Chronic spontaneous urticaria (CSU) is characterized by the appearance of wheals of various shapes and sizes (ranging from a few millimeters to a few centimeters) on the skin's surface accompanied by intense itching. Most cases of CSU follow a course in which the wheals appear in the evening, disappear by the next morning or midday, and reappear in the evening. However, the cause of CSU is not well understood due to the lack of an animal model.
A research group led by Professor Sungrim Seirin-Lee of the Kyoto University Institute for the Advanced Study of Human Biology (ASHBi), and former Professor Michihiro Hide and Associate Professor Shunsuke Takahagi of the Graduate School of Biomedical and Health Sciences at Hiroshima University, used a mathematical model to develop a diagnostic model for CSU that defines pathological states based on the morphological classification of eruption. The research group demonstrated the validity of the developed model using actual patient data. The study was published in Communications Medicine.
In many cases of human-specific skin diseases, the underlying pathology must be inferred based on limited clinical data due to the lack of an appropriate animal model. Although CSU is visually recognizable as wheals of various forms on the skin's surface, the internal mechanism by which it occurs was unexplored. In recent years, studies of various pathophysiological features of urticaria including autoimmune responses and cellular infiltration have been conducted.
The current study analyzed wheal morphology by developing a hierarchical mathematical model that incorporates its intra- and extravascular dynamics using experimental in vitro data and linked the morphological features to the in vivo pathological dynamics of CSU. The wheal patterns were classified into 5 types.
Furthermore, "criteria for the classification of wheal morphology" were developed for use in the clinical setting. An examination of 105 patients based on these criteria revealed that, in 87.6% of cases, the morphology of wheals in CSU could be classified into the 5 morphologic types of the mathematical model.
According to Lee, "We would like to incorporate this model in a smartphone application so that patients can easily self-diagnose CSU. I started to work on the mathematical model during a discussion with Professor Hide at Hiroshima University, when I hypothesized that morphology might be significant."
Publication: Communications Medicine
Title: Mathematical-structure based Morphological Classification of Skin Eruptions and Linking to the Pathophysiological State of Chronic Spontaneous Urticaria
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