermatol. 2006, v. 154 (2), p. 353-356.Asero R. Chronic unremitting urticaria: is the use of antihistamines above the licensed dose effective? A preliminary study of cetirizine at licensed and above-licensed doses.Clin. Exp. Dermatol. 2006, v. 32 (1), p. 34-38.Kaliner M.A. H1-antihistamines in the elderly. Clin. Allergy Immunol. 2002, v. 17, p. 465-481.5 2. Chua S.L., Gibbs S. Chronic urticaria responding to subcutaneous heparin sodium. Br. J. Dermatol. 2005, v. 153 (1), p. 216-217.Chae K.M., Tharp M.D. Use and safety of antihistamines in children. Dermatologic Therapy. 2000, v. 13 (4), p. 374-383.Simons F.E. H1-antihistamines in children. Clin. Allergy Immunol. 2002, v. 17, p. 437-464.Diepgen T.L. Early Treatment of the Atopic Child Study Group. Long-term treatment with cetirizine of infants with atopic dermatitis: a multi-country, double-blind, randomized, placebo-controlled trial (the ETAC trial) over 18 months. Pediatr. Allergy Immunol. 2002, v. 13 (4), p. 278-286.Bloom M., Staudinger H., Herron J. Safety of desloratadine syrup in children. Curr. Med. Res. Opin. 2004, v. 20 (12), p. 1959-1965.Schatz M. H1-antihistamines in pregnancy and lactation. Clin. Allergy Immunol. 2002, v. 17, p. 421-436.Simons E. Comparative pharmacology of H1-antihistamines: clinical relevance. Am. J. Med. 2002, v. 113 (9A), p. 38-46.Belgi G., Friedmann P.S. Traditional therapies: glucocorticoids, azathioprine, methotrexate, hydroxyurea. Clin. Exp. Dermatol. 2002, v. 27 (7), p. 546-554.Paradis L., Lavoie A., Brunet C. et al. Effects of systemic corticosteroids on cutaneous histamine secretion and histamine-releasing factor in patients with chronic idiopathic urticaria. Clin. Exp. Allergy. 1996, v. 26 (7), p. 815-820.Kozel M.M., Sabroe R.A. Chronic urticaria: aetiology, management and current and future treatment options. Drugs. 2004, v. 64 (22), p. 2515-2536.Barnes P.J. Molecular mechanisms and cellular effects of gluco-corticosteroids. Immunol. Allergy Clin. North. Am. 2005, v. 25 (3), p. 451-468.McBayne T., Siddal O.M. Montelukast treatment ofurticaria. The Annals of Pharmacotherapy. 2006, v. 40 (5), p. 939-942.Capra V., Ambrosio M., Riccioni G., Rovati G.E. Cysteinyl-leukotriene receptor antagonists: present situation and future opportunities. Curr. Med. Chem. 2006, v. 13 (26), p. 3213-3226.McBayne T., Siddal O.M. Montelukast treatment ofurticaria. The Annals of Pharmacotherapy. 2006, v. 40 (5), p. 939-942.Di Lorenzo G., Pacor M.L., Mansueto P., Esposito Pellitteri M. et al. Randomized placebo-controlled trial comparing desloratadine and montelukast in monotherapy and desloratadine plus montelukast in combined therapy for chronic idiopathic urticaria. J. Allergy Clin. Immunol. 2004, v. 114 (3), p. 619-625.Reimers A., Pichler C., Helbling A. et al. Zafirlukast has no beneficial effects in the treatment of chronic urticaria. Clin. Exp. Allergy. 2002, v. 32 (12), p. 1763-1768.Pacor M.L., Di Lorenzo G., Corrocher R. Efficacy of leukotriene receptor antagonist in chronic urticaria. A double-blind, placebo-controlled comparison of treatment with montelukast and cetirizine in patients with chronic urticaria with intolerance to food additive and/or acetylsalicylic acid. Clin. Exp. Allergy 2001, v. 31 (10), p. 1607-1614.Nettis E., Colanardi M.C., Paradiso M.T., Ferrannini A. Desloratadine in combination with montelukast in the treatment of chronic urticaria: a randomized, double-blind, placebo-controlled study Clin. Exp. Allergy. 2004, v. 34 (9), p. 1401-1407.Bagenstose S.E., Levin L., Bernstein J.A. The addition of zafir-lukast to cetirizine improves the treatment of chronic urticaria in patients with positive autologous serum skin test results. J. Allergy Clin. Immunol. 2004, v. 113 (1), p. 134-140.Erbagci Z. The leukotriene receptor antagonist montelukast in the treatment of chronic idiopathic urticaria: a single-blind, placebo-controlled, crossover clinical study. J. Allergy Clin. Immunol. 