Mei-Ju Ko1, Yu-Sen Peng2, Hung-Yuan Chen2, Shih-Ping Hsu2, Mei-Fen Pai2, Ju-Yeh Yang2, Su-Ying Wen3, Shiou-Hwa Jee4, Hon-Yen Wu5, Hsien-Ching Chiu4. 1. Department of Dermatology, Taipei City Hospital, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan. 2. Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. 3. Department of Dermatology, Taipei City Hospital, Taipei, Taiwan. 4. Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. 5. Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: honyenwu@ntu.edu.tw.
Abstract
BACKGROUND: Interleukin (IL)-31 induces severe pruritus and dermatitis in transgenic mice, and is associated with many itching skin diseases. OBJECTIVE: We sought to investigate the association of serum IL-31 levels with uremic pruritus in patients undergoing hemodialysis. METHODS: Patients receiving maintenance hemodialysis in a referral medical center were recruited. Serum IL-31 levels were determined by the enzyme-linked immunosorbent assay methodology. The various characteristics of pruritus were assessed using an interview questionnaire. RESULTS: Among the 178 study participants, 34.8% had uremic pruritus. The patients with pruritus had higher serum IL-31 levels than those without pruritus symptoms (median 8.68 [first quartile 0.43, third quartile 35.04] vs 4.91 [0, 15.78], P = .04). A multivariate linear regression analysis showed that higher serum levels of IL-31, high-sensitivity C-reactive protein, and alanine transaminase, and a lower dialysis dose assessed by Kt/V, were independent predictors for higher pruritus intensity. The generalized additive model also showed a positive exposure-response relationship between serum levels of IL-31 and visual analog scale scores of pruritus intensity. LIMITATIONS: The cause-effect relationship between IL-31 and uremic pruritus could not be assessed by the cross-sectional study design. CONCLUSION: IL-31 may play an important role in the pathophysiology of uremic pruritus.
BACKGROUND:Interleukin (IL)-31 induces severe pruritus and dermatitis in transgenic mice, and is associated with many itching skin diseases. OBJECTIVE: We sought to investigate the association of serum IL-31 levels with uremic pruritus in patients undergoing hemodialysis. METHODS:Patients receiving maintenance hemodialysis in a referral medical center were recruited. Serum IL-31 levels were determined by the enzyme-linked immunosorbent assay methodology. The various characteristics of pruritus were assessed using an interview questionnaire. RESULTS: Among the 178 study participants, 34.8% had uremic pruritus. The patients with pruritus had higher serum IL-31 levels than those without pruritus symptoms (median 8.68 [first quartile 0.43, third quartile 35.04] vs 4.91 [0, 15.78], P = .04). A multivariate linear regression analysis showed that higher serum levels of IL-31, high-sensitivity C-reactive protein, and alanine transaminase, and a lower dialysis dose assessed by Kt/V, were independent predictors for higher pruritus intensity. The generalized additive model also showed a positive exposure-response relationship between serum levels of IL-31 and visual analog scale scores of pruritus intensity. LIMITATIONS: The cause-effect relationship between IL-31 and uremic pruritus could not be assessed by the cross-sectional study design. CONCLUSION:IL-31 may play an important role in the pathophysiology of uremic pruritus.
Authors: B Güvercin; K Kaynar; D A Arıca; B V Kural; Ş Ulusoy; M Cansız; L B Selçuk; A Akyüz; C C Kolaylı Journal: Hippokratia Date: 2019 Apr-Jun Impact factor: 0.471