Assessment of interleukin-31 and immunoglobulin E serum levels in psoriasis with and without pruritic symptoms and their correlations with disease severity

Increased serum IL-31 levels in chronic spontaneous urticaria and psoriasis with pruritic symptoms

To observe the clinical efficacy of modified painless wheat-grain blistering moxibustion for allergic rhinitis (AR) of lung deficiency and cold attacking, and to explore its effects on serum immunoglobulin E (IgE) and interleukin-10 (IL-10). Ninety-eight patients of perennial AR with lung deficiency and cold attacking were randomly divided into an observation group (49 cases, 2 dropped out) and a control group (49 cases, 2 dropped out). The control group received mometasone furoate nasal spray treatment. The observation group received modified painless wheat-grain blistering moxibustion at bilateral Feishu (BL 13), Gaohuang (BL 43), Zusanli (ST 36), and Shenzhu (GV 12) in addition to the control group's treatment. Moxibustion at Shenzhu (GV 12) was applied once every other day, 3 grains each time, forming moxibustion sores after about one week. After sores formed, moxibustion was applied once every other 2 days. For Feishu (BL 13), Gaohuang (BL 43), and Zusanli (ST 36), moxibustion was applied on one side first, every other day, 3 grains each time, until sores formed, then on the other side, alternating sides in a cycle. Both groups were treated for 4 weeks. The total nasal symptoms score (TNSS), nasal symptom visual analogue scale (VAS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) scores were observed before and after treatment, and after 4 and 12 weeks of treatment completion (follow-ups). Serum IgE and IL-10 levels were measured before and after treatment, and treatment efficacy and recurrence rates at follow-ups were recorded. Compared before treatment, TNSS, VAS, and RQLQ scores in both groups were reduced after treatment and at follow-ups (P<0.05), and these scores in the observation group were lower than those in the control group (P<0.05). Except for TNSS scores in the control group at the follow-ups, and in the observation group at the 4-week follow-up, all scores at follow-ups in both groups were higher than those after treatment (P<0.05). Compared before treatment, serum IgE levels in both groups were decreased (P<0.05), and serum IL-10 levels were increased (P<0.05) after treatment. The observation group had lower serum IgE levels and higher IL-10 levels than the control group (P<0.05). The total effective rate in the observation group was 93.6% (44/47), higher than 74.5% (35/47) in the control group (P<0.05). The recurrence rates after 4 and 12 weeks of treatment completion in the observation group were lower than those in the control group (4.5% [2/44] vs 22.9% [8/35], 9.1% [4/44] vs 40.0% [14/35], P<0.05). On the basis of mometasone furoate nasal spray, modified painless wheat-grain blistering moxibustion could improve clinical symptoms in patients of AR with lung deficiency and cold attacking, and provide more sustained long-term efficacy, possibly through the regulation of serum IgE and IL-10 levels.

Interleukin 31 (IL-31) is a novel T helper type 2 effector cytokine that plays an important role in the pathogenesis of allergic diseases. However, its role in human asthma remains unclear. The aim of this study was to measure IL-31 levels in the serum, bronchoalveolar lavage fluid (BALF) and bronchial tissue of asthmatics and healthy subjects, and identify its possible correlation to disease severity. We quantified IL-31 levels in the serum of patients with asthma (n = 44), as well as in controls (n = 22). Of these subjects, 9 asthmatics and five controls underwent bronchoscopy with endobronchial biopsy and BALF collection. Our data showed that serum and BALF IL-31 levels were significantly elevated in patients with asthma compared with controls. Expressions of IL-31 and IL-31 receptor (IL-31RA and OSMR) were more prominent in the bronchial tissue in severe compared to mild asthma and controls. Serum IL-31 levels correlated positively with Th2 related cytokines (IL-5, IL-13, and TSLP), asthma severity or total serum immunoglobulin E (IgE), and inversely with asthma control and the forced expiratory volume in 1 second (FEV1). The current data may provide insight into the underlying pathogenesis of asthma, in which IL-31 has an important pathogenic role.

