Is there a role of genetics in acute and chronic urticaria—A systematic review and meta-analysis

IF 4.6 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2025-07-09 DOI:10.1002/clt2.70072

George N. Konstantinou, Indrashis Podder, Arunima Dhabal

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引用次数: 0

Abstract

Background

Chronic urticaria (CU) is a heterogeneous skin disorder whose genetic drivers are incompletely defined.

Objective

To systematically review and meta-analyse genetic and epigenetic factors that influence susceptibility and treatment response in acute and CU.

Methods

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Scopus and Web of Science were searched from inception to 31 July 2024. Original human studies reporting genetic or epigenetic associations with any urticaria subtype were eligible. Random-effects meta-analyses were undertaken when at least three comparable datasets were available.

Results

Sixty-one studies met the inclusion criteria. Associations were confirmed for HLA-B44 (pooled Odds Ratio 8.15, 95% Confidence Interval 1.61–41.29; I² = 86%) and vitamin-D-receptor polymorphisms FokI, TaqI and BsmI, each conferring a 1.5- to 2.1-fold increased risk. Variants in CRTH2, FcεR1α and C-reactive protein predicted antihistamine response, while FCER1G, IL-6, prostaglandin-endoperoxide synthase 2, CCL2 and TNF-pathway genes were over-expressed in lesional tissue, supporting an immune-mediated pathogenesis. Evidence for non-CSU subtypes, acute urticaria, epigenetic modifications and gene–environment interactions was limited.

Conclusions

CU displays an autoimmune-like genetic signature. HLA-B44 and vitamin D receptor variants are susceptibility markers, and pharmacogenetic signals enable personalised therapy. Longitudinal studies integrating environmental exposures and functional genomics are needed to translate these insights into precision care.

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遗传在急性和慢性荨麻疹中的作用——系统回顾和荟萃分析

背景：慢性荨麻疹（CU）是一种异质性皮肤病，其遗传驱动因素尚未完全确定。目的系统回顾和荟萃分析影响急性和CU易感性和治疗反应的遗传和表观遗传因素。方法按照系统评价和荟萃分析指南的首选报告项目，检索PubMed、Scopus和Web of Science从成立到2024年7月31日。报告与任何荨麻疹亚型的遗传或表观遗传关联的原始人类研究是合格的。当至少有三个可比较的数据集时，进行随机效应荟萃分析。结果61项研究符合纳入标准。HLA-B44的相关性得到证实(合并优势比8.15,95%可信区间1.61-41.29；I2 = 86%)和维生素d受体多态性FokI， TaqI和BsmI，每个都使风险增加1.5至2.1倍。CRTH2、FcεR1α和c反应蛋白的变异预测抗组胺反应，而FCER1G、IL-6、前列腺素内过氧化物合酶2、CCL2和tnf通路基因在病变组织中过度表达，支持免疫介导的发病机制。非csu亚型、急性荨麻疹、表观遗传修饰和基因环境相互作用的证据有限。结论CU具有自身免疫样的遗传特征。HLA-B44和维生素D受体变异是易感性标记，药物遗传信号使个性化治疗成为可能。整合环境暴露和功能基因组学的纵向研究需要将这些见解转化为精确护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.