EOSINOPHIL CATIONIC PROTEIN IN UREMIC DIALYZED PATIENTS WITH INTRACTABLE PRURITUS

Abstract

We have analyzed 6 patients(pts) with chronic uremic pruritus(UPG) treated with intermittent hemodialysis more than 5 years,and 7 uremic pts treated under the same conditions but without pruritus(UG).In all pts and in appropriate control group(CG)of healthy subjects(N 0 = 5)we have measured the serum concentration of s.c.eosinophil cationic protein(ECP) known as a protein of allergic states(bronchial asthma as a classic example).We have found elevated serum concentrations of ECP in uremic pts(XECP cg = 2.03±0.02 µg/L vs X ECP ug = 2.63 ±0.29 µg/L),but especially at the uremics with intractable itching(X ECP upg = 8.37±1.67 µg/L). The aim pf the paper:The dialyzed pts with transitory uremic pruritus(u.p)or itching related to the other additioned conditions (like hepatocellular or obstructive jaundice)not differ significantly from the uremics without itching bearing in consi- deration the serum concentration of ECP. Material and methods:1.patients and control group: we have analyzed 6 patients(pts)with chronic imperative u.p(duration more than 6 months!)treated with intermittent hemodialysis more than 5 years(Department of nephrology,Clinical Centre,Skopje,R.of Macedonia) and 7 uremics treated under the same conditions but without up.In all pts(age and sex matched,N 0 = 13)and in the appropriate control group of healthy subjects(c.g,N 0 = 5),we have measured the serum concentrations of s.c.eosinophil cationic protein(ECP)known as a protein of allergic states(allergic rhinitis and conjunctivitis,atopic dermatitis and bronchial asthma as a classic example).The blood was picked up at 8 a clock for investigated persons and before hemodialysis for uremic pts to.Results: From the precedent tables is evident almost the same frequency in men and women(males = 10,females=8),with the mean age(all groups included) of about 44 years.The serum concentration of ECP is lowest(≈ 2 µg/l) in the CG with coefficient of variation(CV) under 2%!The UG is not so compact regarding sECP with CV ≈ 30%,and finally the uremic pts suffering from intractable itching(UPG) are heterogenous group with more elevated level of sECP(at p 1.96 SEM) but especially evident comparing the CG and UPG(Z= 3.8 SEM),respectively UG and UPG(Z >3.3 SEM).We have concluded that in the cases of very promounted u.p,the allergic component is higly included.The further investigations are needed to detect indoubtely the presence of ECP,EPX or eosinophils in the selected planes of the skin tissue and to develop more efficacious antipruritus drugs. Index trems: uremic intractable pruritus eosinophil cationic protein(ECP),Hemodialysis