SpringerLink
Log in

Welche Augmentations- und Triggerfaktoren sind bei der Urtikaria relevant?

Which augmentation and trigger factors are relevant in urticaria?

  • Leitthema
  • Published:
Die Dermatologie Aims and scope Submit manuscript

Zusammenfassung

Ziel dieser Übersichtsarbeit ist es, anhand einer aktuellen, PubMed-basierten Literaturrecherche relevante Augmentations- und Triggerfaktoren darzustellen, die eine Urtikariasymptomatik induzieren oder verstärken können. Neben einer kurzen Beschreibung relevanter Einflussfaktoren bei akuter und chronischer induzierbarer Urtikaria liegt der Fokus nachfolgend auf der chronischen spontanen Urtikaria. Insbesondere wird die aggravierende Rolle von Medikamenten, Stress, Nahrungsmitteln, psychischen und metabolischen Komorbiditäten, Infektionen sowie hormonellen Prozessen diskutiert.

Abstract

The aim of this review is to present relevant trigger as well as augmentation factors that can induce or exacerbate urticaria on the basis of a current, PubMed-based literature search. In addition to a brief description of relevant influencing factors in acute and chronic inducible urticaria, the focus will be on chronic spontaneous urticaria. In particular, the aggravating role of medication, stress, food, psychological and metabolic comorbidities, infections and inflammation as well as hormonal processes will be discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Amsler E, Augey F, Soria A et al (2016) Chronic urticaria and hormones: is there a link? J Eur Acad Dermatol Venereol 30:1527–1530

    Article  CAS  PubMed  Google Scholar 

  2. Balp M‑M, Halliday AC, Severin T et al (2022) Clinical remission of Chronic Spontaneous Urticaria (CSU): a targeted literature review. Dermatol Ther 12:15–27

    Article  Google Scholar 

  3. Bansal CJ, Bansal AS (2019) Stress, pseudoallergens, autoimmunity, infection and inflammation in chronic spontaneous urticaria. Allergy Asthma Clin Immunol 15:1–11

    Article  Google Scholar 

  4. Bansal RA, Bansal AS (2020) Exacerbating factors in chronic spontaneous urticaria. Curr Treat Options Allergy 7:142–154

    Article  Google Scholar 

  5. Bernstein JA, Bouillet L, Caballero T et al (2021) Hormonal effects on urticaria and angioedema conditions. J Allergy Clin Immunol Pract 9:2209–2219

    Article  CAS  PubMed  Google Scholar 

  6. Bunselmeyer B, Laubach HJ, Schiller M et al (2009) Incremental build-up food challenge—a new diagnostic approach to evaluate pseudoallergic reactions in chronic urticaria: a pilot study. Clin Exp Allergy 39:116–126

    Article  CAS  PubMed  Google Scholar 

  7. Catalán V, Gómez-Ambrosi J, Rodríguez A et al (2009) Increased adipose tissue expression of lipocalin‑2 in obesity is related to inflammation and matrix metalloproteinase‑2 and metalloproteinase‑9 activities in humans. J Mol Med 87:803–813

    Article  PubMed  Google Scholar 

  8. Chu C‑Y, Zuberbier T (2020) Urticaria and the gut. Curr Opin Allergy Clin Immunol 20:381–385

    Article  PubMed  Google Scholar 

  9. Chung MC, Symons C, Gilliam J et al (2010) The relationship between posttraumatic stress disorder, psychiatric comorbidity, and personality traits among patients with chronic idiopathic urticaria. Compr Psychiatry 51:55–63

    Article  PubMed  Google Scholar 

  10. Cornillier H, Giraudeau B, Samimi M et al (2019) Effect of diet in chronic spontaneous urticaria: a systematic review. Acta Derm Venereol 99:127–132

    Article  PubMed  Google Scholar 

  11. Curto-Barredo L, Pujol RM, Roura-Vives G et al (2019) Chronic urticaria phenotypes: clinical differences regarding triggers, activity, prognosis and therapeutic response. Eur J Dermatol 29:627–635

    Article  CAS  PubMed  Google Scholar 

  12. Donnelly J, Ridge K, O’Donovan R et al (2023) Psychosocial factors and chronic spontaneous urticaria: a systematic review. BMC Psychol 11:239