Interleukin-31 (IL-31) is a novel T-helper-lymphocyte-derived cytokine that plays an important role in human T-cell-mediated skin diseases. When overexpressed in transgenic mice, IL-31 induces severe pruritus resembling eczema in humans. Serum IL-31 was previously found overexpressed in adults with atopic dermatitis (AD). The novelty of this study is the use of a pediatric patient group as well as comparison of IL-31 levels during flare and quiescence. This case-controlled longitudinal study was designed to determine the levels of IL-31 in serum of AD children and its associations in relation to disease activity and severity. Sera were obtained from 50 AD children and 40 healthy volunteers. IL-31 levels were measured using a sandwich ELISA. All AD patients were followed up and re-sampled for serum IL-31 after clinical remission. Serum IL-31 levels were correlated with AD disease activity and severity variables. Serum IL-31 levels were significantly higher whether during AD flare [median, 1600; mean (SD)=1457.8±770.4 pg/mL] or quiescence (1040; 958.7±419.5 pg/mL), than those in controls (220; 197.3±91.9 pg/mL). Serum IL-31 levels were significantly higher in the high disease severity group compared with the moderate or low severity group. Moreover, serum IL-31 levels correlated positively with the calculated severity scores (LSS, SSS and SCORAD index). The results of this study confirm the importance of IL-31 in AD pathophysiology. Serum IL-31 level is an objective reliable marker of AD severity in children. It may represent a novel target for antipruritic drug development.

Nutritional status and the IgE response against Ascaris lumbricoides in children from a tropical slum

Purpose: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease. Vitamin D and interleukin-31 (IL-31) are known to be related to the pathogenesis of AD with pruritus. The purpose of this study was to investigate the relationship between serum levels of 25-hydroxyvitamin D (25(OH)D) and IL-31 and the disease severity of AD in children with AD. Methods: We recruited 160 children with AD and 42 controls. We used the SCORing Atopic Dermatitis (SCORAD) index to measure the severity of AD. Serum IL-31 and 25(OH)D levels were assayed using enzyme-linked immunosorbent assay and high-performance liquid chromatography, respectively. Serum levels of total IgE, specific IgE to common allergens and peripheral blood total eosinophil count were carried out in children with AD. Results: Serum IL-31 level was significantly higher in AD group compared to control group and 25(OH)D level was significantly lower in AD group than control group. Serum IL-31 level showed the highest level in severe AD group followed by moderate and mild AD group, whilst serum 25(OH)D level was the lowest in severe AD group compared to moderate and mild AD group. There was no difference in serum IL-31 level between AD group and nonatopic dermatitis group. IL-31 level was positively correlated with subjective SCORAD index indicating pruritus in children with AD, and 25(OH)D was inversely correlated with SCORAD index. Conclusion: IL-31 and vitamin D may be related to the pathogenesis of AD, especially with regard to the pruritus. (Allergy Asthma Respir Dis 2015;3:396-401)

Interleukin 17 (IL-17) is a Th17 cytokine associated with inflammation, autoimmunity, and defense against some bacteria; it has been implicated in many chronic autoimmune diseases including psoriasis, multiple sclerosis, and systemic sclerosis. However, whether IL-17 plays a role in the pathogenesis of ankylosing spondylitis (AS) remains unclear. To analyze the content of IL-17 and IL-23 in the serum from patients with AS compared with health control subject, 50 patients with AS and 43 healthy volunteers were recruited. Serum IL-17 levels were examined by enzyme linked immunosorbent assay (ELISA). Statistic analyses were performed by SPSS 13.0. Results show that the serum IL-17 and IL-23 levels were significantly elevated in AS patients as compared with normal controls. Nevertheless, no associations of serum IL-17 and IL-23 levels with clinical and laboratory parameters were found; no significant difference regarding serum IL-17 and IL-23 levels was found between less active AS and more active AS. However, there was a strong positive association between the serum levels of IL-17 and IL-23 in the AS patients. Our results indicate increased serum IL-17 and IL-23 levels in AS patients, suggesting that this two cytokine may play critical roles in the pathogenesis of AS. Therefore, further studies are required to confirm this preliminary data.

