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Journal of the American Academy of Dermatology
Volume 71, n° 6
page 1151 (décembre 2014)
Doi : 10.1016/j.jaad.2014.08.004
accepted : 4 August 2014
Original Articles

Interleukin-31 is associated with uremic pruritus in patients receiving hemodialysis
 

Mei-Ju Ko, MD, PhD a, c, e, Yu-Sen Peng, MD, PhD b, d, Hung-Yuan Chen, MD b, d, Shih-Ping Hsu, MD, PhD b, d, Mei-Fen Pai, MD b, d, Ju-Yeh Yang, MD, MS b, d, Su-Ying Wen, MD a, Shiou-Hwa Jee, MD, PhD c, Hon-Yen Wu, MD, PhD b, d, f, , Hsien-Ching Chiu, MD c
a Department of Dermatology, Taipei City Hospital, Taipei, Taiwan 
b Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan 
c Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan 
d Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan 
e Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan 
f Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan 

Reprint requests: Hon-Yen Wu, MD, PhD, Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Rd, Banciao District, New Taipei City 220, Taiwan.
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.

The full text of this article is available in PDF format.

Key words : cytokines, hemodialysis, interleukin-31, itching, pruritogen, uremic pruritus

Abbreviations used : hsCRP, IL, VAS



 Supported by research grants to Dr Ko from the National Science Council, Taiwan (NSC 102-2314-B-532-002); Department of Health, Taipei City Government, Taipei, Taiwan (10101-62-052; 10201-62-009); and Taipei City Hospital, Ren-Ai branch, Taipei, Taiwan (No.19, 2013).
 Drs Wu and Chiu contributed equally to this collaborative research work as corresponding authors.
 Conflicts of interest: None declared.



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