{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:02:53Z","timestamp":1791475373658,"version":"4.3.4"},"reference-count":46,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T00:00:00Z","timestamp":1564358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Autoimmune chronic spontaneous urticaria (aiCSU) is an important subtype of chronic spontaneous urticaria (CSU) in which functional IgG autoantibodies to IgE or its high\u2010affinity receptor (Fc\u03b5RI) induces mast cell degranulation and subsequent symptom development. However, it has not been tightly characterized. This study aimed to better define the clinical and immunological features and to explore potential biomarkers of aiCSU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multinational, multicenter study of 182 CSU patients. The clinical features studied included: urticaria activity and impact (UAS7 and quality of life); autologous serum skin test (ASST); IgG anti\u2010Fc\u03b5RI and IgG anti\u2010IgE; IgG\u2010anti\u2010thyroperoxidase (IgG anti\u2010TPO); total serum IgE; and basophil reactivity (BASO) using the basophil activation test (BAT) and basophil histamine release assay (BHRA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 182 patients, 107 (59%) were ASST+, 46 (25%) were BASO+, and 105 (58%) were IgG anti\u2010Fc\u03b5RI+\/IgE+. Fifteen patients (8%) fulfilled all three criteria of aiCSU. aiCSU patients appeared more severe (UAS7 21 vs 9 <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.016) but showed no other clinical or demographic differences from non\u2010aiCSU patients. aiCSU patients also had markedly lower total IgE levels (<jats:italic>P\u00a0&lt;\u00a0<\/jats:italic>0.0001) and higher IgG anti\u2010TPO levels (<jats:italic>P\u00a0&lt;\u00a0<\/jats:italic>0.001). Of biomarkers, positive BAT and BHRA tests were 69% and 88% predictive of aiCSU, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>aiCSU is a relatively small but immunologically distinct subtype of CSU that cannot be identified by routine clinical parameters. Inclusion of BHRA or BAT in the diagnostic workup of CSU patients may aid identification of aiCSU patients, who may have a different prognosis and benefit from specific management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.13949","type":"journal-article","created":{"date-parts":[[2019,6,22]],"date-time":"2019-06-22T23:49:22Z","timestamp":1561247362000},"page":"2427-2436","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":213,"title":["Biomarkers and clinical characteristics of autoimmune chronic spontaneous urticaria: Results of the PURIST Study"],"prefix":"10.1111","volume":"74","author":[{"given":"Nicole","family":"Schoepke","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergy Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8277-1700","authenticated-orcid":false,"given":"Riccardo","family":"Asero","sequence":"additional","affiliation":[{"name":"Department of Allergology Clinica San Carlo Paderno Dugnano (MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Ellrich","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8495-1302","authenticated-orcid":false,"given":"Marta","family":"Ferrer","sequence":"additional","affiliation":[{"name":"Department of Allergy and Clinical Immunology, Clinica Universidad de Navarra, Instituto de Investigaci\u00f3n Sanitaria de Navarra (IdiSNA), RETIC de Asma Reacciones adversas y Al\u00e9rgicas (ARADYAL) Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9548-5423","authenticated-orcid":false,"given":"Ana","family":"Gimenez\u2010Arnau","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital del Mar, IMIM, Universitat Aut\u00f2noma Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive","family":"E. 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Grattan","sequence":"additional","affiliation":[{"name":"Guy's Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Jakob","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, University Medical Center Giessen and Marburg Justus\u2010Liebig University Gie\u00dfen Gie\u00dfen Germany"},{"name":"Allergy Research Group, Medical Center University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George N.","family":"Konstantinou","sequence":"additional","affiliation":[{"name":"Department of Allergy and Clinical Immunology 424 General Military Training Hospital Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Raap","sequence":"additional","affiliation":[{"name":"Department of Human Medicine and Health Sciences, University Clinic of Dermatology and Allergy University of Oldenburg Oldenburg 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