Interleukin 10 (IL-10) plays a role in inflammation and cell-type responses. The anti-SS-A/Ro antibody contributes to leucopenia, and cutaneous and neonatal lupus. Objectives: To evaluate the association between serum IL-10 levels and autoantibodies, disease activity and organ involvement in systemic lupus erythematosus (SLE) patients. Patients and methods: We studied 200 SLE patients and 50 controls. We analyzed organ involvement, disease activity, serum IL-10 and interleukin-6 (IL-6) levels, and antinuclear and antiphospholipid antibody profiles. Results: Serum IL-10 and IL-6 levels were higher in SLE patients than in controls (all p < 0.00001). Serum IL-10 levels were positively correlated with IL-6 (p < 0.00001), CRP (p < 0.00001), fibrinogen (p = 0.003), and ESR (p < 0.00001), and negatively correlated with hemoglobin (p = 0.0004) and lymphocytes (p = 0.01). Serum IL-6 levels were positively correlated with CRP (p < 0.00001), fibrinogen (p = 0.001), and ESR (p < 0.00001); and negatively correlated with hemoglobin (p = 0.008) and lymphocytes (p = 0.03). Elevated serum IL-10 levels were associated with an increased risk of anti-SS-A/Ro antibody positivity (p = 0.03). Elevated serum IL-6 levels were associated with an increased risk of heart (p = 0.007) and lung (p = 0.04) involvement. Conclusions: In SLE patients, increased serum IL-10 levels were associated with increased disease activity and risk of anti–SS-A/Ro antibody positivity.

BackgroundSeveral inflammatory cytokines play a key part in the induction of osteoporosis. Until now, involvement of the Th2 cytokine interleukin-31 (IL-31) in osteoporosis hadn’t yet been studied. IL-31 is a proinflammatory cytokine mediating multiple immune functions, whose involvement in a wide range of diseases, such as atopic dermatitis, inflammatory bowel diseases and cutaneous lymphomas, is now emerging. Given the important role of IL-31 in inflammation, we measured its serum levels in postmenopausal osteoporotic patients.Methods and resultsIn fifty-six postmenopausal females with osteoporosis and 26 healthy controls, bone mineral density (BMD) measurements were performed by using calcaneal quantitative ultrasound (QUS) technique, confirmed at the lumbar spine and hip by dual energy X-ray absorptiometry (DXA). Both patients and controls were divided according to age (less or more than 65 years) and disease severity (T-score levels and presence of fractures). Serum IL-31 levels were measured by ELISA technique. Osteoporotic patients exhibited elevated levels of serum IL-31 compared with healthy controls (43.12 ± 6.97 vs 29.58 ± 6.09 pg/ml; p < 0.049). IL-31 expression was higher in over 65 years old patients compared to age-matched controls (45 ± 11.05 vs. 17.92 ± 5.92; p < 0.01), whereas in younger subjects no statistically significant differences were detected between patients and controls (37.91 ± 6.9 vs 32.08 ± 8.2). No statistically significant differences were found between IL-31 levels in patients affected by mild (T-score > -3) compared to severe (T-score < -3) osteoporosis (59.17 ± 9.22 vs 37.91 ± 10.52), neither between fractured and unfractured osteoporotic women (33.75 ± 9.16 vs 51.25 ± 8.9).ConclusionsWe showed for the first time an increase of IL-31 serum levels in postmenopausal women with decreased BMD. Although they did not reflect the severity of osteoporosis and/or the presence of fractures, they clearly correlated with age, as reflected by the higher levels of this cytokine in aged patients.

Uremic pruritus (UP) is a disturbing symptom in a quite large proportion of hemodialysis (HD) patients. Recent studies have indicated a potential role of interleukin-31 (IL-31) in the pathophysiology of pruritus, and it is becoming a promising therapeutic target for UP. Hemoperfusion (HP) is an extracorporeal technique that has been shown to be effective in absorbing molecules which may be responsible for inducing pruritus. In this study, we conducted this study to explore whether additional HP could enhance the removal of IL-31 in UP patients. The study was conducted in two parts. In Part A, the prevalence and intensity of UP were recorded and the basal serum IL-31 level was determined three times a week in HD patients. Patients with detectable serum IL-31 levels in part A were included in Part B. Each patient had two 4-h test sessions: conventional HD or HD plus HP (HDHP). The reduction ratio (RR) of IL-31 from HD and HDHP was compared. Forty patients completed part A and 40% of them were suffering from UP. Serum IL-31 was detected at significantly higher percentages in UP patients than in non-UP patients (50% vs 4.2%). Serum levels of IL-31 in UP patients were significantly higher than that in non-UP patients (median: 8.35pg/ml vs 7.8pg/ml). Serum IL-31 levels were significantly correlated with pruritus intensity in patients with UP(r = 0.55, P < .05). Eight patients were enrolled and completed part B. The use of combined HD and HP treatment produced a better RR for IL-31 than HD alone (34.26 ± 1.43% vs 15.28 ± 2.11%, P < .01). IL-31 may play an important role in the pathophysiology of uremic pruritus. The addition of hemoperfusion to conventional hemodialysis provides enhanced removal of IL-31.

