Publications by authors named "Martin Metz"

Background: Chronic spontaneous urticaria (CSU), a common and debilitating disease, is widely held not to be life-limiting, but the mortality of CSU has not been investigated.

Objective: To assess all-cause mortality in CSU patients, risk for comorbidities that are leading causes of death and impact of guideline-recommended urticaria treatments on mortality rates.

Methods: This is a retrospective population-based cohort study of electronic health records of 272,190 adult CSU patients and 12,728,913 non-urticaria controls from the US Collaborative TriNetx Analytics Network.

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Background: Mastocytosis is characterized by expanding neoplastic mast cells in organs such as the skin, bone marrow, and gastrointestinal tract. The release of mast cell mediators triggers cutaneous, gastrointestinal, and other symptoms. Currently, no validated mastocytosis-specific patient-reported outcome measure (PROM) exists to assess disease control.

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Article Synopsis
  • CRUSE® is an app designed for people with chronic spontaneous urticaria (CSU) to track their symptoms using visual analogue scales (VASs), aiming to assess the app's effectiveness in measuring disease activity.
  • A study analyzed three VASs related to CSU impact on daily life, including one specifically for the severity of urticaria, one for productivity, and a general health measure (EQ-5D), using data from nearly 6,000 patients over many days.
  • The results showed that the CRUSE® app's VASs demonstrate strong validity and reliability, with the "VAS urticaria" being most effective in capturing symptom changes, while the minimal important difference (MID) values indicated meaningful changes
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Article Synopsis
  • * Diagnosis is usually made based on recurring symptoms like wheals and angioedema, and it often lasts over a year; around 40% of patients experience significant negative effects on their quality of life.
  • * First-line treatment includes second-generation H1 antihistamines, with about 40% of patients showing improvement, while omalizumab is recommended for those not responding to antihistamines, although 30% may not benefit; cyclosporine is another option with some effectiveness but potential side
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  • Patients with primary cutaneous T-cell lymphoma (CTCL) often suffer from intense itching (pruritus) that greatly diminishes their quality of life, and the reasons behind this itching are not well understood. * A study involved 142 CTCL patients and 129 healthy subjects, assessing factors like itch intensity and various blood markers related to inflammation and immune response, finding that itch was more severe in CTCL patients compared to those with other skin conditions. * The research identified several key blood markers (like IL-31 and substance P) that are linked to pruritus in CTCL, suggesting these could be potential targets for new treatments aimed at alleviating the severe itching experienced by these patients.
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Chronic spontaneous urticaria (CSU) is a debilitating, inflammatory skin condition characterized by infiltrating immune cells. Available treatments are limited to improving the signs and symptoms. There is an unmet need to develop therapies that target disease-driving pathways upstream of mast cell activation to inhibit or delay the progression of CSU and associated comorbidities.

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Background: Mas-related G protein-coupled receptor X2 (MRGPRX2) is a promiscuous receptor on mast cells that mediates IgE-independent degranulation and has been implicated in multiple mast cell-mediated disorders, including chronic urticaria, atopic dermatitis, and pain disorders. Although it is a promising therapeutic target, few potent, selective, small molecule antagonists have been identified, and functional effects of human MRGPRX2 inhibition have not been evaluated in vivo.

Objective: We sought to identify and characterize novel, potent, and selective orally active small molecule MRGPRX2 antagonists for potential treatment of mast cell-mediated disease.

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Article Synopsis
  • - Chronic itch significantly impacts the quality of life and can be caused by issues in the nervous system, either peripheral or central, including conditions like small-fiber neuropathy and nerve compression syndromes.
  • - Neuropathic itch often appears on normal skin, may be associated with pain, and can be alleviated by applying cold, with its distribution depending on the affected area of the nervous system.
  • - Diagnosis requires a thorough medical history, and may involve skin biopsies or imaging, while treatments include topical agents like capsaicin, and systemic medications such as gabapentinoids and antidepressants.
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Urban areas are often hotspots for the dissemination of non-native (invasive) plant species, some of which release (potentially) allergenic pollen. Given the high population density in cities, a considerable number of people can be regularly and potentially intensively exposed to the pollen from these plants. This study delves into the Tree-of-Heaven (Ailanthus altissima, [Mill.

