Urticaria: An Evolving Story

摘要

Chronic spontaneous urticaria affects nearly 20% of the population. Although it is commonly considered a mast cell-mediated disease, the mechanism of mast cell activation remains a medical mystery. A number of new developments in this field got us quite excited. The demonstration of the presence of an anti-lgE receptor autoantibody and sometimes an anti-lgE autoantibody in serum from urticaria patients suggested an autoimmune mechanism. Although some studies have shown that these autoanti-bodies are more prevalent in patients with severe urticaria, the clinical correlation is not very strong. This is similar to autoantibodies found in rheumatologic disorders. It is possible that the anti-lgE autoantibody primes the mast cells, which require a second trigger for full activation and manifestation of the disease. We need to further understand the specific role of these autoantibodies in pathogenesis. There are a number of tests that detect this autoantibody. We need a standardized approach for optimal detection of the autoantibodies.