The Serum Level of IL-31 in Patients with Chronic Kidney Disease-Associated Pruritus: What Can We Expect?

Abstract

Chronic-kidney-disease-associated pruritus (CKD-aP) is one of the most common and burdensome dermatological symptoms affecting patients undergoing dialysis, and its etiopathogenesis has still not been fully discovered. This study was designed to investigate the possible contribution of interleukin-31 (IL-31) to the pathogenesis of itch in patients undergoing maintenance hemodialysis (HD). We evaluated the serum level of IL-31 in HD patients with pruritus, in HD patients without pruritus and in healthy controls, as well as its correlation to the severity of itch. The study enrolled 175 adult subjects. The participants were divided into three groups. Group A included 64 patients on maintenance HD with CKD-aP, Group B included 62 patients on maintenance HD not reporting CKD-aP and Group C included 49 healthy controls. Pruritus severity was assessed using the Numerical Rating Scale (NRS), and the serum levels of IL-31 were measured. The results showed that the IL-31 serum level was significantly higher in the itchy group (p < 0.001) in comparison to the patients free from pruritus. Moreover, a marginal trend towards significance (r = 0.242, p = 0.058) was observed between the IL-31 serum level and itch intensity. Our study supports earlier findings on the extended role of IL-31 in the development of CKD-aP.

High Serum IL-31 Concentration Is Associated with Itch among Renal Transplant Recipients

“…This is the only study indicating such a correlation in CKD-aI patients. In the study by our group [ 21 ], a positive trend of moderate strength was observed. However, it did not reach statistical significance ( p = 0.058).…”

“…Moreover, the IL-31 level was considered an independent predictor for higher pruritus intensity [ 40 ]. Recently, our group has also shown a statistically significant increase in serum IL-31 levels in patients with CKD-aI on HD in comparison to non-itchy HD patients [ 21 ]. Similar results were reported by Haggag et al [ 41 ] on a group of 88 patients with CKD.…”

“…It was already proven that interleukin-31 (IL-31), which is often called an itchy cytokine, plays an important role in the development of itch in multiple dermatological and systemic disorders [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. Moreover, our group has recently described significant differences in IL-31 concentrations between itchy and non-itchy patients treated with HD [ 21 ].…”

Blockage of the IL-31 Pathway as a Potential Target Therapy for Atopic Dermatitis

“…IL-31 is one of the main cytokines linked to pruritus [ 29 ], the most prominent symptom of AD [ 15 ]. IL-31 is also an inducer of epidermal cell proliferation and skin remodeling and thickening in the chronic Th1-mediated phase [ 30 , 31 ].…”

Data independent acquisition reveals in-depth serum proteome changes in uremic pruritus

“…It has also been beneficial in screening serum biomarkers for these diseases and the presence of disease endotypes ( Parthasarathy et al, 2023 ). Currently, for UP, several potential protein biomarkers have been identified, such as C-reactive protein, substance P, interleukin two and interleukin 31 ( Cho et al, 1997 ; Chen et al, 2010 ; Fallahzadeh et al, 2011 ; Oweis et al, 2021 ; Swierczynska et al, 2022 ). Among moderate/severe hemodialysis pruritic patients, those with higher high-sensitive C-reactive protein (hs-CRP) levels have higher mortality ( Chen et al, 2010 ).…”