Substance P and stress are associated with the development of chronic urticaria

Introduction . Allergic diseases are a pressing challenge in practical healthcare, attracting increased attention of various medical specialists. The pathogenesis of stress-induced urticaria is driven by neurogenic immune inflammation, accompanied by an increase in the level of neuropeptide substance P (SP). Objective . Assessment of the relationship between stress factors and substance P levels with the purpose of justifying the use of SP as a biomarker for assessing the clinical course and prognosis of the disease in patients with chronic urticaria. Materials and methods . The study was involved 165 adults aged 18–68 years. The main group included 97 patients with the confirmed diagnosis of chronic urticaria (CU) who were treated in a hospital setting in the period from 2018 to 2023. The comparison group included 68 practically healthy individuals, comparable in gender and age with the study group of patients. The level of substance P in the blood serum was estimated by immunoenzymatic techniques (Infinite F50 Tecan, Austria), using a CEA393Hu test system. Statistical processing of the results was performed using the STATA 18 software package (StataCorp LLC). Results . An increase in the production of substance P to 220.62 pg/mL in CU patients, compared to 96.57 pg/mL in the reference group (p < 0.001), was observed. The logistic regression revealed an association between stress and substance P levels in CU patients. Thus, an increase in the concentration of substance P by 1 pg/mL led to a 1.02-fold increase in the CU risk. The CU risk increased by 3 times in the presence of a stress situation as a trigger. Conclusions . The constructed multivariant logistic regression model produced positive values of the model parameters (p ≤ 0.01). This indicates the correlation between the increased blood levels of substance P under the impact of stress factors and the risk of chronic urticaria development. The data obtained suggests that the concentration of substance P in the blood of CU patients can be considered as a potential diagnostic biomarker. This biomarker can be recommended for extending panel screening tests to clarify the pathogenesis of the disease, thus improving the differential diagnosis of the disease and facilitating early detection of patients with stress-induced urticaria.