What does this research mean for the field?

Patients with chronic spontaneous urticaria exhibit significantly elevated levels of inflammatory markers (IL-6, CRP, ESR) and total IgE, as well as a higher prevalence of Vitamin D deficiency, which strongly correlate with disease severity. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate serum levels of immunological biomarkers in chronic spontaneous urticaria patients and correlate these with disease severity.

June 2, 2026Open Access

Clinical and Immunological Biomarkers in Chronic Spontaneous Urticaria

Key Points

To evaluate serum levels of immunological biomarkers in chronic spontaneous urticaria patients and correlate these with disease severity.
Conducted case–control study at tertiary care hospital from April 2023 to September 2024.
Enrolled 50 CSU patients and 50 age-matched controls, assessing disease severity with Urticaria Activity Score (UAS7).
Analyzed blood samples for inflammatory markers (ESR, CRP, IL-6), IgE, Anti-TPO, Vitamin D, and leukocyte counts using ELISA.
CSU patients showed significantly higher IL-6 levels (9.1 ± 5.1 pg/mL vs. 3.12 ± 2.8 pg/mL, P = 0.004) compared to controls.
Total IgE levels were elevated in CSU patients (212.6 ± 239.8 IU/mL vs. 67.8 ± 72.3 IU/mL, P < 0.001).
Vitamin D deficiency was observed more frequently in CSU patients (68% vs. 38%, P = 0.008), with significant correlations between IL-6, CRP, ESR, and total IgE levels with disease severity.

Abstract

Abstract Background: Chronic spontaneous urticaria (CSU) is a complex dermatological disorder characterized by recurrent wheals persisting beyond 6 weeks without identifiable triggers. Despite significant impact on the quality of life, its immunopathological mechanisms remain incompletely understood. Aims: To evaluate the serum levels of immunological biomarkers in CSU patients and to correlate them with disease severity compared to healthy controls. Settings and Design: Tertiary care hospital setting and a case–control study. Materials and Methods: This case–control study was conducted at a tertiary care hospital from April 2023 to September 2024 and enrolled 50 CSU patients and 50 age-matched controls. Disease severity was assessed using the Urticaria Activity Score (UAS7). Blood samples were analyzed for inflammatory markers (erythrocyte sedimentation rate ESR, C-reactive protein CRP, and interleukin-6 IL-6), immunological parameters (total immunoglobulin E IgE and anti-thyroid peroxidase antibody Anti-TPO), Vitamin D, and differential leukocyte counts using the enzyme-linked immunosorbent assay. Statistical Analysis Used: All calculations were performed using the Statistical Package for the Social Sciences (SPSS) software version 20 (SPSS Inc., Chicago). Results: Most CSU patients (66%) were young adults (20–40 years) with equal gender distribution. Seventy-two percent presented with severe disease (UAS 16–42). CSU patients showed significantly elevated levels of inflammatory markers including IL-6 (9.1 ± 5.1 vs. 3.12 ± 2.8 pg/mL, P = 0.004), CRP, and ESR compared to controls. Total IgE levels were significantly higher in cases (212.6 ± 239.8 vs. 67.8 ± 72.3 IU/mL, P < 0.001), while Anti-TPO levels showed no significant difference. Vitamin D deficiency was more prevalent in CSU patients (68% vs. 38%, P = 0.008). IL-6, CRP, ESR, and total IgE levels demonstrated significant correlation with disease severity. Eosinophil counts showed borderline significant elevation in cases ( P = 0.05). Conclusions: This study demonstrates significant alterations in inflammatory and immunological markers in CSU patients, with strong correlations between certain markers and disease severity. These findings suggest potential biomarkers for disease monitoring and therapeutic targets in CSU management.

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