ClinicalTrials.gg
CompletedNCT00887939Updated Mar 30, 2026

Pathogenesis of Physical Induced Urticarial Syndromes

An observational study in Hypersensitivity, Immediate, Autoinflammatory Syndromes and Physical Urticaria, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 1 site in United States. Open to participants aged 2 Years to 90 Years. Per ClinicalTrials.gov, last updated 2026-03-30.

Primary conditionCryopyrin-Associated Periodic SyndromesRegistry: Hypersensitivity, ImmediateReclassifiedWhy we changed it
Registry
Hypersensitivity, Immediate — the first condition term the registry derived for this study.
ClinicalTrials.gg
Cryopyrin-Associated Periodic Syndromes
Why
  1. The study's listed conditions name Cryopyrin-Associated Periodic Syndromes, a narrower term within Hypersensitivity, Immediate.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Observational

Study type
Observational
Model
Case-control
Time perspective
Cross-sectional
Enrollment
173
Ages
2 Years to 90 Years
Sex
All
01

Study summary

Background:

  • Urticaria is a common itchy skin disorder that may occur spontaneously or on exposure to a physical trigger (called physical urticaria).
  • Researchers are studying the genetic basis of a physically induced urticarial syndrome. Once called familial cold urticaria, this condition is now called familial cold autoinflammatory syndrome (FCAS). FCAS is an autoinflammatory disease, a group of inherited disorders characterized by unprovoked episodes of inflammation. Patients with FCAS often have hives, joint pain, and fever following general exposure to cold.
  • Patients with FCAS have a mutation in a gene that makes a protein called cryopyrin. Cryopyrin seems to be involved with the production of a proinflammatory mediator called interleukin-1 (IL-1). Patients with FCAS and others with autoinflammatory syndromes have benefited from medication that blocks the effects of IL-1.

Objectives:

  • To investigate mechanisms that may cause physical hives or urticaria.
  • To reproduce urticaria through challenge testing (procedures to test the skin for a reaction to a stimulus), followed by mast cell studies, measurement of IL-1, genetic studies, and other molecular studies to lead to a better understanding of urticaria and to design safe and more effective treatments.

Eligibility:

  • Patients between 6 months and 65 years of age with a documented history of clinically reproducible physical urticaria that triggers hives and that has been evaluated by a physician. Patients should have a letter of referral, including copies of pertinent medical history and laboratory studies, from a referring physician.
  • Affected and nonaffected family members of such patients.
  • Exclusion criteria include (1) the presence of conditions that may put the subject at undue risk, such as acute infection, severe thrombocytopenia (a lower than normal number of platelets in the blood), or significant cardiovascular disease; (2) any condition that would make the subject unsuitable for enrollment in this study; and (3) a history of HIV, other known immunodeficiency, or evidence of chronic Hepatitis B and/or C infection.

Design:

  • Researchers will conduct the following tests to verify which triggers cause the hives:

    • History and physical exam to determine the relationship between the trigger and appearance of the hives.
    • Blood samples for baseline screening (additional samples may be taken within 8 hours of triggering hives).
    • Verification of hives using standard challenge testing.
  • Procedures to trigger urticaria (the challenge testing) include dermatographism (stroking the skin), delayed pressure urticaria (direct pressure), cold-induced urticaria (cold exposure), cholinergic urticaria (exercise, hot water), solar urticaria (sun exposure), localized heat urticaria (direct heat exposure), aquagenic urticaria (room temperature water), and vibratory angioedema (direct vibratory stimulus exposure).
  • Participants who have a positive history for hives and failed challenge testing (that is, hives resulted from the triggers) will be asked to provide a skin biopsy and additional bloods samples for research purposes.
  • Participants will be asked to return to the clinic within 1 month if multiple triggers could not be verified during the initial visit, or to return for additional research evaluations, which may include a skin punch biopsy and blood sample collection. Patients may have to stay at the hospital overnight, if required to document the disease.
  • Nonaffected family members who enroll in this protocol will provide samples for comparison with the family member who has a history of hives.
  • Participants will receive a small financial compensation for the skin biopsy.
Read the detailed description

Urticaria is a common skin disorder that is classified according to its chronicity into acute and chronic forms. It may occur spontaneously or on exposure to a physical factor. In the latter case, the urticaria is classified as a physical urticaria . Physical urticaria may be induced by mechanical and applied pressure, exercise, or exposure to cold, heat, sun, water, or vibration. The urticarial lesions are generally thought to be the result of mast cell activation and degranulation, which is supported by the finding of increased levels of serum histamine during some urticarial flares. Passive transfer experiments, whereupon serum from affected donors is transferred into recipient s skin followed by physical stimulation with resultant urticaria at the site of challenge, have been positive in some instances. This suggests the presence of an intrinsic factor in serum, such as IgE, which then mediates activation of tissue mast cells. However, the pathogenesis in general remains unclear and a genetic basis for these disorders has not been elucidated.

