Portal de Periódicos da CAPES

Pathophysiologic mechanisms of itch in bullous pemphigoid

2019; Elsevier BV; Volume: 83; Issue: 1 Linguagem: Inglês

10.1016/j.jaad.2019.07.060

1097-6787

Takashi Hashimoto, Christina Kursewicz, Rachel Fayne, Sonali Nanda, Serena Shah, Leigh Nattkemper, Hiroo Yokozeki, Gil Yosipovitch,

Dermatology and Skin Diseases

BackgroundOne of the hallmarks of bullous pemphigoid (BP) is moderate to severe chronic itch. Managing this is difficult because little is known about the mechanisms of itch in BP.ObjectiveWe sought to elucidate the pathophysiologic mechanisms of itch in BP.MethodsThe expression of itch mediators in lesions of 24 patients with BP and 6 healthy individuals were examined through immunofluorescence staining. Furthermore, the expression of itch mediators and itch severity was correlated.ResultsItch severity was correlated with eosinophils, substance P, neurokinin 1R, interleukin (IL) 31 receptor A, oncostatin M receptor-β, IL-13, periostin, and basophils. There was also a trend between itch severity and IL-31 expression. Most of the cells expressing IL-31 or neurokinin 1R were identified as eosinophils. Intraepidermal nerve fiber density was decreased. Other itch mediators, including mast cells, IL-4, thymic stromal lymphopoietin, transient receptor potential vanilloid 1 and ankyrin 1, and protease activated receptor 2 were not significantly correlated with itch severity.LimitationsThe relatively small sample size, the examination of protein expression exclusively through immunofluorescent analysis, and lack of functional assays in patients are the limitations.ConclusionsMultiple factors are involved in BP-associated itch, including eosinophils, substance P, neurokinin 1R, IL-31, IL-31 receptor A, oncostatin M receptor-β, IL-13, periostin, and basophils. They could be useful therapeutic targets.