Details zur Publikation

Kategorie Textpublikation
Referenztyp Zeitschriften
DOI 10.3389/falgy.2022.892673
Lizenz creative commons licence
Titel (primär) Urticaria in pregnancy and lactation
Autor Kocatürk, E.; Podder, I.; Zenclussen, A.C.; Kasperska Zajac, A.; Elieh-Ali-Komi, D.; Church, M.K.; Maurer, M.
Quelle Frontiers in Allergy
Erscheinungsjahr 2022
Department IMMU
Band/Volume 3
Seite von art. 892673
Sprache englisch
Topic T9 Healthy Planet
Keywords urticaria; pregnancy; lactation; treatment; autoimmunity; immunological changes; mast cells; hormones
Abstract Chronic urticaria (CU) is a mast cell-driven chronic inflammatory disease with a female predominance. Since CU affects mostly females in reproductive age, pregnancy is an important aspect to consider in the context of this disease. Sex hormones affect mast cell (MC) biology, and the hormonal changes that come with pregnancy can modulate the course of chronic inflammatory conditions, and they often do. Also, pregnancy-associated changes in the immune system, including local adaptation of innate and adaptive immune responses and skewing of adaptive immunity toward a Th2/Treg profile have been linked to changes in the course of inflammatory diseases. As of now, little is known about the effects of pregnancy on CU and the outcomes of pregnancy in CU patients. Also, there are no real-life studies to show the safety of urticaria medications during pregnancy. The recent PREG-CU study provided the first insights on this and showed that CU improves during pregnancy in half of the patients, whereas it worsens in one-third; and two of five CU patients experience flare-ups of their CU during pregnancy. The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for urticaria recommends adopting the same management strategy in pregnant and lactating CU patients; starting treatment with standard doses of second-generation (non-sedative) H1 antihistamines, to increase the dose up to 4-folds in case of no response, and to add omalizumab in antihistamine-refractory patients; but also emphasizes the lack of evidence-based information on the safety and efficacy of urticaria treatments during pregnancy. The PREG-CU study assessed treatments and their outcomes during pregnancy. Here, we review the reported effects of sex hormones and pregnancy-specific immunological changes on urticaria, we discuss the impact of pregnancy on urticaria, and we provide information and guidance on the management of urticaria during pregnancy and lactation.
dauerhafte UFZ-Verlinkung
Kocatürk, E., Podder, I., Zenclussen, A.C., Kasperska Zajac, A., Elieh-Ali-Komi, D., Church, M.K., Maurer, M. (2022):
Urticaria in pregnancy and lactation
Front. Allergy 3 , art. 892673 10.3389/falgy.2022.892673