Objective — Experimental data demonstrate that inflammation plays an important role in the initiation, progression, and complications of atherosclerosis. Statins were shown to downregulate inflammatory cytokines.We conducted this study to investigate the effects of fluvastatin therapy on plasma interleukin-18 (IL-18) and interleukin-10 (IL-10) concentration in patients with acute coronary syndrome.Methods and results — Serum IL-18 and IL-10 levels were measured in 90 patients with acute coronary syndrome, 47 patients with stable angina pectoris, and 55 normal control subjects. Patients in the acute coronary syndrome group were randomly assigned to a fluvastatin group and a routine group. The fluvastatin group was given fluvastatin 40 mg/day and the routine group a placebo. After one month of follow-up, serum IL-18, IL-10 levels, and serum lipid concentration were measured again. Serum IL-18 levels were significantly higher in the acute coronary syndrome group than in the stable angina pectoris group and the control group. However, serum IL-10 levels were significantly lower than in the stable angina pectoris group and the control group. After one month of treatment, the serum IL-18 levels decreased significantly and the serum IL-10 levels increased significantly in all patients with acute coronary syndrome, but the changes of serum IL-18 and IL-10 levels were more pronounced in the fluvastatin group. No relationship was observed between the rate of decrease of serum IL-18 or the rate of increase of serum IL-10 and serum lipids levels.Conclusion — Inflammation plays an important role in the initiation of acute coronary syndromes. Fluvastatin possesses an anti-inflammatory effect, independent of its lipid-lowering action.

Migraines are headaches caused by changes in the trigeminovascular metabolic pathway. Migraine headache attacks are associated with neurovascular inflammation, but their pathophysiological mechanisms have not been fully explained. To investigate the relationship between serum vaspin, visfatin, chemerin and interleukin-18 (IL-18) levels and the frequency of attacks in migraine headache. Three groups were established: migraine with aura (n = 50), migraine without aura (n = 50) and control group (n = 50). The migraine diagnosis was made in accordance with the International Classification of Headache Disorders-III beta diagnostic criteria. The analyses on serum vaspin, visfatin, chemerin and IL-18 levels were performed using the enzyme-linked immunosorbent assay method. The serum vaspin, visfatin, chemerin and IL-18 levels were found to be significantly higher in the migraine patients than in the control group (p < 0.01). No statistically significant differences in serum vaspin, visfatin, chemerin and IL-18 levels were found among the migraine patients during attacks or in the interictal period (p>0.05). The serum visfatin and chemerin levels of the migraine patients were positively correlated with their serum IL-18 levels (p < 0.01), while their serum chemerin and visfatin levels were positively correlated with their serum vaspin levels (p < 0.05). This study showed that these biomarkers may be related to migraine pathogenesis. Nonetheless, we believe that more comprehensive studies are needed in order to further understand the role of vaspin, visfatin, chemerin and IL-18 levels in the pathophysiology of migraine headaches.

Background and Aims Chronic Kidney Disease-associated Pruritus (CKD-aP), also referred to as uremic pruritus (UP), is a common complication with a prevalence ranging from 18% to 80%, and approximately 40% of patients reporting severe symptoms. Interleukin-31 (IL-31), often termed the “itch cytokine,” has been implicated in the pathogenesis of pruritus in various dermatological disorders. This study aimed to evaluate changes in pruritus severity and serum IL-31 levels before and after kidney transplantation, and to determine the correlation between these parameters. Method A prospective observational study was conducted at Sir Ganga Ram Hospital, New Delhi, involving patients with CKD stage V who were scheduled for renal transplantation. Pruritus was assessed using the 5D Itch Scale, and serum IL-31 levels were measured pre- and post-transplant. A total of 202 patients were screened; 89 of these had pruritus, and 86 were ultimately included in the analysis (after excluding those with primary skin disorders). Results Among the 86 patients with pruritus, 75.5% were male. The dialysis vintage ranged from four preemptive transplants to a maximum of 60 months on dialysis. Mean serum IL-31 levels significantly decreased from 145.02 ± 103.27 pg/mL pre-transplant to 89.91 ± 59.51 pg/mL post-transplant (P &amp;lt; 0.001), alongside a significant reduction in mean 5D itch scores from 15.03 ± 4.36 to 7.44 ± 2.11 (P &amp;lt; 0.001). One month post-transplant, 63.9% of patients reported complete resolution of pruritus, 29.1% had mild pruritus, and 6.9% experienced moderate pruritus. Post-transplant itch scores demonstrated a moderate positive correlation with IL-31 levels (r = 0.411, P = 0.001). Changes in itch scores from pre- to post-transplant also positively correlated with changes in serum IL-31 (r = 0.464, P = 0.001). Conclusion Kidney transplantation leads to a significant reduction in both pruritus severity and serum IL-31 levels in patients with CKD-aP. These findings highlight the potential role of IL-31 as a biomarker for pruritus and offer insights into targeted therapeutic strategies for CKD-associated pruritus.