2002, v. 110 (3), p. 484-488.Sanada S., Tanaka T., Kameyoshi Y., Hide M. The effectiveness of montelukast for the treatment of anti-histamine-resistant chronic urticaria. Arch. Dermatol. Res. 2005, v. 297 (3), p. 134-138.Asero R., Tedeschi A., Lorini M. Leukotriene receptor antagonists in chronic urticaria. Allergy. 2001, v. 56 (5), p. 456-457.McGirt L.Y., Vasagar K., Gober L.M. et al. Successful treatment of recalcitrant chronic idiopathic urticaria with sulfasalazine. Arch. Dermatol. 2006, v. 142 (10), p. 1337-1342.Leynadier F., Duarte-Risselin C. Murrieta M. Comparative therapeutic effect and safety of mizolastine and loratadine in chronic idiopathic urticaria. URTILOR study group. Eur. J. Dermatol. 2000, v. 10 (3), p. 205-211.Sago J., Hall R.P. Dapsone. Dermatologic Therapy. 2002, v. 15, p. 340-351.Cassano N., D'Argento V., Filotico R., Vena G.A. Low-dose dapsone in chronic idiopathic urticaria: preliminary results of an open study. Acta. Derm. Venereol. 2005, v. 85 (3), p. 254-255.Wedi B., Kapp A. Chronic urticaria: assessment of current treatment. Expert. Rev. Clin. Immunol. 2005, v. 1 (3), p. 459-473.Wedi B., Novacovic V., Koerner M., Kapp A. Chronic urticaria serum induces histamine release, leukotriene production, and basophil CD63 surface expression-inhibitory effects ofanti-inflammatory drugs. J. Allergy Clin. Immunol. 2000, v. 105 (3), p. 552-560.Kessel A., Bamberger E., Toubi E. Tacrolimus in the treatment of severe chronic idiopathic urticaria: an open-label prospective study. J. Am. Acad. Dermatol. 2005, v. 52 (1), p. 145-148.Reeves G.E., Boyle M.J., Bonfield J. et al. Impact of hydroxychloroquine therapy on chronic urticaria: chronic autoimmune urticaria study and evaluation. Intern. Med. J. 2004, v. 34 (4), p. 182-186.Van Beek M.J., Piette W.W. Antimalarials. Dermatol. Clin. 2001, v. 9 (1), p. 147-60.Asero R., Tedeschi A., Riboldi P., Cugno M. Plasma of patients with chronic urticaria shows signs of thrombin generation, and its intradermal injection causes wheal-and-flare reactions much more frequently than autologous serum. J. Allergy Clin. Immunol. 2006, v. 117 (5), p. 1113-1117.Parslew R., Pryce D., Ashworth J., Friedmann P.S. Warfarin treatment of chronic idiopathic urticaria and angio-oedema. Clin. Exp. Allergy. 2000, v. 30 (8), p. 1161-1165.Chua S.L., Gibbs S. Chronic urticaria responding to subcutaneous heparin sodium. Br. J. Dermatol. 2005, v. 153 (1), p. 216-217.Marsland A.M., Soundararajan S., Joseph K., Kaplan A.P. Effects of calcineurin inhibitors on an in vitro assay for chronic urticaria. Clin. Exp. Allergy. 2005, v. 35 (5), p. 554-559.Tharp M. Calcineurin Inhibitors. Dermatologic Therapy. 2002, v. 15 (4), p. 325 -332.Toubi E., Adir-Shani A., Kessel A. et al. Immune aberrations in B- and T-lymphocytes derived from chronic urticaria patients. J. Clin. Immunol. 2000, v. 20 (5), p. 371-378.Mallipeddi R., Grattan C.E.H. Lack ofresponse ofsevere steroid-dependent urticaria to rituximab. Clin. Exp. Dermatol. in press.Loria M.P., Dambra P.P., D'Oronzio L., Nettis E. et al. Cyclosporin A in patients affected by chronic idiopathic urticaria: a therapeutic alternative. Immunopharmacol Immunotoxicol. 2001, v. 23 (2), p. 205-213.Grattan C.E., O'Donnell B.F., Francis D.M. et al. Randomized double-blind study of cyclosporin in chronic 'idiopathic' urticaria. Br. J. Dermatol. 2000, v. 143 (2), p. 365-372.Kessel A., Bamberger E., Toubi E. Tacrolimus in the treatment of severe chronic idiopathic urticaria: an open-label prospective study. J. Am. Acad. Dermatol. 2005, v. 52 (1), p. 145-148.Di Gioacchino M., Di Stefano F., Cavallucci E. et al Treatment of chronic idiopathic urticaria and positive autologous serum skin test with cyclosporine: clinical and immunological evaluation. Allergy Asthma Proc. 2003, v. 24 (4), p. 285-290.Baskan E.B., Tunali S., Turker T., Saricaoglu H. Comparison of short- and long-term cyclosporine A therapy in chronic idiopathic urticaria. J. Dermatolog. Treat. 2004, v. 15 (3), p. 164-168.Toubi E., Blant A. Kessel A., Golan T.D. Low-dose cyclosporin A in the treatment of severe chronic idiopathic urticaria. Allergy. 1997, v. 52 (3), p. 312-316.