Interleukin-31 has been implicated in the pathophysiology of multiple
atopic disorders such as atopic dermatitis (AD), rhinitis and airway
hyperreactivity. In AD, IL-31 has been identified as one of the main
‘drivers’ of its cardinal symptom pruritus. Here, we aim to summarize
the mechanisms by which IL-31 modulates inflammatory and allergic
diseases. TH2 cells play a central role in AD and release high levels of
TH2-produced cytokines including IL-31, thereby mediating inflammatory
responses, initiating immunoregulatory circuits, and stimulating itch
and neuronal outgrowth through activation of the heterodimer receptor
IL-31 receptor alpha (IL31RA)/Oncostatin M receptor β. IL31RA expression
is found on human and murine dorsal root ganglia neurons, epithelial
cells including keratinocytes as well as various innate immune cells.
IL-31 is a critical cytokine involved in neuro-immune communication,
which opens new avenues for cytokine modulation in neuroinflammatory
diseases including AD/pruritus, as validated by recent clinical trials
using an anti-IL-31 antibody. Accordingly, inhibition of IL-31
downstream signaling may be a beneficial approach for various
inflammatory diseases including prurigo nodularis. For example, whether
downstream JAK inhibitors directly block IL-31-mediated-signaling needs
to be clarified. Targeting the IL-31/IL31RA/OSMRβ axis appears to be a
promising approach for inflammatory, neuroinflammatory and pruritic
disorders in the future.