    Article  PubMed  PubMed Central  Google Scholar 

  13. Dyke SM, Carey BS, Kaminski ER (2008) Effect of stress on basophil function in chronic idiopathic urticaria. Clin Exp Allergy 38:86–92

    Article  CAS  PubMed  Google Scholar 

  14. Ensina LF, Min TK, Félix MMR et al (2022) Acute urticaria and anaphylaxis: differences and similarities in clinical management. Front Allergy 3:

  15. Fava GA, Perini GI, Santonastaso P et al (1980) Life events and psychological distress in dermatologic disorders: psoriasis, chronic urticaria and fungal infections. Br J Med Psychol 53:277–282

    Article  CAS  PubMed  Google Scholar 

  16. Federman DG, Kirsner RS, Moriarty JP et al (2003) The effect of antibiotic therapy for patients infected with helicobacter pylori who have chronic urticaria. J Am Acad Dermatol 49:861–864

    Article  PubMed  Google Scholar 

  17. Geller M (2020) Clinical management of exercise-induced anaphylaxis and cholinergic urticaria. J Allergy Clin Immunol Pract 8:2209–2214

    Article  PubMed  Google Scholar 

  18. Gonçalo M, Gimenéz-Arnau A, Al-Ahmad M et al (2021) The global burden of chronic urticaria for the patient and society. Br J Dermatol 184:226–236

    Article  PubMed  Google Scholar 

  19. Grumach AS, Staubach-Renz P, Villa RC et al (2021) Triggers of exacerbation in chronic urticaria and recurrent angioedema—prevalence and relevance. J Allergy Clin Immunol Pract 9:2160–2168

    Article  CAS  PubMed  Google Scholar 

  20. Grzanka A, Machura E, Misiolek M et al (2015) Systemic inflammatory response and calcification markers in patients with long lasting moderate-severe chronic spontaneous urticaria. Eur J Dermatol 25:26–28

    Article  CAS  PubMed  Google Scholar 

  21. Hsu M‑L, Li L‑F (2012) Prevalence of food avoidance and food allergy in Chinese patients with chronic urticaria. Br J Dermatol 166:747–752

    Article  PubMed  Google Scholar 

  22. Hunkin V, Chung MC (2012) Chronic idiopathic urticaria, psychological co-morbidity and posttraumatic stress: the impact of alexithymia and repression. Psychiatr Q 83:431–447

    Article  PubMed  Google Scholar 

  23. Imbalzano E, Casciaro M, Quartuccio S et al (2016) Association between urticaria and virus infections: a systematic review. Allergy Asthma Proc 37:18–22

    Article  PubMed  Google Scholar 

  24. Jaberi SA, Cohen A, D’Souza C et al (2021) Lipocalin-2: Structure, function, distribution and role in metabolic disorders. Biomed Pharmacother 142:112002

    Article  CAS  PubMed  Google Scholar 

  25. Kasperska-Zajac A (2012) Acute-phase response in chronic urticaria. J Eur Acad Dermatol Venereol 26:665–672

    Article  CAS  PubMed  Google Scholar 

  26. Kasperska-Zajac A, Brzoza Z, Rogala B (2008) Sex hormones and urticaria. J Dermatol Sci 52:79–86

    Article  CAS  PubMed  Google Scholar 

  27. Kasperska-Zajac A, Sztylc J, Machura E et al (2011) Plasma IL‑6 concentration correlates with clinical disease activity and serum C‑reactive protein concentration in chronic urticaria patients. Clin Exp Allergy 41:1386–1391

    Article  CAS  PubMed  Google Scholar 

  28. Kim Y, Han KD, Bang C et al (2021) High waist circumference rather than high body mass index may be a predictive risk factor for the longer disease duration of chronic spontaneous urticaria. Sci Rep 11(1):1875

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Kocatürk E, Salman A, Cherrez-Ojeda I et al (2020) The global impact of the COVID-19 pandemic on the management and course of chronic urticaria. Allergy 76(3):816–830

    Article  PubMed  Google Scholar 

  30. Kocatürk E, Al-Ahmad M, Krause K et al (2021) Effects of pregnancy on chronic urticaria: results of the PREG-CU UCARE study. Allergy 76:3133–3144

    Article  PubMed  Google Scholar 

  31. Kocatürk E, Muñoz M, Elieh-Ali-Komi D et al (2023) How infection and vaccination are linked to acute and chronic urticaria: a special focus on COVID-19. Viruses 15:1585

