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Pathogenesis of Chronic Urticaria: An Overview

The pathogenesis of chronic urticaria is not well delineated and the treatment is palliative as it is not tied to the pathomechanism. The centrality of mast cells and their inappropriate activation and degranulation as the key pathophysiological event are well established. The triggering stimuli and...

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Autor principal: Jain, Sanjiv
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120476/
https://www.ncbi.nlm.nih.gov/pubmed/25120565
http://dx.doi.org/10.1155/2014/674709
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author Jain, Sanjiv
author_facet Jain, Sanjiv
author_sort Jain, Sanjiv
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description The pathogenesis of chronic urticaria is not well delineated and the treatment is palliative as it is not tied to the pathomechanism. The centrality of mast cells and their inappropriate activation and degranulation as the key pathophysiological event are well established. The triggering stimuli and the complexity of effector mechanisms remain speculative. Autoimmune origin of chronic urticaria, albeit controversial, is well documented. Numerical and behavioral alterations in basophils accompanied by changes in signaling molecule expression and function as well as aberrant activation of extrinsic pathway of coagulation are other alternative hypotheses. It is also probable that mast cells are involved in the pathogenesis through mechanisms that extend beyond high affinity IgE receptor stimulation. An increasing recognition of chronic urticaria as an immune mediated inflammatory disorder related to altered cytokine-chemokine network consequent to immune dysregulation resulting from disturbed innate immunity is emerging as yet another pathogenic explanation. It is likely that these different pathomechanisms are interlinked rather than independent cascades, acting either synergistically or sequentially to produce clinical expression of chronic urticaria. Insights into the complexities of pathogenesis may provide an impetus to develop safer, efficacious, and targeted immunomodulators and biological treatment for severe, refractory chronic urticaria.
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spelling pubmed-41204762014-08-12 Pathogenesis of Chronic Urticaria: An Overview Jain, Sanjiv Dermatol Res Pract Review Article The pathogenesis of chronic urticaria is not well delineated and the treatment is palliative as it is not tied to the pathomechanism. The centrality of mast cells and their inappropriate activation and degranulation as the key pathophysiological event are well established. The triggering stimuli and the complexity of effector mechanisms remain speculative. Autoimmune origin of chronic urticaria, albeit controversial, is well documented. Numerical and behavioral alterations in basophils accompanied by changes in signaling molecule expression and function as well as aberrant activation of extrinsic pathway of coagulation are other alternative hypotheses. It is also probable that mast cells are involved in the pathogenesis through mechanisms that extend beyond high affinity IgE receptor stimulation. An increasing recognition of chronic urticaria as an immune mediated inflammatory disorder related to altered cytokine-chemokine network consequent to immune dysregulation resulting from disturbed innate immunity is emerging as yet another pathogenic explanation. It is likely that these different pathomechanisms are interlinked rather than independent cascades, acting either synergistically or sequentially to produce clinical expression of chronic urticaria. Insights into the complexities of pathogenesis may provide an impetus to develop safer, efficacious, and targeted immunomodulators and biological treatment for severe, refractory chronic urticaria. Hindawi Publishing Corporation 2014 2014-07-10 /pmc/articles/PMC4120476/ /pubmed/25120565 http://dx.doi.org/10.1155/2014/674709 Text en Copyright © 2014 Sanjiv Jain. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Jain, Sanjiv
Pathogenesis of Chronic Urticaria: An Overview
title Pathogenesis of Chronic Urticaria: An Overview
title_full Pathogenesis of Chronic Urticaria: An Overview
title_fullStr Pathogenesis of Chronic Urticaria: An Overview
title_full_unstemmed Pathogenesis of Chronic Urticaria: An Overview
title_short Pathogenesis of Chronic Urticaria: An Overview
title_sort pathogenesis of chronic urticaria: an overview
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120476/
https://www.ncbi.nlm.nih.gov/pubmed/25120565
http://dx.doi.org/10.1155/2014/674709
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