title: Factors linked to disease severity and time to remission in patients with chronic spontaneous urticaria.
abstract: Biomarkers useful for the evaluation and management of patients with chronic spontaneous urticaria (CSU) are not currently available. A review of various clinical and laboratory markers that have been studied to assess their value for determining the severity or predicting the evolution of disease in adult patients with CSU was carried out. A search of the medical literature on PubMed and MEDLINE including the terms urticaria, chronic urticaria, chronic idiopathic urticaria, CSU, severity, prognosis and treatment was performed. Based on our review of the literature, among the clinical markers studied, higher age at onset, being female, long disease duration and aspirin/NSAID hypersensitivity may be linked to both severe CSU and a long time to spontaneous remission. In addition, a positive autologous serum skin test (ASST) may be associated with severe CSU, and comorbidity of inducible urticaria and concomitant recurrent angio-oedema may be linked to longer CSU duration. Potential biomarkers of CSU severity and/or duration include basophil numbers and susceptibility to activation, inflammatory markers, markers of activation of the extrinsic coagulation pathway, immunoglobulin E and vitamin D. Although the described markers are promising, further studies on representative and well-characterized patient populations are needed to determine the value of these clinical and biological markers for predicting the severity and course of disease in patients with CSU.
authors.affiliation: Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela.|Allergy Service, Clínica El Avila, Caracas, Venezuela.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Borges
authors.affiliation: Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela.|Allergy Service, Centro Médico de Caracas, Caracas, Venezuela.
authors.forename: F
authors.initials: F
authors.lastname: Caballero-Fonseca
authors.affiliation: Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela.|Allergy Service, Centro Médico de Caracas, Caracas, Venezuela.
authors.forename: A
authors.initials: A
authors.lastname: Capriles-Hulett
authors.affiliation: Dermatology Service, Centro Médico de Caracas, Caracas, Venezuela.
authors.forename: L
authors.initials: L
authors.lastname: González-Aveledo
authors.affiliation: Department of Dermatology and Allergy, Allergie-Centrum Charité/ECARF, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Maurer
mesh_terms: D000328:Adult; D000367:Age Factors; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D012074:Remission Induction; D014581:Urticaria / Q000473:pathology*; D055815:Young Adult