    Article  PubMed  PubMed Central  Google Scholar 

  32. Kocatürk E, Podder I, Zenclussen AC et al (2022) Urticaria in pregnancy and lactation. Front Allergy 3:892673

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kolkhir P, Balakirski G, Merk HF et al (2016) Chronic spontaneous urticaria and internal parasites—a systematic review. Allergy 71:308–322

    Article  CAS  PubMed  Google Scholar 

  34. Kolkhir P, Church MK, Weller K et al (2017) Autoimmune chronic spontaneous urticaria: what we know and what we do not know. J Allergy Clin Immunol 139:1772–1781

    Article  CAS  PubMed  Google Scholar 

  35. Kolkhir P, Giménez-Arnau AM, Kulthanan K et al (2022) Urticaria. Nat Rev Dis Primers 8:61

    Article  PubMed  Google Scholar 

  36. Kolkhir P, Metz M, Altrichter S et al (2017) Comorbidity of chronic spontaneous urticaria and autoimmune thyroid diseases: a systematic review. Allergy 72:1440–1460

    Article  CAS  PubMed  Google Scholar 

  37. Kolkhir P, Muñoz M, Asero R et al (2022) Autoimmune chronic spontaneous urticaria. J Allergy Clin Immunol 149:1819–1831

    Article  CAS  PubMed  Google Scholar 

  38. Konstantinou GN, Konstantinou GN (2019) Psychiatric comorbidity in chronic urticaria patients: a systematic review and meta-analysis. Clin Transl Allergy 9:42

    Article  PubMed  PubMed Central  Google Scholar 

  39. Krišto M, Lugović-Mihić L, Muñoz M et al (2023) Gut microbiome composition in patients with chronic urticaria: a review of current evidence and data. Life 13:152

    Article  PubMed  PubMed Central  Google Scholar 

  40. Luo Z, ** Z, Tao X et al (2023) Combined microbiome and metabolome analysis of gut microbiota and metabolite interactions in chronic spontaneous urticaria. Front Cell Infect Microbiol 12:1094737

    Article  PubMed  PubMed Central  Google Scholar 

  41. Maged MA, Rushdy M (2018) Hyperlipidemia in association with pro-inflammatory cytokines among chronic spontaneous urticaria: case-control study. Eur Ann Allergy Clin Immunol 50:254–261

    Article  Google Scholar 

  42. Magen E (2018) Chronic spontaneous urticaria following vaccination. Int J Adv Res 6:1434–1439

    Article  Google Scholar 

  43. Magerl M, Altrichter S, Borzova E et al (2016) The definition, diagnostic testing, and management of chronic inducible urticarias—The EAACI/GA 2 LEN/EDF/UNEV consensus recommendations 2016 update and revision. Allergy 71:780–802

    Article  CAS  PubMed  Google Scholar 

  44. Magerl M, Pisarevskaja D, Scheufele R et al (2010) Effects of a pseudoallergen-free diet on chronic spontaneous urticaria: a prospective trial. Allergy 65:78–83

    Article  CAS  PubMed  Google Scholar 

  45. Malhotra S, Mehta V (2008) Role of stressful life events in induction or exacerbation of psoriasis and chronic urticaria. Indian J Dermatol Venereol Leprol 74:594

    Article  CAS  PubMed  Google Scholar 

  46. Maurer M, Church MK, Metz M et al (2015) Galactose-α‑1,3‑galactose allergy is not a hitherto unrecognized cause of chronic spontaneous urticaria. Int Arch Allergy Immunol 167:250–252

    Article  CAS  PubMed  Google Scholar 

  47. Maurer M, Fluhr JW, Khan DA (2018) How to approach chronic inducible urticaria. J Allergy Clin Immunol Pract 6:1119–1130

    Article  PubMed  Google Scholar 

  48. Maurer M, Metz M, Brehler R et al (2018) Omalizumab treatment in patients with chronic inducible urticaria: a systematic review of published evidence. J Allergy Clin Immunol 141:638–649

    Article  CAS  PubMed  Google Scholar 

  49. Maurer M, Weller K, Bindslev-Jensen C et al (2011) Unmet clinical needs in chronic spontaneous urticaria. A GA2LEN task force report1. Allergy 66:317–330

