Nanomaterials in Targeted Immunotherapy for Chronic Spontaneous Urticaria: Focusing on Immune Cell Modulation and Precision Treatment

Wei Yao,1,2,* Chaoxia Peng,1,2,* Yufeng He,3 Guihong Yang,1,2 Dan Luo,1,2 Zhongsong Zhang,4,5 Long Chen,4– 6 Xianqiong Huang1,2 1Department of Dermatology, Daping Hospital, Army Medical University, Chongqing, 400042, People’s Republic of China; 2Research Center for Skin Tissue Engineering of Chongqing Higher Education Institutions, Daping Hospital, Army Medical University, Chongqing, 400042, People’s Republic of China; 3Department of Dermatology, 77th Group Army Hospital, Leshan, Sichuan, 614000, People’s Republic of China; 4The Second Affiliated Hospital of Chengdu Medical College, Nuclear Industry 416 Hospital, Chengdu, Sichuan, 610000, People’s Republic of China; 5Non-Coding RNA and Drug Discovery Key Laboratory of Sichuan Province, School of Basic Medical Sciences, Chengdu Medical College, Chengdu, Sichuan, 610550, People’s Republic of China; 6Department of Immunology, School of Basic Medical Sciences, Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China*These authors contributed equally to this workCorrespondence: Long Chen, Email chenlong@cmc.edu.cn Xianqiong Huang, Email xianqiong@tmmu.edu.cnAbstract: Chronic spontaneous urticaria (CSU) is an immune-mediated skin disorder marked by recurrent hives and angioedema, affecting a large proportion of the global population. Traditional immunotherapy often fails, particularly in difficult-to-treat cases, highlighting the need for more precise, immune cell-targeted treatments. Nanomaterials offer unique advantages, such as size tuning, surface functionalization, and controlled release, allowing precise targeting of immune cell receptors. This is crucial for enhancing treatment efficacy and minimizing systemic side effects. This review explores the potential of nanomaterials in CSU immunotherapy, focusing on their ability to modulate immune cells—such as mast cells, eosinophils, basophils, and T lymphocytes—to restore immune balance and alleviate symptoms. However, challenges remain in the clinical application of nanomaterials, including concerns about immunotoxicity, long-term safety, and the need for stronger evidence of efficacy in human trials. Additionally, while AI in optimizing nanomaterial design shows promise, it is still in early development and requires further exploration to enhance its practical applications. Current nanomaterial applications in allergic diseases, such as food allergies and asthma, show promise but differ from CSU in immune mechanisms like mast cell-eosinophil interactions and neuroimmune pathways. This approach is novel in that nanomaterials could provide a more precise, targeted solution for CSU, overcoming the limitations of current therapies. Future research should focus on optimizing nanomaterial formulations, integrating multi-omics analyses, and developing AI-driven strategies for personalized treatment. These advances could pave the way for safer, more effective immunotherapies in CSU and other immune-mediated diseases.Keywords: chronic spontaneous urticaria, nanomaterials, immune cells, mast cells, drug delivery systems, immunotherapy