Antihistamine Efficacy in Relation to the Morphology of Skin Eruptions in Chronic Spontaneous Urticaria

YingXie

Kyoto University

"Antihistamine Efficacy in Relation to the Morphology of Skin Eruptions in Chronic Spontaneous Urticaria"

Chronic spontaneous urticaria (CSU) is a persistent skin disorder characterized by red, itchy eruptions of various shapes, known as wheals. These wheals appear and disappear daily, persisting for months or even decades, and severely impact patients' quality of life. The standard treatment for CSU primarily consists of second-generation H1 antihistamines, often administered at higher-than-usual doses. However, approximately 30% of patients remain symptomatic despite these conventional therapies. On the other hand, our previous mathematical modeling and clinical studies have identified five distinct types of wheal shapes through the development of clinical criteria for eruption geometry (EGe Criteria) and have shown how the characteristics of each wheal type are involved in the pathophysiology of CSU. These findings suggest that CSU may be classified into five medical subtypes based on wheal morphology. Thus, in this study, we explore the effectiveness of antihistamines based on wheal shape. We first evaluate the efficacy of antihistamines in silico using three key measures: wheal area, itching severity, and wheal expansion dynamics, across the five identified wheal types. Additionally, we validate some of our theoretical observations using clinical data from patients. By elucidating the relationships among the key networks involved in CSU pathophysiology, wheal morphology, and drug efficacy, we can enhance the development of more accurate diagnostic tools and treatment strategies in clinical settings.
Additional authors:

---