Sage Journals: Discover world-class research

Abstract

Background:

Thymus and activation-regulated chemokine (TARC), which induces a Th2-dominated inflammation, is a well-known biomarker that reflects the severity of atopic dermatitis. The present study aimed to evaluate TARC as a Th2-associated marker with chronic kidney disease-associated pruritus (CKD-aP) in patients with peritoneal dialysis (PD).

Methods:

This single-centre cross-sectional study included patients who underwent PD in our hospital between August 2020 and July 2021. The severity and impaired quality of life (QOL) of CKD-aP were assessed using the visual analogue scale (VAS) and Japanese version of the 5-D itch scale (5D-J), respectively.

Results:

A total of 48 patients with PD were included in the present study. Age and dialysis vintage were (mean ± SD) 64.8 ± 12.0 year and (median (IQR)) 38.5 (11.5–91.5) month, respectively. VAS and 5D-J scores were 3.3 ± 2.0 and 10.5 (9.0–12.0), respectively. Serum TARC level was 481.5 (278.9–603.4) pg/mL (upper limits of normal 450 pg/mL) and significantly correlated with VAS (r = 0.39, p = 0.006) and 5D-J score (r = 0.37, p = 0.009). Multivariate linear analysis revealed that higher serum TARC level was significantly associated with VAS (p < 0.001) and 5D-J score (p < 0.001). Furthermore, the serum brain natriuretic peptide level tended to be associated with VAS (p = 0.060) and 5D-J score (p = 0.029).

Conclusion:

Serum TARC level is an independent predictor of the severity and impaired QOL of CKD-aP in patients with PD, and TARC might be involved in the pathogenesis of CKD-aP.

Keywords

5-D itch scale chronic kidney disease-associated pruritus eosinophil immunoglobulin E thymus and activation-regulated chemokine

Get full access to this article

View all access options for this article.

References

Narita

Alchi

Omori

, et al. Etiology and prognostic significance of severe uremic pruritus in chronic hemodialysis patients. Kidney Int 2006; 69(9): 1626–1632.

Tessari

Dalle Vedove

Loschiavo

, et al. The impact of pruritus on patients’ quality of life undergoing dialysis: a single-center cohort study. J Nephrol 2009; 22(2): 241–248.

Mathur

Lindberg

Germain

, et al. A longitudinal study of uremic pruritus in hemodialysis patients. Clin J Am Soc Nephrol 2010; 5(8): 1410–1419.

Rayner

Larkina

Wang

, et al. International comparisons of prevalence, awareness, and treatment of pruritus in people on hemodialysis. Clin J Am Soc Nephrol 2017; 12(12): 2000–2007.

Min

Kim

, et al. Comparison of uremic pruritus between patients undergoing hemodialysis and peritoneal dialysis. Kidney Res Clin Pract 2016; 35(2): 107–113.

Pisoni

Wikström

Elder

, et al. Pruritus in hemodialysis patients: international results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 2006; 21(12): 3495–3505.

Chou

Huang

, et al. A study on pruritus after parathyroidectomy for secondary hyperparathyroidism. J Am Coll Surg 2000; 190(1): 65–70.

Szepietowski

Reich

Schwartz

. Uraemic xerosis. Nephrol Dial Transplant 2004; 19(11): 2709–2712.

Johansson

Hilliges

Ståhle-Bäckdahl

. Intraepidermal neuron-specific enolase (NSE)-immunoreactive nerve fibers: evidence for sprouting in uremic patients on maintenance hemodialysis. Neurosci Lett 1989; 99(3): 281–286.

10.

Kimata

Fuller

Saito

, et al. Pruritus in hemodialysis patients: results from the Japanese Dialysis Outcomes and Practice Patterns Study (JDOPPS). Hemodial Int 2014; 18(3): 657–667.

11.

Ozen

Cinar

Askin

, et al. Uremic pruritus and associated factors in hemodialysis patients: a multicenter study. Kidney Res Clin Pract 2018; 37(2): 138–147.

12.

Koyuncu

Solak

Karakukcu

, et al. Evaluation of the causes affecting the development of pruritus in patients with peritoneal dialysis. Int Urol Nephrol 2022; 54(3): 619–625.

13.

Huang

Tsai

, et al. Prognostic importance and determinants of uremic pruritus in patients receiving peritoneal dialysis: a prospective cohort study. PLoS One 2018; 13(9): e0203474.

14.

Imai

Nagira

Takagi

, et al. Selective recruitment of CCR4-bearing Th2 cells toward antigen-presenting cells by the CC chemokines thymus and activation-regulated chemokine and macrophage-derived chemokine. Int Immunol 1999; 11(1): 81–88.

15.

Campbell

Haraldsen

Pan

, et al. The chemokine receptor CCR4 in vascular recognition by cutaneous but not intestinal memory T cells. Nature 1999; 400(6746): 776–780.

16.

Vestergaard

Yoneyama

Murai

, et al. Overproduction of Th2-specific chemokines in NC/Nga mice exhibiting atopic dermatitis-like lesions. J Clin Invest 1999; 104(8): 1097–1105.

