Surreal image representing relief from chronic urticaria through AWB therapy, with blood cells transforming into dandelion seeds.

Breakthrough for Urticaria Sufferers: Can AWB Injections Offer Long-Term Relief?

Soraya Malik in Health & Wellness December 2025 • 4 min read.

"Explore how autologous whole blood (AWB) injections are providing new hope for those with chronic antihistamine-resistant urticaria, offering a potential path to lasting relief and improved quality of life."

Chronic spontaneous urticaria (CSU), characterized by persistent and spontaneous wheals, affects many individuals, significantly impacting their quality of life. Unlike typical allergic reactions, CSU arises without external triggers, making it challenging to manage. For many sufferers, conventional treatments, including high-dose antihistamines, offer little to no relief, leading to frustration and a search for alternative solutions.

One such alternative gaining attention is autologous whole blood (AWB) injection, a procedure where a patient's own blood is re-injected into their body. While AWB has been used for various conditions like allergic rhinitis and atopic dermatitis, its application in CSU is relatively new and scientifically unproven. The theory behind AWB is that it may help desensitize the patient to their own triggers, potentially modulating the immune response.

A recent study by You et al. (2015) investigated the efficacy of AWB injections in treating antihistamine-resistant CSU. This research aimed to determine if AWB could provide relief and whether its effectiveness differed between chronic autoimmune urticaria (CAU) and chronic idiopathic urticaria (CIU) subtypes. The findings offer valuable insights into a promising, albeit still experimental, treatment option for those struggling with persistent urticaria.

AWB Injections: A New Approach to Treating Chronic Urticaria

Surreal image representing relief from chronic urticaria through AWB therapy, with blood cells transforming into dandelion seeds.

The study conducted by You and colleagues involved 22 patients with CSU who had not found relief from antihistamine therapy for more than six weeks. These patients underwent AWB injections for eight consecutive weeks, with researchers closely monitoring their urticaria activity. The goal was to assess whether AWB injections could reduce the severity and frequency of their symptoms.

The study classified patients into two groups based on the autologous serum skin test (ASST): those with positive ASST, indicating chronic autoimmune urticaria (CAU), and those with negative ASST, indicating chronic idiopathic urticaria (CIU). This distinction aimed to explore whether AWB injections had varying effects based on the underlying cause of the urticaria.

Study Design: 22 CSU patients unresponsive to antihistamines received AWB injections weekly for 8 weeks.
Classification: Patients were divided into CAU (autoimmune) and CIU (idiopathic) groups based on ASST results.
Measurements: Urticaria activity score (UAS) was used to assess symptom severity. A responder was defined as someone with a >30% improvement in UAS after the AWB treatment.

The results showed that 36.4% of the CSU patients responded positively to AWB injections, experiencing a significant reduction in their urticaria symptoms. While there was no significant difference in responder rates between the CAU and CIU groups, the study highlighted that patients with higher baseline urticaria activity scores (UAS) showed the most improvement after the AWB treatment. This suggests that AWB injections may be particularly beneficial for those with more severe symptoms.

The Future of AWB Injections in Urticaria Treatment

While the study offers promising insights, it's essential to interpret the results cautiously. AWB injections are not yet a standard treatment for CSU, and more research is needed to fully understand their mechanism of action and long-term effectiveness. However, for individuals with antihistamine-resistant urticaria, AWB injections represent a potential avenue for relief, particularly for those with high disease activity. As research progresses, AWB injections may become a more established option in the management of chronic urticaria, offering hope for a better quality of life for those who suffer from this challenging condition.

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Everything You Need To Know

What is chronic spontaneous urticaria (CSU), and why is it difficult to treat?

Chronic spontaneous urticaria (CSU) is characterized by the sudden appearance of wheals (hives) that persist for more than six weeks without any identifiable external trigger. Unlike typical allergic reactions, CSU arises spontaneously, making it difficult to manage. Many individuals with CSU find that conventional treatments, such as high-dose antihistamines, provide little to no relief, leading to a search for alternative solutions. This unpredictability and resistance to standard treatments contribute to the challenges in managing this condition, significantly impacting the quality of life for those affected.

How do autologous whole blood (AWB) injections work in treating urticaria?

The theory behind autologous whole blood (AWB) injections is that re-injecting a patient's own blood may help desensitize them to their own triggers, potentially modulating the immune response that causes urticaria. Although the exact mechanism is not fully understood, the concept is that by reintroducing the patient's blood, the body's immune system may be re-educated to tolerate the factors causing the urticaria. While AWB injections have been applied to other conditions such as allergic rhinitis and atopic dermatitis, the application in CSU is relatively new and requires further investigation.

What were the key findings of the You et al. (2015) study on AWB injections for antihistamine-resistant CSU?

The You et al. (2015) study found that 36.4% of patients with antihistamine-resistant CSU responded positively to AWB injections, showing a significant reduction in their urticaria symptoms. The study involved 22 patients who received AWB injections weekly for eight weeks, closely monitoring their urticaria activity. Patients were categorized into chronic autoimmune urticaria (CAU) and chronic idiopathic urticaria (CIU) groups based on the autologous serum skin test (ASST) results. While there was no significant difference in responder rates between the CAU and CIU groups, patients with higher baseline urticaria activity scores (UAS) showed the most improvement after AWB treatment, suggesting the treatment is particularly beneficial for those with more severe symptoms.

How did the researchers classify patients in the You et al. study, and what was the purpose?

In the You et al. study, patients were classified into two groups: chronic autoimmune urticaria (CAU) and chronic idiopathic urticaria (CIU). This classification was based on the results of the autologous serum skin test (ASST), which helped identify the underlying cause of the urticaria. The aim was to explore whether AWB injections had varying effects depending on the underlying cause of the urticaria, either an autoimmune process (CAU) or an unknown cause (CIU). This distinction was crucial in understanding how the treatment might work differently based on the type of urticaria.

What are the limitations and future implications of using AWB injections for urticaria treatment?

While AWB injections show promise, they are not a standard treatment for CSU, and more research is needed. The study results should be interpreted cautiously because the long-term effectiveness and precise mechanism of action are not fully understood. Further studies are necessary to validate these findings and optimize the treatment protocol. However, for individuals with antihistamine-resistant urticaria, AWB injections represent a potential path to relief, particularly for those with high disease activity. As research progresses, AWB injections could become a more established option in managing chronic urticaria, offering hope for a better quality of life for sufferers.