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Purpose of Review <p>This review aims to evaluate the utility of biomarkers in the diagnosis, endotyping, and management of chronic spontaneous urticaria (CSU). It seeks to address whether biomarkers are ready for integration into routine clinical practice and how they can guide personalized treatment approaches.</p> Recent Findings <p>Emerging evidence underscores the heterogeneity of CSU, primarily characterized by autoimmune Type I (IgE-mediated) and Type IIb (IgG-mediated) endotypes. Biomarkers such as total IgE, C-reactive protein, and basophil counts have shown promise in predicting disease severity and treatment responses. Novel biomarkers, including FcεRI expression, IL-6, and D-Dimer, offer insights into disease pathogenesis and therapeutic outcomes. The use of biomarkers for newer agents like Bruton’s tyrosine kinase inhibitors and anti-IL-4R therapies further exemplifies their clinical potential.</p> Summary <p>The review highlights the pivotal role of biomarkers in transitioning CSU management from a generalized to a precision medicine approach. Biomarkers facilitate endotyping, optimize therapy selection, and predict treatment responses. While current data is promising, the routine implementation of biomarker-driven strategies requires standardized assays, validation in diverse populations, and integration into clinical workflows. Advancing biomarker research will not only improve patient outcomes but also streamline therapeutic decisions, marking a significant step toward personalized care in CSU.</p>

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Biomarkers in Chronic Spontaneous Urticaria: Are We Ready for its Use in Clinical Practice?

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月2日

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  • Yi-Kui Xiang,
  • Man Hu,
  • Daniel Elieh-Ali-Komi,
  • Andac Salman,
  • Anna Smola,
  • Emek Kocatürk

摘要

Purpose of Review

This review aims to evaluate the utility of biomarkers in the diagnosis, endotyping, and management of chronic spontaneous urticaria (CSU). It seeks to address whether biomarkers are ready for integration into routine clinical practice and how they can guide personalized treatment approaches.

Recent Findings

Emerging evidence underscores the heterogeneity of CSU, primarily characterized by autoimmune Type I (IgE-mediated) and Type IIb (IgG-mediated) endotypes. Biomarkers such as total IgE, C-reactive protein, and basophil counts have shown promise in predicting disease severity and treatment responses. Novel biomarkers, including FcεRI expression, IL-6, and D-Dimer, offer insights into disease pathogenesis and therapeutic outcomes. The use of biomarkers for newer agents like Bruton’s tyrosine kinase inhibitors and anti-IL-4R therapies further exemplifies their clinical potential.

Summary

The review highlights the pivotal role of biomarkers in transitioning CSU management from a generalized to a precision medicine approach. Biomarkers facilitate endotyping, optimize therapy selection, and predict treatment responses. While current data is promising, the routine implementation of biomarker-driven strategies requires standardized assays, validation in diverse populations, and integration into clinical workflows. Advancing biomarker research will not only improve patient outcomes but also streamline therapeutic decisions, marking a significant step toward personalized care in CSU.