Antihistamines are widely used in allergic diseases such as urticaria and allergic rhinitis, mainly by reverse excited histamine and anti-allergic effects. Antihistamines are generally safe, but there may be some adverse reactions like cardiotoxicity, central inhibition, anticholinergic effects, etc. And there are also individual differences in clinical practice. The concept of individualized medicine has been deeply rooted in people's minds since it was put forward. In recent decades, pharmacogenomics has been developing rapidly, which provides new ideas for the occurrence of individual medication. Gene polymorphism in the metabolic enzyme, transports, and target receptors have been shown to affect the application of antihistamines. Besides, recent evidence suggests that genetic polymorphisms influence urticaria susceptibility and antihistamine therapy. Here, we summarize current reports of this area, aim to contribute to the future research and clinical guidance of antihistamine personalized medicine.

Chronic spontaneous urticaria (CSU) is defined as the recurrent episodes of spontaneous wheals and/or angioedema for more than 6 weeks, and at least twice a week. The core link in the pathogenesis of CSU is the activation of mast cells and other immune cells caused by various reasons. These activated immune cells release a series of inflammatory active mediators such as histamine, arachidonic acid metabolites, chemokines, etc., resulting in clinical features such as wheals and/or edema. However, the specific mechanisms leading to the activation of various immune cells have not been fully elucidated. Previous evidence has shown that about 50% of CSU patients have potential autoimmune reactions. Here we review the functional implication of immune cells in CSU focusing on the crosstalk between them and discuss whether their crosstalk promotes the occurrence and development of the disease.

Article type: Research LetterTitle: Dupilumab therapy in children aged 6 months to 12 years with uncontrolled moderate-to-severe atopic dermatitis: a Chinese real-world study