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Urticaria
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DOI：10.1038/s41572-022-00389-z.png)
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摘要
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Urticaria is an inflammatory skin disorder that affects up to 20% of the world population at some point during their life. It presents with wheals, angioedema or both due to activation and degranulation of skin mast cells and the release of histamine and other mediators. Most cases of urticaria are acute urticaria, which lasts <= 6 weeks and can be associated with infections or intake of drugs or foods. Chronic urticaria (CU) is either spontaneous or inducible, lasts >6 weeks and persists for >1 year in most patients. CU greatly affects patient quality of life, and is linked to psychiatric comorbidities and high healthcare costs. In contrast to chronic spontaneous urticaria (CSU), chronic inducible urticaria (CIndU) has definite and subtype-specific triggers that induce signs and symptoms. The pathogenesis of CSU consists of several interlinked events involving autoantibodies, complement and coagulation. The diagnosis of urticaria is clinical, but several tests can be performed to exclude differential diagnoses and identify underlying causes in CSU or triggers in CIndU. Current urticaria treatment aims at complete response, with a stepwise approach using second-generation H1 antihistamines, omalizumab and cyclosporine. Novel treatment approaches centre on targeting mediators, signalling pathways and receptors of mast cells and other immune cells. Further research should focus on defining disease endotypes and their biomarkers, identifying new treatment targets and developing improved therapies. Urticaria is an inflammatory skin disorder that presents with itchy wheals and/or angioedema mediated by skin mast cells and release of histamine and other mediators. This Primer by Kolkhir et al. summarizes the epidemiology, mechanisms, diagnosis and treatment of urticaria, and discusses patient quality of life and open research questions for this condition.
Keyword:
QUALITY-OF-LIFE
CHRONIC IDIOPATHIC URTICARIA
AUTOIMMUNE THYROID-DISEASES
REPORTED OUTCOME INSTRUMENT
CHRONIC INDUCIBLE URTICARIA
ULTRAVIOLET-B PHOTOTHERAPY
SERUM SKIN-TEST
MAST-CELL
DOUBLE-BLIND
SYMPTOMATIC DERMOGRAPHISM
期刊
N
IF:
60.6
论文数:
649
被引数:
3.8W
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引用论文
Prevalence, Management, and Anaphylaxis Risk of Cold Urticaria: A Systematic Review and Meta-Analysis寒冷性荨麻疹的患病率，管理和过敏反应风险: 系统回顾和荟萃分析
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