Research progress in the pathogenesis of chronic urticaria

Abstract

Chronic urticaria is very common in clinic, but its pathogenesis is not fully elucidated. Most patients can't find the exact cause, resulting in misdiagnosis or delayed treatment. Previous studies have found that mast cell activation is the central link in the pathogenesis of chronic urticaria. Genetics, autoimmune, coagulation disorders, and infection may also be involved in the pathophysiological process of chronic urticaria. With the deepening of research, more immune and non-immune mechanisms have been gradually revealed in the pathogenesis of chronic urticaria, such as the interaction of immune cells in the microenvironment of urticaria, intestinal flora and metabolism, neuroimmunity, environmental factors and hormones. Clarifying the pathogenesis of chronic urticaria will help to find more treatment targets and provide more diversified ideas for clinical diagnosis and treatment.

Keywords: autoimmune; chronic urticaria; mast cell; pathogenesis.

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免疫细胞在CSU患者外周血和组织中的相互作用 Figure 1 Interaction of immune cells in peripheral blood and tissue of patients with CSU Innate immunity and adaptive immunity play extremely complex interactions in CSU through soluble inflammatory factors, microvesicles or cell-to-cell contact. Endothelial cells can participate in the maturation or activation of immune cells through various cytokines, and immune cells in peripheral blood migrate under the action of chemokines released by mast cells. There is a complex interaction between neurons and immune cells in itching and inflammation. CSU: Chronic spontaneous urticaria; IL: Interleukin; MMP-9: Matrix metalloproteinase-9; CXCL: C-X-C motif ligand; CCL2: C-C motif ligand 2; TF: Tissue factor; MCP-1: Monocyte chemotactic protein 1; PGD2: Prostaglandin D2; SCF: Stem cell factor; VCAM-1: Vascular cell adhesion molecule 1; VEGF: Vascular endothelial growth factor; C5a: Complement 5a; MIF: Migration inhibitory factor; IFN-λ1: Interferon-λ1; LTE4: Leukotriene E4; TSLP: Thymic stromal lymphopoietin; MBP: Major basic protein; ECP: Eosinophil cationic protein; EPO: Eosinophil peroxidase; NGF: Nerve growth factor; SP: Substance P; CGRP: Calcitonin gene-related peptide; ILC2: Group 2 innate lymphocytes; GM-CSF: Granulocyte-macrophage colony-stimulating factor.