    Article  CAS  PubMed  Google Scholar 

  50. Melikoglu M, Pala E, Bayraktar M (2022) Etiological causes in patients with acute urticaria and angioedema: a cross-sectional study. Allergol Immunopathol 50:15–23

    Article  Google Scholar 

  51. Miller ES, Apple CG, Kannan KB et al (2019) Chronic stress induces persistent low-grade inflammation. Am J Surg 218:677–683

    Article  PubMed  PubMed Central  Google Scholar 

  52. Nebiolo F, Bergia R, Bommarito L et al (2009) Effect of arterial hypertension on chronic urticaria duration. Ann Allergy Asthma Immunol 103:407–410

    Article  PubMed  Google Scholar 

  53. Nettis E, Marcandrea M, Di Maggio G et al (2001) Retrospective analysis of drug-induced urticaria and angioedema: a survey of 2287 patients. Immunopharmacol Immunotoxicol 23:585–595

    Article  CAS  PubMed  Google Scholar 

  54. Ornek SA, Suroji Alkilinc A, Kızıltac U et al (2023) Effect of puberty, menstruation, pregnancy, lactation, and menopause on chronic urticaria activity. J Cutan Med Surg 27:466–471

    Article  PubMed  Google Scholar 

  55. Papadopoulou N, Kalogeromitros D, Staurianeas NG et al (2005) Corticotropin-releasing hormone receptor‑1 and histidine decarboxylase expression in chronic urticaria. J Invest Dermatol 125:952–955

    Article  CAS  PubMed  Google Scholar 

  56. Pedersen HS-LT, Sørensen JA, Madsen F et al (2022) Prevalence, predictors, and clinical relevance of α‑gal sensitization in patients with chronic urticaria. Clin Transl Allergy 12:e12199

    Article  PubMed  PubMed Central  Google Scholar 

  57. Plumb J, Norlin C, Young PC et al (2001) Exposures and outcomes of children with urticaria seen in a pediatric practice-based research network s case-control study. Arch Pediatr Adolesc Med 155:1017

    Article  CAS  PubMed  Google Scholar 

  58. Ricci G, Giannetti A, Belotti T et al (2010) Allergy is not the main trigger of urticaria in children referred to the emergency room. J Eur Acad Dermatol Venereol 24:1347–1348

    Article  CAS  PubMed  Google Scholar 

  59. Ryan D, Tanno LK, Angier E et al (2022) Clinical review: the suggested management pathway for urticaria in primary care. Clin Transl Allergy 12:

  60. Sánchez J, Amaya E, Acevedo A et al (2017) Prevalence of inducible urticaria in patients with chronic spontaneous urticaria: associated risk factors. J Allergy Clin Immunol Pract 5:464–470

    Article  PubMed  Google Scholar 

  61. Sánchez J, Diez S, Cardona R (2020) Clinical control of CSU with antihistamines allows for tolerance of NSAID-exacerbated cutaneous disease. J Allergy Clin Immunol Pract 8:3577–3583.e1

    Article  PubMed  Google Scholar 

  62. Sánchez J, Sánchez A, Cardona R (2019) Prevalence of drugs as triggers of exacerbations in chronic urticaria. J Investig Allergol Clin Immunol 29:112–117

    Article  PubMed  Google Scholar 

  63. Seitz CS, Bröcker E‑B, Trautmann A (2011) Diagnosis of drug hypersensitivity in children and adolescents: discrepancy between physician-based assessment and results of testing. Pediatr Allergy Immunol 22:405–410

    Article  PubMed  Google Scholar 

  64. Shakouri A, Compalati E, Lang DM et al (2010) Effectiveness of helicobacter pylori eradication in chronic urticaria: evidence-based analysis using the grading of recommendations assessment, development, and evaluation system. Curr Opin Allergy Clin Immunol 10:362–369

    Article  PubMed  Google Scholar 

  65. Shalom G, Magen E, Babaev M et al (2018) Chronic urticaria and the metabolic syndrome: a cross-sectional community-based study of 11 261 patients. J Eur Acad Dermatol Venereol 32:276–281

    Article  CAS  PubMed  Google Scholar 

  66. Siebenhaar F, Melde A, Magerl M et al (2016) Histamine intolerance in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol 30:1774–1777