17.

Kakinuma

Nakamura

Wakugawa

, et al. Thymus and activation-regulated chemokine in atopic dermatitis: serum thymus and activation-regulated chemokine level are closely related with disease activity. J Allergy Clin Immunol 2001; 107(3): 535–541.

18.

Komatsu-Fujii

Kaneko

Chinuki

, et al. Serum TARC levels are strongly correlated with blood eosinophil count in patients with drug eruptions. Allergol Int 2017; 66(1): 116–122.

19.

Kakinuma

Wakugawa

Nakamura

, et al. High level of thymus and activation-regulated chemokine in blister fluid and sera of patients with bullous pemphigoid. Br J Dermatol 2003; 148(2): 203–210.

20.

Thijs

Krastev

Weidinger

, et al. Biomarkers for atopic dermatitis: a systematic review and meta-analysis. Curr Opin Allergy Clin Immunol 2015; 15(5): 453–460.

21.

Nitta

Akiba

Kawashima

, et al. Characterization of TH1/TH2 profile in uremic patients. Nephron 2002; 91(3): 492–495.

22.

Libetta

Esposito

Sepe

, et al. Effects of different peritoneal dialysis fluids on the TH1/TH2 balance. Eur Cytokine Netw 2011; 22(1): 24–31.

23.

Furue

Ebata

Ikoma

, et al. Verbalizing extremes of the visual analogue scale for pruritus: a consensus statement. Acta Derm Venereol 2013; 93(2): 214–215.

24.

Elman

Hynan

Gabriel

, et al. The 5-D itch scale: a new measure of pruritus. Br J Dermatol 2010; 162(3): 587–593.

25.

Takahashi

Yoshizawa

Okubo

, et al. Usefulness of the Japanese version of the 5-D itch scale for rating pruritus experienced by patients undergoing hemodialysis. Ren Replace Ther 2018; 4(1): 26.

26.

Takehara

Iizaka

, et al. Reliability and validity of a portable device measuring stratum corneum hydration. J Jpn WOCM 2017; 2: 296–303.

27.

Minato

Hirai

Morino

, et al. Factors associated with uremic pruritus in patients undergoing peritoneal dialysis. Int J Nephrol Renovasc Dis 2020; 13: 1–9.

28.

Guo

Lin

, et al. Prevalence and associated factors of uraemic pruritus in continuous ambulatory peritoneal dialysis patients. Intern Med 2015; 54(22): 2827–2833.

29.

Shimizu

Sonoda

Nogi

, et al. B-type (brain) natriuretic peptide and pruritus in hemodialysis patients. Int J Nephrol Renovasc Dis 2014; 7: 329–335.

30.

Kanda

. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013; 48(3): 452–458.

31.

Peng

Chen

, et al. Interleukin-31 is associated with uremic pruritus in patients receiving hemodialysis. J Am Acad Dermatol 2014; 71(6): 1151–1159.e1.

32.

Oweis

Al-Qarqaz

Bodoor

, et al. Elevated interleukin 31 serum levels in hemodialysis patients are associated with uremic pruritus. Cytokine 2021; 138: 155369.

33.

Raap

Wichmann

Bruder

, et al. Correlation of IL-31 serum levels with severity of atopic dermatitis. J Allergy Clin Immunol 2008; 122(2): 421–423.

34.

Uchiyama

Washida

Kusahana

, et al. Eosinophilic reaction at the time of catheter insertion predicts survival in patients initiating peritoneal dialysis. Blood Purif 2021: 1–10.

35.

Kataoka

. Thymus and activation-regulated chemokine as a clinical biomarker in atopic dermatitis. J Dermatol 2014; 41(3): 221–229.

36.

Rothenberg

. Eosinophilia. N Engl J Med 1998; 338(22): 1592–1600.

37.

Wittig

Belloit

De Fillippi

, et al. Age-related serum immunoglobulin E levels in healthy subjects and patients with allergic disease. J Allergy Clin Immunol 1980; 66(4): 305–313.

38.

Kyoya

Kawakami

Soma

. Serum thymus and activation-regulated chemokine (TARC) and interleukin-31 levels as biomarkers for monitoring in adult atopic dermatitis. J Dermatol Sci 2014; 75(3): 204–207.

39.

Kinugasa

Igawa

Shimada

, et al. Anti-pruritic effect of nemolizumab in hemodialysis patients with uremic pruritus: a phase II, randomized, double-blind, placebo-controlled clinical study. Clin Exp Nephrol 2021; 25(8): 875–884.

40.

Meng

Chen

Wang

. Interventions in the B-type natriuretic peptide signaling pathway as a means of controlling chronic itch. Br J Pharmacol 2020; 177(5): 1025–1040.

41.

Meng

Moriyama

Feld

, et al. New mechanism underlying IL-31-induced atopic dermatitis. J Allergy Clin Immunol 2018; 141(5): 1677–1689.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.04 MB