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Background: Chronic spontaneous urticaria (CSU) is a relatively common skin disease associated with hives and angio-oedema. Eosinophils play a role in CSU pathogenesis. Benralizumab, an anti-interleukin-5 receptor-α monoclonal antibody, has been shown to induce nearly complete depletion of eosinophils.

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  • Cholinergic urticaria (CholU) is a common condition where symptoms like itchy hives arise from sweating, but existing treatments often fail to provide adequate control for patients.
  • In a phase IIa trial, the new oral medication izuforant was tested on adults with CholU who didn't respond well to traditional antihistamines.
  • Results showed that while izuforant did not significantly improve the primary measures of urticaria activity, it did lead to noticeable improvements in patient-reported severity assessments compared to placebo.
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Background: Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE , the Chronic Urticaria Self Evaluation app, aims to address this unmet need.

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Importance: Chronic prurigo (CPG), including prurigo nodularis, is a difficult disease to treat and considerably affects patients' quality of life. Helping patients obtain control of CPG is a major treatment goal.

Objective: To develop and validate the Prurigo Control Test (PCT), a tool for assessing disease control in CPG, and to identify a cutoff value for controlled disease to aid treatment decisions.

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Atopic dermatitis (AD) is a chronic, relapsing immunoinflammatory skin condition characterized by sensations such as pruritis, pain, and neuronal hypersensitivity. The mechanisms underlying these sensations are multifactorial and involve complex crosstalk among several cutaneous components. This review explores the role these components play in the pathophysiology of atopic dermatitis.

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Atopic dermatitis (AD) is predominantly characterized by intense itching, but concomitant skin pain is experienced by more than 40% of patients. Patients with AD display considerable somatosensory aberrations, including increased nerve sensitivity to itch stimuli (hyperknesis), perception of itch from innocuous stimuli (alloknesis), or perception of pain from innocuous stimuli (allodynia). This review summarizes the current understanding of the similarities and differences in the peripheral mechanisms underlying itch and pain in AD.

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Health apps play an increasing role in everyday healthcare, especially for chronic diseases. The Chronic Urticaria Self Evaluation (CRUSE) is a new mobile health app for chronic spontaneous urticaria (CSU) patients, which replaces disease tracking via paper and pen, thus making disease monitoring more convenient, increasing tracking compliance, and improving data quality and access. CRUSE enables patients to complete patient-reported outcome measures on their smartphone and send the results, along with current medication and pictures, to their treating physician via email.

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Background: Mycosis fungoides (MF) is an indolent T-cell lymphoma that mainly affects the skin and presents with itch in more than half of the patients. Recently, the expression of Mas-related G protein-coupled receptor X2 (MRGPRX2), a receptor of mast cell (MC) responsible for the IgE-independent non-histaminergic itch, has been shown in lesional skin of patients with pruritic skin diseases, including chronic urticaria, prurigo, and mastocytosis. As of yet, limited knowledge exists regarding the MRGPRX2 expression in the skin of patients with MF.

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Background: Urticarial vasculitis (UV) should be differentiated from chronic spontaneous urticaria (CSU) in patients initially presenting with recurrent wheals, although criteria for differential diagnosis remain ill-defined.

Objectives: To set the goals, define criteria and unmet needs in UV diagnosis and differential diagnosis with CSU, and explore the possibility of coexistence of both diseases.

Methods: Thirteen experts experienced in UV research participated in a Delphi survey of European Academy of Allergy and Clinical Immunology taskforce.

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[Chronic prurigo].

Dermatologie (Heidelb)

November 2023

Article Synopsis
  • - Chronic prurigo is a debilitating skin condition marked by repetitive scratching that leads to the formation of itchy nodules and plaques, significantly impacting patients' quality of life due to associated anxiety, depression, and sleep issues.
  • - Managing chronic prurigo is challenging because of its complex causes and varying symptoms, but disease-specific guidelines offer diagnostic strategies and a step-by-step treatment framework.
  • - New treatments for chronic prurigo, including monoclonal antibodies and small molecules, are currently under investigation, highlighting a growing interest in addressing this condition in the medical field.
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Chronic urticaria (CU) is a mast cell (MC)-dependent disease with limited therapeutic options. Current management strategies are directed at inhibiting IgE-mediated activation of MCs and antagonizing effects of released mediators. Due to the complexity and heterogeneity of CU and other MC diseases and mechanisms of MC activation-including multiple activating receptors and ligands, diverse signaling pathways, and a menagerie of mediators-strategies of MC depletion or MC silencing (i.

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