Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticaria
Abstract Chronic urticaria (CU) arises from a multifaceted interplay of immunological, neurological, and psychological components. Immune dysregulation, mediated through both immunoglobulin E (IgE)-dependent and IgE-independent pathways, plays a pivotal role in CU pathogenesis, involving key effecto...
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| Format: | Article |
| Language: | English |
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BMC
2025-03-01
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| Series: | Journal of Neuroinflammation |
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| Online Access: | https://doi.org/10.1186/s12974-025-03397-4 |
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| author | Shurui Yang Li Chen Haiming Zhang Yanjuan Song Wenyan Wang Zhengbo Hu Siyu Wang Liuyang Huang Yayuan Wang Song Wu Rui Chen Fengxia Liang |
| author_facet | Shurui Yang Li Chen Haiming Zhang Yanjuan Song Wenyan Wang Zhengbo Hu Siyu Wang Liuyang Huang Yayuan Wang Song Wu Rui Chen Fengxia Liang |
| author_sort | Shurui Yang |
| collection | DOAJ |
| description | Abstract Chronic urticaria (CU) arises from a multifaceted interplay of immunological, neurological, and psychological components. Immune dysregulation, mediated through both immunoglobulin E (IgE)-dependent and IgE-independent pathways, plays a pivotal role in CU pathogenesis, involving key effector cells such as mast cells (MCs), basophils, and eosinophils. This dysregulation culminates in the release of histamine, prostaglandins, and other mediators, which precipitate pruritus. The chronicity of the disease leads to sustained pruritic symptoms, contributing to both central and peripheral sensitization. The excitation of the itch circuit is augmented, leading to the release of neurotransmitters and neuropeptides, which subsequently interact with immune cells. Psychological factors such as depression, anxiety, and stress exacerbate CU symptoms and diminish quality of life. These factors disrupt the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS). Furthermore, the act of scratching activates the reward circuit, resulting in the manifestation of the itch-scratching cycle. Current treatments, such as antihistamines, omalizumab, and cyclosporine, demonstrate variable efficacy and are often associated with adverse effects. A holistic approach addressing both psychological and physiological aspects is advocated. This review highlights the critical importance of understanding neuroimmune interactions and the influence of psychosomatic factors in CU. It aims to enhance diagnostic and therapeutic strategies by integrating psychological, neurological, and immunological perspectives. |
| format | Article |
| id | doaj-art-d5f11bbde1de45d3a374b0c20775e18b |
| institution | DOAJ |
| issn | 1742-2094 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Neuroinflammation |
| spelling | doaj-art-d5f11bbde1de45d3a374b0c20775e18b2025-08-20T03:02:21ZengBMCJournal of Neuroinflammation1742-20942025-03-0122111810.1186/s12974-025-03397-4Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticariaShurui Yang0Li Chen1Haiming Zhang2Yanjuan Song3Wenyan Wang4Zhengbo Hu5Siyu Wang6Liuyang Huang7Yayuan Wang8Song Wu9Rui Chen10Fengxia Liang11College of Acupuncture and Orthopedics, Hubei University of Chinese MedicineCollege of Acupuncture and Orthopedics, Hubei University of Chinese MedicineDepartment of Oncology, Integrated Traditional Chinese and Western Medicine, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyHubei Shizhen LaboratoryDepartment of acupuncture and moxibustion, Wuhan Hospital of Traditional Chinese MedicineCollege of Acupuncture and Orthopedics, Hubei University of Chinese MedicineCollege of Acupuncture and Orthopedics, Hubei University of Chinese MedicineCollege of Acupuncture and Orthopedics, Hubei University of Chinese MedicineCollege of Acupuncture and Orthopedics, Hubei University of Chinese MedicineCollege of Acupuncture and Orthopedics, Hubei University of Chinese MedicineDepartment of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyCollege of Acupuncture and Orthopedics, Hubei University of Chinese MedicineAbstract Chronic urticaria (CU) arises from a multifaceted interplay of immunological, neurological, and psychological components. Immune dysregulation, mediated through both immunoglobulin E (IgE)-dependent and IgE-independent pathways, plays a pivotal role in CU pathogenesis, involving key effector cells such as mast cells (MCs), basophils, and eosinophils. This dysregulation culminates in the release of histamine, prostaglandins, and other mediators, which precipitate pruritus. The chronicity of the disease leads to sustained pruritic symptoms, contributing to both central and peripheral sensitization. The excitation of the itch circuit is augmented, leading to the release of neurotransmitters and neuropeptides, which subsequently interact with immune cells. Psychological factors such as depression, anxiety, and stress exacerbate CU symptoms and diminish quality of life. These factors disrupt the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS). Furthermore, the act of scratching activates the reward circuit, resulting in the manifestation of the itch-scratching cycle. Current treatments, such as antihistamines, omalizumab, and cyclosporine, demonstrate variable efficacy and are often associated with adverse effects. A holistic approach addressing both psychological and physiological aspects is advocated. This review highlights the critical importance of understanding neuroimmune interactions and the influence of psychosomatic factors in CU. It aims to enhance diagnostic and therapeutic strategies by integrating psychological, neurological, and immunological perspectives.https://doi.org/10.1186/s12974-025-03397-4Chronic urticariaNeuroimmunityDepressionAnxietyStressItch |
| spellingShingle | Shurui Yang Li Chen Haiming Zhang Yanjuan Song Wenyan Wang Zhengbo Hu Siyu Wang Liuyang Huang Yayuan Wang Song Wu Rui Chen Fengxia Liang Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticaria Journal of Neuroinflammation Chronic urticaria Neuroimmunity Depression Anxiety Stress Itch |
| title | Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticaria |
| title_full | Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticaria |
| title_fullStr | Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticaria |
| title_full_unstemmed | Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticaria |
| title_short | Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticaria |
| title_sort | beyond the itch the complex interplay of immune neurological and psychological factors in chronic urticaria |
| topic | Chronic urticaria Neuroimmunity Depression Anxiety Stress Itch |
| url | https://doi.org/10.1186/s12974-025-03397-4 |
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