Objective To investigate the correlation of serum interleukin-17 (IL-17), vascular endothelial growth factor (VEGF) and lactate dehydrogenase (LDH) levels with the prognosis of gastric cancer patients. Methods From December 2018 to December 2020, 45 patients with gastric cancer treated in our hospital and 50 healthy individuals were assessed for eligibility and recruited. The eligible patients were assigned to an observation group, and the healthy subjects were assigned to a control group. Serum IL-17, LDH, and VEGF levels of the eligible participants were determined by the enzyme-linked immunosorbent assay (ELISA) and biochemical testing. The association of serum IL-7, LDH, and VEGF levels with their pathological characteristics was examined in the observation group. The correlation between serum IL-17 and VEGF was analyzed using the Pearson method, and regression models were established using COX proportional risk to explore the independent risk factors for gastric cancer. Results Gastric cancer was associated with higher levels of IL-17, LDH, and VEGF versus a healthy status (P < 0.05). There was no significant difference in serum IL-17, LDH, and VEGF levels between the two groups of patients with different clinical characteristics (P > 0.05). Higher tumor TNM stages resulted in significantly higher levels of IL-17, LDH, and VEGF (P < 0.05). Serum IL-17 level was positively correlated with VEGF level (P < 0.05). Cox regression multifactorial analysis showed that serum IL-17, LDH, VEGF, and tumor TNM stages could be independent high-risk influencing factors for gastric cancer (P < 0.05). Serum IL-17 was positively correlated with VEGF levels in patients with gastric cancer. Conclusion Serum IL-17, LDH, and VEGF levels in gastric cancer patients are closely correlated with the TNM stage and patients' prognosis, both of which show great potential as effective indicators for evaluating the prognosis of gastric cancer.

Purpose: Serum vitamin D (25-hydroxyvitamin D, 25[OH] D) and interleukin-31 (IL-31) are related to atopic dermatitis, but their rela tionship with allergic rhinitis is unclear. The purpose of this study was to compare the levels of serum IL-31 and 25 (OH) D between the allergic rhinitis (AR), nonallergic rhinitis (NAR), and control groups and to investigate the relationship between IL-31 and 25 (OH) D. Methods: We recruited 59 children with only rhinitis and 33 controls without any allergic diseases. Serum IL-31 and 25(OH) D levels were assayed using an enzyme-linked immunosorbent assay and high-performance liquid chromatography, respectively. The pa tients were considered to have atopic sensitization if the levels of serum specific IgE to inhalant allergens as assessed using immu noCAP were ≥0.35 IU/mL or if they tested positive for one or more allergens by the skin prick test. Results: Of children with rhinitis, 25 had nonatopy (NAR), and 34 children had atopy (AR). Serum 25(OH) D levels were significantly lower in the rhinitis group than in the control group, while there was no significant difference serum 25(OH) D levels between the AR and NAR groups. Children with rhinitis demonstrated higher serum IL-31 levels than controls; however, there was no difference in serum IL-31 levels between the AR and NAR groups. Serum 25(OH) D levels were inversely correlated with serum IL-31 levels and blood eosinophil counts. On the other hand, serum 25(OH) D levels were not correlated with total serum IgE levels. Conclusion: Serum 25(OH) D and IL-31 may play a role in the pathogenesis of rhinitis via mechanisms other than IgE-related path way. (Allergy Asthma Respir Dis 2018;6:41-46)