{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:47:16Z","timestamp":1782362836781,"version":"3.54.5"},"reference-count":79,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Urticaria is a condition characterized by the development of itchy wheals (hives), angioedema, or both. The pathophysiology of chronic spontaneous urticaria (CSU) is still poorly understood. It is suggested that there is no dominant and independent mechanism of CSU; however, there are different immunological and non-immunological abnormalities that act simultaneously or\/and follow each other resulting in clinical symptoms. The latest hypothesis points out that mast cells (MCs) to be activated via autoantibodies in autoallergic or autoimmune mechanism mediators released from degranulated MCs are responsible for the vasoactive and neurospecific effect in CSU. According to many clinical observations, it is suggested that psychological stress can be both a triggering factor in the onset of CSU and a modulating one in the course of the disease and therapy effectiveness. Of importance, the mechanistic background of the psychological stress response in the skin has not yet been fully elucidated. However, of note, a variety of inflammatory mediators, neuropeptides, and neurotransmitters facilitate this phenomenon. This review presents recent findings on the neuro\u2013immuno\u2013psychological aspects of CSU, highlighting an emerging role of neuro\u2013immune interactions. It also points out the usefulness of psychological tools employment for the baseline diagnosis of perceived stress level and the presence of its symptoms. Furthermore, it proposes the implementation of non-invasive interventions to reduce psychological stress and anxiety. A bio\u2013psycho\u2013social approach including psychological support and patient education seems to be as important as traditional pharmacotherapy for CSU. It facilitates the effective control of active disease and a prolonged remission time in this disease.<\/jats:p>","DOI":"10.3390\/jcm12093134","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T02:18:34Z","timestamp":1682561914000},"page":"3134","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Neuro\u2013Immuno\u2013Psychological Aspects of Chronic Urticaria"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8328-4245","authenticated-orcid":false,"given":"Katarzyna","family":"Tomaszewska","sequence":"first","affiliation":[{"name":"Psychodermatology Department, Chair of Pulmonology, Rheumatology and Clinical Immunology, Medical University of Lodz, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"S\u0142odka","sequence":"additional","affiliation":[{"name":"Psychodermatology Department, Chair of Pulmonology, Rheumatology and Clinical Immunology, Medical University of Lodz, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart\u0142omiej","family":"Tarkowski","sequence":"additional","affiliation":[{"name":"Psychodermatology Department, Chair of Pulmonology, Rheumatology and Clinical Immunology, Medical University of Lodz, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9900-7680","authenticated-orcid":false,"given":"Anna","family":"Zalewska-Janowska","sequence":"additional","affiliation":[{"name":"Psychodermatology Department, Chair of Pulmonology, Rheumatology and Clinical Immunology, Medical University of Lodz, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1111\/all.15090","article-title":"The International EAACI\/GA2LEN\/EuroGuiDerm\/APAAACI Guideline for the Definition, Classification, Diagnosis, and Management of Urticaria","volume":"77","author":"Zuberbier","year":"2022","journal-title":"Allergy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100533","DOI":"10.1016\/j.waojou.2021.100533","article-title":"The Challenges of Chronic Urticaria Part 1: Epidemiology, Immunopathogenesis, Comorbidities, Quality of Life, and Management","volume":"14","author":"Ansotegui","year":"2021","journal-title":"World Allergy Organ. 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