Clinical phenotypes and molecular endotypes of chronic urticaria: Linking clinical expression to underlying immune mechanisms
Chronic urticaria (CU) is a biologically heterogeneous inflammatory skin disease characterized by recurrent wheals and/or angioedema. Despite its uniform clinical presentation, the disease encompasses diverse clinical phenotypes and molecular endotypes driven by distinct immune mechanisms. Integrating these patterns is essential for transitioning from empirical management toward precision medicine. This review explores the convergence of observable clinical phenotypes and underlying molecular endotypes to refine diagnosis and guide stratified therapeutic strategies. A comprehensive literature review was conducted, focusing on clinical clusters (eg, pediatric, elderly, and ethnic variations), immunological drivers (type I autoallergy and type IIb autoimmunity), and emerging targeted therapies. Linking clinical phenotypes with molecular endotypes enables a more personalized approach to CU management. Future directions include the validation of point-of-care biomarkers and the utilization of digital phenotyping to achieve disease modification and long-term remission.
Authors
- Pelin Kuteyla Can (ORCID: https://orcid.org/0000-0002-9124-5817)
- Y. Xiang (ORCID: https://orcid.org/0000-0002-9423-4865)
- Gülseren Tuncay (ORCID: https://orcid.org/0000-0001-6529-9750)
- Paulo Ricardo Criado (ORCID: https://orcid.org/0000-0001-9785-6099)
- Muhammed Burak Yücel (ORCID: https://orcid.org/0000-0003-0130-8229)
- Deniz OZCEKER
- Professor R. Pawankar
- Mojca Bizjak-Suran
- P. Pyatilova
- E. Kocatürk
- J. Sanchez
- Andaç Salman
- Joachim W. Fluhr
- Murat Türk
Institutions
- Tongji University (CN)
- Bahçeşehir University (TR)
- University of Ljubljana (SI)
- Adıyaman University (TR)
- Acıbadem University (TR)
- Universidad de Antioquia (CO)
- University of Maribor (SI)
- Humboldt-Universität zu Berlin (DE)
- Fraunhofer Institute for Translational Medicine and Pharmacology (DE)
- University Clinic of Pulmonary and Allergic Diseases Golnik (SI)
- Kayseri Eğitim ve Araştırma Hastanesi (TR)
- Acıbadem Kadıköy Hospital (TR)
- Faculdade de Medicina do ABC (BR)
- Teknoloji Arastirma ve Gelistirme Endustriyel Urunler Bilisim Teknolojileri San Tic (TR)
- Shanghai Skin Disease Hospital (CN)
- Freie Universität Berlin (DE)
- Charité - Universitätsmedizin Berlin (DE)
- Nippon Medical School (JP)
- Erciyes University (TR)
Publication Details
- Journal
- Asia Pacific Allergy
- Published
- 2025-03-23
- DOI
- https://doi.org/10.5415/apallergy.0000000000000279
- Primary Topic
- Urticaria and Related Conditions
- Type
- article
- Field-Weighted Citation Impact
- 0.00