Clinical phenotypes and molecular endotypes of chronic urticaria: Linking clinical expression to underlying immune mechanisms
Year: 2026
Type: article
Abstract: Chronic urticaria (CU) is a biologically heterogeneous inflammatory skin disease characterized by recurrent wheals and/or angioedema. Despite its uniform clinical presentation, the disease encompasses diverse clinical phenotypes and molecular endotypes driven by distinct immune mechanisms. Integrating these patterns is essential for transitioning from empirical management toward precision medicine. This review explores the convergence of observable clinical phenotypes and underlying molecular endotypes to refine diagnosis and guide stratified therapeutic strategies. A comprehensive literature review was conducted, focusing on clinical clusters (eg, pediatric, elderly, and ethnic variations), immunological drivers (type I autoallergy and type IIb autoimmunity), and emerging targeted therapies. Linking clinical phenotypes with molecular endotypes enables a more personalized approach to CU management. Future directions include the validation of point-of-care biomarkers and the utilization of digital phenotyping to achieve disease modification and long-term remission.
Source: Asia Pacific Allergy
Institutions: Erciyes University, University of Ljubljana, University of Maribor, University Clinic of Pulmonary and Allergic Diseases Golnik, Faculdade de Medicina do ABC, Humboldt-Universität zu Berlin, Fraunhofer Institute for Translational Medicine and Pharmacology, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Nippon Medical School, Acıbadem University, Universidad de Antioquia, Adıyaman Eğitim ve Araştırma Hastanesi, Tongji University, Shanghai Skin Disease Hospital, Bahçeşehir University
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7140282997