Clinical and molecular aspects of managing Chronic Urticaria: Identifying endotypes, phenotypes, and factors determining responses and resistance to treatment

Chronic Urticaria (CU) is a complex condition, presenting a significant challenge in clinical management due to its diverse presentations and variability in treatment response. Advances in the understanding of CU highlight the importance of identifying distinct phenotypes and endotypes to develop more tailored treatment approaches. Despite these strides, significant gaps remain in predicting treatment outcomes, particularly for patients unresponsive to standard therapies like antihistamines and immunomodulators. The presence of comorbidities in CU patients further complicates effective management, underscoring the need for a comprehensive approach to optimize therapeutic results.

While omalizumab has shown efficacy for many CU patients, resistance to this treatment has brought attention to the need for further research into the underlying factors driving treatment resistance. Investigating additional management options is crucial, especially for patients who do not respond to existing therapies. Special populations with CU—including children, elderly individuals, pregnant women, and those who are lactating—pose unique challenges that call for focused strategies to improve care and outcomes. Moreover, exploring therapies that go beyond IgE-targeted treatments, such as antihistamines and omalizumab, offers promising new pathways in expanding the options available for CU management.

The aim of this research collection is to explore the multifaceted landscape of chronic urticaria, focusing on key areas that remain under-examined. These include identifying predictors of treatment response, categorizing phenotypic and endotypic variations, understanding the impact of comorbidities, and examining factors that contribute to treatment resistance. By addressing these core themes, this collection seeks to drive advancements in management strategies for CU, particularly for patients with refractory disease. In addition, it encourages exploration into alternative therapeutic avenues beyond the conventional options.

We invite manuscripts that address the following topics:
1. Indicators of treatment response in CU and strategies for early prediction.
2. Detailed analysis of CU phenotypes and endotypes, and their implications for personalized care.
3. The role of comorbidities in CU, including their influence on disease severity and treatment approach.
4. Mechanisms underlying treatment resistance, encompassing primary and secondary resistance to antihistamines and immunomodulators.
5. Factors contributing to omalizumab resistance, along with potential management strategies for affected patients.
6. Approaches to managing patients who exhibit both inducible and spontaneous urticaria.
7. Specialized management techniques for challenging populations, including pediatric and geriatric patients, pregnant or lactating individuals, and those with significant comorbidities.
8. Exploration of new therapeutic approaches that extend beyond IgE-targeted treatments, focusing on novel drugs and treatment targets.

This initiative aims to assemble cutting-edge research and insights from experts in dermatology and immunology, fostering collaboration and a deeper understanding of chronic urticaria. Authors are invited to contribute their original work, creating a valuable resource for advancing patient care and expanding the treatment landscape for chronic urticaria.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Community Case Study
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• ... View all formats

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Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Community Case Study
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review

Keywords: Chronic Urticaria, Treatment-Response Indicators in CU, Phenotypes and Endotypes in CU, Co-Morbidities in CU, Treatment Resistance in CU, Precision Medicine in Urticaria

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.