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Urticaria in Pregnancy and Lactation
Chronic urticaria (CU) is a mast cell-driven chronic inflammatory disease with a female predominance. Since CU affects mostly females in reproductive age, pregnancy is an important aspect to consider in the context of this disease. Sex hormones affect mast cell (MC) biology, and the hormonal changes...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300824/ https://www.ncbi.nlm.nih.gov/pubmed/35873599 http://dx.doi.org/10.3389/falgy.2022.892673 |
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author | Kocatürk, Emek Podder, Indrashis Zenclussen, Ana C. Kasperska Zajac, Alicja Elieh-Ali-Komi, Daniel Church, Martin K. Maurer, Marcus |
author_facet | Kocatürk, Emek Podder, Indrashis Zenclussen, Ana C. Kasperska Zajac, Alicja Elieh-Ali-Komi, Daniel Church, Martin K. Maurer, Marcus |
author_sort | Kocatürk, Emek |
collection | PubMed |
description | Chronic urticaria (CU) is a mast cell-driven chronic inflammatory disease with a female predominance. Since CU affects mostly females in reproductive age, pregnancy is an important aspect to consider in the context of this disease. Sex hormones affect mast cell (MC) biology, and the hormonal changes that come with pregnancy can modulate the course of chronic inflammatory conditions, and they often do. Also, pregnancy-associated changes in the immune system, including local adaptation of innate and adaptive immune responses and skewing of adaptive immunity toward a Th2/Treg profile have been linked to changes in the course of inflammatory diseases. As of now, little is known about the effects of pregnancy on CU and the outcomes of pregnancy in CU patients. Also, there are no real-life studies to show the safety of urticaria medications during pregnancy. The recent PREG-CU study provided the first insights on this and showed that CU improves during pregnancy in half of the patients, whereas it worsens in one-third; and two of five CU patients experience flare-ups of their CU during pregnancy. The international EAACI/GA(2)LEN/EuroGuiDerm/APAAACI guideline for urticaria recommends adopting the same management strategy in pregnant and lactating CU patients; starting treatment with standard doses of second-generation (non-sedative) H1 antihistamines, to increase the dose up to 4-folds in case of no response, and to add omalizumab in antihistamine-refractory patients; but also emphasizes the lack of evidence-based information on the safety and efficacy of urticaria treatments during pregnancy. The PREG-CU study assessed treatments and their outcomes during pregnancy. Here, we review the reported effects of sex hormones and pregnancy-specific immunological changes on urticaria, we discuss the impact of pregnancy on urticaria, and we provide information and guidance on the management of urticaria during pregnancy and lactation. |
format | Online Article Text |
id | pubmed-9300824 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93008242022-07-22 Urticaria in Pregnancy and Lactation Kocatürk, Emek Podder, Indrashis Zenclussen, Ana C. Kasperska Zajac, Alicja Elieh-Ali-Komi, Daniel Church, Martin K. Maurer, Marcus Front Allergy Allergy Chronic urticaria (CU) is a mast cell-driven chronic inflammatory disease with a female predominance. Since CU affects mostly females in reproductive age, pregnancy is an important aspect to consider in the context of this disease. Sex hormones affect mast cell (MC) biology, and the hormonal changes that come with pregnancy can modulate the course of chronic inflammatory conditions, and they often do. Also, pregnancy-associated changes in the immune system, including local adaptation of innate and adaptive immune responses and skewing of adaptive immunity toward a Th2/Treg profile have been linked to changes in the course of inflammatory diseases. As of now, little is known about the effects of pregnancy on CU and the outcomes of pregnancy in CU patients. Also, there are no real-life studies to show the safety of urticaria medications during pregnancy. The recent PREG-CU study provided the first insights on this and showed that CU improves during pregnancy in half of the patients, whereas it worsens in one-third; and two of five CU patients experience flare-ups of their CU during pregnancy. The international EAACI/GA(2)LEN/EuroGuiDerm/APAAACI guideline for urticaria recommends adopting the same management strategy in pregnant and lactating CU patients; starting treatment with standard doses of second-generation (non-sedative) H1 antihistamines, to increase the dose up to 4-folds in case of no response, and to add omalizumab in antihistamine-refractory patients; but also emphasizes the lack of evidence-based information on the safety and efficacy of urticaria treatments during pregnancy. The PREG-CU study assessed treatments and their outcomes during pregnancy. Here, we review the reported effects of sex hormones and pregnancy-specific immunological changes on urticaria, we discuss the impact of pregnancy on urticaria, and we provide information and guidance on the management of urticaria during pregnancy and lactation. Frontiers Media S.A. 2022-07-07 /pmc/articles/PMC9300824/ /pubmed/35873599 http://dx.doi.org/10.3389/falgy.2022.892673 Text en Copyright © 2022 Kocatürk, Podder, Zenclussen, Kasperska Zajac, Elieh-Ali-Komi, Church and Maurer. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Allergy Kocatürk, Emek Podder, Indrashis Zenclussen, Ana C. Kasperska Zajac, Alicja Elieh-Ali-Komi, Daniel Church, Martin K. Maurer, Marcus Urticaria in Pregnancy and Lactation |
title | Urticaria in Pregnancy and Lactation |
title_full | Urticaria in Pregnancy and Lactation |
title_fullStr | Urticaria in Pregnancy and Lactation |
title_full_unstemmed | Urticaria in Pregnancy and Lactation |
title_short | Urticaria in Pregnancy and Lactation |
title_sort | urticaria in pregnancy and lactation |
topic | Allergy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300824/ https://www.ncbi.nlm.nih.gov/pubmed/35873599 http://dx.doi.org/10.3389/falgy.2022.892673 |
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