Advances in Chronic Urticaria: Biomarkers, Comorbidities, Therapeutic Strategies, and Patient‑Reported Outcomes

Chronic urticaria (CU) is a heterogeneous mast cell-driven inflammatory skin disorder characterized by recurrent wheals, angioedema, and/or pruritus lasting longer than six weeks. It includes chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), which differ in their clinical presentation, triggering factors and underlying mechanisms. The pathophysiology of CU encompasses complex immune mechanisms, including autoantibody‑driven mast cell activation and dysregulated cytokine signaling. Emerging endotypes include autoimmune, autoallergic, and non-autoimmune forms. Despite progress in understanding these pathways, translating biological insights into clinically useful biomarkers remains a major challenge. Current and emerging therapies, ranging from second-generation H1-antihistamines to targeted biologics, have transformed management. However, treatment responses vary widely, emphasizing the need for better predictors of disease activity, remission, and therapeutic success.

At the same time, patient‑reported outcome measures (PROMs) have become essential for capturing disease burden, quality of life, and the subjective dimensions of symptom control that are not fully reflected by clinical or laboratory parameters. Integrating PROMs with biomarker data and therapeutic outcomes offers a promising route toward more holistic, personalized care.

This Research Topic aims to unify mechanistic, translational, clinical, and patient‑centered research to advance the understanding and management of CU. Contributions may address biomarker discovery, disease endotyping, novel therapeutic approaches, predictive modeling, real‑world treatment outcomes, and innovations in disease monitoring, including digital tools and longitudinal PROM‑based assessment. By fostering collaboration across dermatology, allergy, immunology, and related disciplines, this Topic seeks to accelerate progress toward precision medicine and improved quality of life for patients with CU.

We welcome submissions addressing, but not limited to:
• Immune and molecular mechanisms underlying CSU and CIndU
• Diagnostic, prognostic, and treatment-response biomarkers
• Omics‑based approaches to endotyping and disease stratification
• Clinical trial data and real‑world evidence on current and emerging therapies
• Predictive modeling of treatment response and remission
• Integration of PROMs with biological and clinical endpoints
• CU-associated comorbidities and their impact on disease course and management
• Innovations in disease monitoring, digital health tools and quality‑of‑life assessment

Article types: Original Research, Review, Mini Review, Hypothesis and Theory, Case Report, and Clinical Trial reports.

- Mojca Bizjak-Suran is or recently was a speaker and advisor for Novartis.
- Pavel Kolkhir has received research funding as a speaker/consultant for Novartis and Sanofi/Regeneron. He is on the Advisory Board for ALK.
- Ivan Cherrez-Ojeda is or recently was a speaker for Zaval.

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
• General Commentary
• Hypothesis and Theory
• Methods
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

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
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review

Keywords: Mast cell activation, Chronic Urticaria, Chronic Spontaneous Urticaria (CSU), Chronic Inducible Urticaria (CIndU), Angioedema, Biomarkers, Targeted Biologics, Patient-Reported Outcomes (PROMs)

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.