    Article  CAS  PubMed  Google Scholar 

  67. Silpa-archa N, Kulthanan K, Pinkaew S (2011) Physical urticaria: prevalence, type and natural course in a tropical country. J Eur Acad Dermatol Venereol 25:1194–1199

    Article  CAS  PubMed  Google Scholar 

  68. Treudler R, Zarnowski J, Wagner N (2023) Acute urticaria—what to do? Allergo J Int 32:303–308

    Article  Google Scholar 

  69. Trinh HKT, Le Pham D, Ban G‑Y et al (2016) Altered systemic adipokines in patients with chronic urticaria. Int Arch Allergy Immunol 171:102–110

    Article  CAS  PubMed  Google Scholar 

  70. Vena GA, Cassano N (2017) The link between chronic spontaneous urticaria and metabolic syndrome. Eur Ann Allergy Clin Immunol 49:208

    Article  CAS  PubMed  Google Scholar 

  71. Wagner N, Dirk D, Peveling-Oberhag A et al (2017) A Popular myth—low-histamine diet improves chronic spontaneous urticaria—fact or fiction? J Eur Acad Dermatol Venereol 31:650–655

    Article  CAS  PubMed  Google Scholar 

  72. Wagner N, Zink A, Hell K et al (2021) Patients with chronic urticaria remain largely undertreated: results from the DERMLINE online survey. Dermatol Ther 11:1027–1039

    Article  Google Scholar 

  73. Wedi B, Raap U, Wieczorek D, Kapp A (2009) Urticaria and infections. Allergy Asthma Clin Immunol 5:10

    Article  PubMed  PubMed Central  Google Scholar 

  74. Weller K, Siebenhaar F, Hawro T et al (2017) Clinical measures of chronic urticaria. Immunol Allergy Clin North Am 37:35–49

    Article  PubMed  Google Scholar 

  75. Yang H‑Y, Sun C‑C, Wu Y‑C et al (2005) Stress, insomnia, and chronic idiopathic urticaria‑a case-control study. J Formos Med Assoc 104:254–263

    PubMed  Google Scholar 

  76. YM Y, HJ J, EK H et al (2013) Co-existence of chronic urticaria and metabolic syndrome: clinical implications. Acta Derm Venereol 93:

  77. Zarnowski J, Simon J‑C, Treudler R (2022) Chronische spontane Urtikaria, Adipositas und metabolische Erkrankungen. Adipositas – Ursachen Folgeerkrankungen Ther 16:212–219

    Article  Google Scholar 

  78. Zhong H, Song Z, Chen W et al (2014) Chronic urticaria in Chinese population: a hospital-based multicenter epidemiological study. Allergy 69:359–364

    Article  CAS  PubMed  Google Scholar 

  79. Zuberbier T (2001) The role of allergens and pseudoallergens in urticaria. J Investig Dermatol Symp Proc 6:132–134

    Article  CAS  PubMed  Google Scholar 

  80. Zuberbier T, Abdul Latiff AH, Abuzakouk M et al (2021) The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy

Download references

Danksagung

Clinician Scientist Programm, Universitätsmedizin Leipzig.

Funding

Diese Arbeit erhielt keine gesonderte finanzielle Unterstützung.

Author information

Authors and Affiliations

  1. Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig A.ö.R., Philipp-Rosenthal-Str. 69, 04103, Leipzig, Deutschland

    Julia Zarnowski &  Regina Treudler

  2. Institut für Allergieforschung, Charité Universitätsklinikum Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland

    Regina Treudler

Authors
  1. Julia Zarnowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Regina Treudler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julia Zarnowski.

Ethics declarations

Interessenkonflikt

J. Zarnowski erhielt Honorare für Vorträge zur Urtikaria und Forschungsunterstützung (Fa. Novartis, Fa. Sanofi Genzyme). R. Treudler und J. Zarnowski waren an klinischen Studien zur Urtikaria beteiligt (Fa. Novartis, Fa. Sanofi Genzyme). Hieraus ergibt sich kein Zusammenhang mit dieser Arbeit.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Hinweis des Verlags

Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zarnowski, J., Treudler, R. Welche Augmentations- und Triggerfaktoren sind bei der Urtikaria relevant?. Dermatologie 75, 295–302 (2024). https://doi.org/10.1007/s00105-024-05306-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00105-024-05306-x

Schlüsselwörter

Keywords

Search

Navigation