REVIEW article
Front. Allergy
Sec. Mechanisms in Allergy
Volume 6 - 2025 | doi: 10.3389/falgy.2025.1673041
This article is part of the Research TopicClinical and molecular aspects of managing Chronic Urticaria: Identifying endotypes, phenotypes, and factors determining responses and resistance to treatmentView all articles
The roles of serum Th1, Th2, and Th17 cytokines in patients with chronic urticaria: a systemic review and meta-analysis
Provisionally accepted
- Beijing Tsinghua Changgung Hospital, Beijing, China
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Objectives: To conduct a systematic review and meta-analysis to identify Th1-, Th2, and Th17 related serum biomarkers that reflect disease activity in chronic urticaria (CU), thereby enhancing the assessment of disease activity in both trials and clinical practice. Methods: Systematic searches of PubMed, EMBASE, and Web of Science were conducted through November 2024 to identify articles reporting the associations between CU and serum biomarkers. Serum Th1, Th2, and Th17 related biomarkers were identified in CU patients and correlated with disease severity and patient characteristics (ex. Age, sex, and comorbidities). The study quality was assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tool for case-control studies. Meta-analysis was performed using the random-effects model with Hedges' g to pool standardized mean differences (SMDs). For meta-analysis, data were included for biomarkers reported in at least four studies with available means and standard deviations (SDs). Data reported as medians with ranges or interquartile ranges (IQRs) were evaluated for skewness. If the data were found to be significantly skewed, the means and SDs were not calculated. Conversely, if the data were not skewed, the means and SDs were estimated using validated methods. Results: A total of 6,013 studies were screened, of which 50 were included, reporting 22 serum Th1, Th2, and Th17 related cytokines. Meta-analyses revealed significant pooled standardized mean differences (SMDs) for serum TNF-αand IL-17. Conclusions: Serum TNF-αand IL-17 levels are significantly increased in patients with CU compared to healthy age-and sex-matched controls. These findings have the potential to influence clinical guidelines for the diagnostic workup of CU to include testing the serum levels of TNF-αand IL-17.
Keywords: chronic urticaria, Serum biomarkers, TNF-α, IL-17, T lymhocytes
Received: 25 Jul 2025; Accepted: 16 Sep 2025.
Copyright: © 2025 Xue, Sun, Shi, Li and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yi Zhao, zhaoyimd@tsinghua.edu.cn
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