{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:16:16Z","timestamp":1789168576981,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic spontaneous urticaria (CSU) is frequently refractory to guideline\u2010based therapy, highlighting the need for predictive biomarkers. Dysregulation of the complement system has been implicated in CSU severity, but global complement activity has not been systematically evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to assess the total hemolytic complement (CH50) assay as a biomarker for disease activity and predictor of treatment response in CSU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational, ambispective, single\u2010center study included 180 CSU patients and 45 healthy controls. CH50 levels were measured and correlated with clinical and immunological markers. Response to second\u2010generation antihistamines and omalizumab at 3, 6, and 12\u2009months was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CH50 levels were significantly higher in CSU patients than in controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and were associated with more active and prolonged disease. CH50 correlated with Weekly Urticaria Activity Scores (UAS7) (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), Urticaria Control Test (UCT) scores\u00a0(\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u2009\u22120.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), longer disease duration (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002), D\u2010dimer (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and immunoglobulin G (IgG) anti\u2010thyroid peroxidase (anti\u2010TPO) (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.005). Higher CH50 levels were linked to antihistamine resistance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with superior predictive accuracy (area under the curve [AUC]\u2009=\u20090.87) over D\u2010dimer, C4, and UAS7. CH50 was also an independent predictor of antihistamine resistance (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09\u20131.18). No association was observed with omalizumab response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CH50 is a novel and promising biomarker for antihistamine resistance in CSU, outperforming previously described markers. Its low cost and accessibility support integration into CSU stratification and endotype\u2010driven therapeutic algorithms, pending validation in multicenter cohorts.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/ijd70339-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijd.70339","type":"journal-article","created":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T14:54:25Z","timestamp":1771167265000},"page":"2066-2073","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>CH50<\/scp>\n                    as a Clinically Useful Biomarker of Disease Activity and Antihistamine Resistance in Chronic Spontaneous Urticaria: An Observational Ambispective Single\u2010Center Study"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1303-2422","authenticated-orcid":false,"given":"Nidia","family":"Planella\u2010Fontanillas","sequence":"first","affiliation":[{"name":"Department of Dermatology Hospital del Mar Research Institute  Barcelona Spain"},{"name":"Department of Medicine and Life Sciences (MELIS) Universitat Pompeu Fabra (UPF)  Barcelona 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