The goal of this protocol is thus to gain a better understanding of the pathogenesis of physical urticaria through the investigation of subjects with severe and unusual phenotypes and/or inherited patterns of disease. Subjects will undergo a clinical evaluation that will include verification of their urticaria. Blood and tissue samples, if available, will be collected for analysis. The analysis will be targeted toward the determination of novel serum mediators, mast cell activation and mutational analysis in families with inherited patterns.

02

Conditions studied

  • Hypersensitivity, Immediate
  • Autoinflammatory Syndromes
  • Physical Urticaria
  • Familial Cold Autoinflammatory Syndrome

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Keywords

  • Hives
  • Inflammasome
  • Mast Cell
  • Natural History
  • Urticaria
03

In context

Cryopyrin-Associated Periodic Syndromes Reclassified

35 studies on the registry are indexed under Cryopyrin-Associated Periodic Syndromes; 5 are open to participants now.

Browse Cryopyrin-Associated Periodic Syndromes studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,446 studies on the registry; 179 are open to participants now.

Of its 405 completed or terminated interventional studies of FDA-regulated products, 302 (75%) have results posted.

Compared within Cryopyrin-Associated Periodic Syndromes, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Hypersensitivity, Immediate. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
2 Years to 90 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Primary clinical

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Affected subjects/guardian must:

  1. Be at least 2 years of age and no older than 90 years of age
  2. Have a history of a physical urticaria, which has been evaluated by the patient's healthcare practitioner.
  3. Provide copies of pertinent medical records and laboratory studies
  4. Have a health care provider outside of NIH
  5. Be willing to give
  6. Be willing to donate blood for sample storage to be used for future research

Non-affected relatives/guardian must:

  1. Be at least 2 years of age and no older than 90 years of age
  2. Have a relative who is enrolled on this protocol and is known to have a documented history of a physical urticaria
  3. Not have a history of physical urticaria
  4. Be willing to give informed consent
  5. Be willing to donate blood for sample storage to be used for future research

Healthy volunteers must:

  1. Be 18-65 years of age
  2. Be non-atopic (not have a history of allergic rhinitis, asthma, atopic dermatitis) per subject medical history
  3. Have the ability to give informed consent
  4. Be willing to donate blood for sample storage to be used for future research
  5. Not have a history of physical urticaria

Exclusion criteria

EXCLUSION CRITERIA:

The following criteria apply to all subjects:

  1. Presence of conditions which, in the judgment of the investigator or the referring physician, may put the subject at undue risk, such as acute infection, severe thrombocytopenia (minimum count of 30,000), or significant cardiovascular disease
  2. Any condition that in the view of the principal investigator (PI) would make the subject unsuitable for enrollment in this study
  3. History of or other known immunodeficiency
  4. History or evidence of chronic and/or C infection
  5. Pregnancy
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

05

Study design

Observational model
Case-control
Time perspective
Cross-sectional
Enrollment
173 participants (actual)

Groups and cohorts

  • 1

    Affected physical urticaria

  • 2

    Healthy volunteer

  • 3

    Unaffected relative

06

What researchers measure

Primary outcomes

  1. to determine the role of mast cell activation and genetic predisposition in the pathogenesis of physically induced urticaria.

    The patient s physical urticaria will be verified through standard testing.

    Time frame: 12/31/2028

07

Study locations

1 site
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
08

References and documents

Publications

  • Meyer J, Gorbach AM, Liu WM, Medic N, Young M, Nelson C, Arceo S, Desai A, Metcalfe DD, Komarow HD. Mast cell dependent vascular changes associated with an acute response to cold immersion in primary contact urticaria. PLoS One. 2013;8(2):e56773. doi: 10.1371/journal.pone.0056773. Epub 2013 Feb 22. PubMed 23451084 ↗
  • Boyden SE, Desai A, Cruse G, Young ML, Bolan HC, Scott LM, Eisch AR, Long RD, Lee CC, Satorius CL, Pakstis AJ, Olivera A, Mullikin JC, Chouery E, Megarbane A, Medlej-Hashim M, Kidd KK, Kastner DL, Metcalfe DD, Komarow HD. Vibratory Urticaria Associated with a Missense Variant in ADGRE2. N Engl J Med. 2016 Feb 18;374(7):656-63. doi: 10.1056/NEJMoa1500611. Epub 2016 Feb 3. PubMed 26841242 ↗

Individual participant data

Plan to share: No — IDP will not be shared since sequencing is performed through NIH Centralized sequencing.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Jun 2009 to primary completion in Jun 2024, 179 months.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 23, 2009
First posted
Apr 24, 2009
StartActual
Jun 17, 2009
Primary completionActual
Jun 3, 2024
CompletionActual
Jun 3, 2024
Last update
Mar 30, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 30, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00887939
Responsible party
Sponsor
First posted
Apr 24, 2009
Start date
Jun 17, 2009
Primary completion
Jun 3, 2024
Completion
Jun 3, 2024
Last update
Mar 30, 2026

Study contacts

Hirsh D Komarow, M.D.
principal investigator · National Institute of Allergy and Infectious Diseases (NIAID)

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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