Clinical Study Seeks to Understand Pathogenesis of Urticaria

By: Nicole Martino

Episode # 31
Uploaded: December 1, 2009
Running Time: 4:19

MARTINO: From the National Institutes of Health in Bethesda, Maryland, this is CLINICAL CENTER RADIO. Urticaria, more commonly known as hives, is a common skin disorder manifested by redness, itchiness and usually a raised type of lesion. This disorder can occur spontaneously or after an exposure to a physical trigger like heat, cold or pressure. Sometimes this kind of reaction is common within families, yet not much is known about how the reaction originates and develops into those itchy, red bumps that are the hallmark of the condition. That's what researchers at the National Institute of Allergy and Infections Diseases hope to learn as result of an ongoing clinical research study being conducted here at the NIH Clinical Center. Dr. Hirsh Komarow is the study's principal investigator.

KOMAROW: About 25% of people will have hives at some point in their lifetime, some of those people, about 25% of those people will have hives for an extended period of time which we would call chronic urticaria. Within chronic urticaria there is a subset or a group of types of urticaria which is called physical urticaria. Physical urticaria is defined by some type of physical contact or trigger with the skin or the environment that causes urticaria or hives. Approximately 25% of patients with chronic urticaria have physical urticaria, this is what we are studying. We are trying to understand the connection between the trigger and the urticaria, what pathways in the body are activated with this type of urticaria.

MARTINO: The intent of this study is to understand the mechanisms in the body that trigger this kind of allergic reaction. Because this study focuses on physical urticaria, or hives in response to a specific physical trigger, the study requires that all participants have a documented history of this reaction in response to the trigger whether it is heat, pressure, sunlight, or vibration.

KOMAROW: This area of study is one that has not been investigated very thoroughly. We are trying to expose mechanisms for why people get these types of urticaria. It is thought to be a type of allergic disease, and hopefully by understanding this allergic disease it will enable us to understand other allergic disease which are maybe more common, like asthma, allergic rhinitis, anaphylaxis, eczema.

MARTINO: The study plans to enroll people from a variety of identity groups, male and female, six months of age through 60 years, adults and children of any ethnicity. Once patients have been enrolled in the study the team will attempt to trigger the hives before they examine and characterize the reaction. The team will also be taking blood samples to study the genetic basis of physical urticarial syndrome. Currently the standard therapy for urticarial symptoms involves antihistamines of different types and dosages but Dr. Komarow hopes to learn more about this disorder so that antihistamines are not the only treatment option.

KOMAROW: If we can isolate different activating pathways we can hopefully come up with treatments that may abort these episodes or prevent them.

MARTINO: If you would like more information about this study or one of the 1,500 other studies offered at the NIH Clinical Center, log on to http://clinicalcenter.nih.gov, or e-mail prpl@mail.cc.nih.gov. You may also our call center toll free at 1-800-411-1222. From America's Clinical Research Hospital, this has been CLINICAL CENTER RADIO. In Bethesda, Maryland, I'm Nicole Martino at the National Institutes of Health, an agency of the United States Department of Health and Human Services.

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