Pruritus as a Distinctive Feature of Type 2 Inflammation

Pruritus is a common symptom of several skin diseases, both inflammatory and neoplastic. Pruritus might have a tremendous impact on patients’ quality of life and strongly interfere with sleep, social, and work activities. We review the role of type-2 inflammation and immunity in the pathogenesis of...

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Published in:Vaccines (Basel) Vol. 9; no. 3; p. 303
Main Authors: Garcovich, Simone, Maurelli, Martina, Gisondi, Paolo, Peris, Ketty, Yosipovitch, Gil, Girolomoni, Giampiero
Format: Journal Article
Language:English
Published: Switzerland MDPI 23.03.2021
MDPI AG
Subjects:
chronic pruritus
interleukin 31
itch
pruritogenic mediator
Review
skin diseases
T-helper type 2 cells
interleukin-4
pruritogenic mediator
itch
atopic dermatitis
prurigo
T-helper type 2 cells
chronic pruritus
interleukin-13
skin diseases
dupilumab
interleukin 31
ISSN:2076-393X, 2076-393X
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Abstract Pruritus is a common symptom of several skin diseases, both inflammatory and neoplastic. Pruritus might have a tremendous impact on patients’ quality of life and strongly interfere with sleep, social, and work activities. We review the role of type-2 inflammation and immunity in the pathogenesis of chronic pruritic conditions of the skin. Type 2 cytokines, including IL-4, IL-13, thymic stromal lymphopoietin, periostin, IL-31, IL-25, and IL-33 are released by mast cells, innate lymphoid cells 2, keratinocytes, and type 2 T lymphocytes, and are master regulators of chronic itch. These cytokines might act as direct pruritogen on primary sensory neurons (pruriceptors) or alter the sensitivity to other itch mediators Type 2 inflammation- and immunity-dominated skin diseases, including atopic dermatitis, prurigo nodularis, bullous pemphigoid, scabies, parasitic diseases, urticaria, and Sézary syndrome are indeed conditions associated with most severe pruritus. In contrast, in other skin diseases, such as scleroderma, lupus erythematosus, hidradenitis suppurativa, and acne, type 2 inflammation is less represented, and pruritus is milder or variable. Th2 inflammation and immunity evolved to protect against parasites, and thus, the scratching response evoked by pruritus might have developed to alert about the presence and to remove parasites from the skin surface.
AbstractList Pruritus is a common symptom of several skin diseases, both inflammatory and neoplastic. Pruritus might have a tremendous impact on patients’ quality of life and strongly interfere with sleep, social, and work activities. We review the role of type-2 inflammation and immunity in the pathogenesis of chronic pruritic conditions of the skin. Type 2 cytokines, including IL-4, IL-13, thymic stromal lymphopoietin, periostin, IL-31, IL-25, and IL-33 are released by mast cells, innate lymphoid cells 2, keratinocytes, and type 2 T lymphocytes, and are master regulators of chronic itch. These cytokines might act as direct pruritogen on primary sensory neurons (pruriceptors) or alter the sensitivity to other itch mediators Type 2 inflammation- and immunity-dominated skin diseases, including atopic dermatitis, prurigo nodularis, bullous pemphigoid, scabies, parasitic diseases, urticaria, and Sézary syndrome are indeed conditions associated with most severe pruritus. In contrast, in other skin diseases, such as scleroderma, lupus erythematosus, hidradenitis suppurativa, and acne, type 2 inflammation is less represented, and pruritus is milder or variable. Th2 inflammation and immunity evolved to protect against parasites, and thus, the scratching response evoked by pruritus might have developed to alert about the presence and to remove parasites from the skin surface.
Pruritus is a common symptom of several skin diseases, both inflammatory and neoplastic. Pruritus might have a tremendous impact on patients' quality of life and strongly interfere with sleep, social, and work activities. We review the role of type-2 inflammation and immunity in the pathogenesis of chronic pruritic conditions of the skin. Type 2 cytokines, including IL-4, IL-13, thymic stromal lymphopoietin, periostin, IL-31, IL-25, and IL-33 are released by mast cells, innate lymphoid cells 2, keratinocytes, and type 2 T lymphocytes, and are master regulators of chronic itch. These cytokines might act as direct pruritogen on primary sensory neurons (pruriceptors) or alter the sensitivity to other itch mediators Type 2 inflammation- and immunity-dominated skin diseases, including atopic dermatitis, prurigo nodularis, bullous pemphigoid, scabies, parasitic diseases, urticaria, and Sézary syndrome are indeed conditions associated with most severe pruritus. In contrast, in other skin diseases, such as scleroderma, lupus erythematosus, hidradenitis suppurativa, and acne, type 2 inflammation is less represented, and pruritus is milder or variable. Th2 inflammation and immunity evolved to protect against parasites, and thus, the scratching response evoked by pruritus might have developed to alert about the presence and to remove parasites from the skin surface.Pruritus is a common symptom of several skin diseases, both inflammatory and neoplastic. Pruritus might have a tremendous impact on patients' quality of life and strongly interfere with sleep, social, and work activities. We review the role of type-2 inflammation and immunity in the pathogenesis of chronic pruritic conditions of the skin. Type 2 cytokines, including IL-4, IL-13, thymic stromal lymphopoietin, periostin, IL-31, IL-25, and IL-33 are released by mast cells, innate lymphoid cells 2, keratinocytes, and type 2 T lymphocytes, and are master regulators of chronic itch. These cytokines might act as direct pruritogen on primary sensory neurons (pruriceptors) or alter the sensitivity to other itch mediators Type 2 inflammation- and immunity-dominated skin diseases, including atopic dermatitis, prurigo nodularis, bullous pemphigoid, scabies, parasitic diseases, urticaria, and Sézary syndrome are indeed conditions associated with most severe pruritus. In contrast, in other skin diseases, such as scleroderma, lupus erythematosus, hidradenitis suppurativa, and acne, type 2 inflammation is less represented, and pruritus is milder or variable. Th2 inflammation and immunity evolved to protect against parasites, and thus, the scratching response evoked by pruritus might have developed to alert about the presence and to remove parasites from the skin surface.
Author Garcovich, Simone
Yosipovitch, Gil
Girolomoni, Giampiero
Maurelli, Martina
Peris, Ketty
Gisondi, Paolo
AuthorAffiliation 4 Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; gyosipovitch@med.miami.edu
2 Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
3 Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; maurelli.martina@gmail.com (M.M.); paolo.gisondi@univr.it (P.G.); giampiero.girolomoni@univr.it (G.G.)
1 Dermatology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; ketty.peris@unicatt.it
AuthorAffiliation_xml – name: 2 Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
– name: 4 Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; gyosipovitch@med.miami.edu
– name: 3 Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; maurelli.martina@gmail.com (M.M.); paolo.gisondi@univr.it (P.G.); giampiero.girolomoni@univr.it (G.G.)
– name: 1 Dermatology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; ketty.peris@unicatt.it
Author_xml – sequence: 1
  givenname: Simone
  surname: Garcovich
  fullname: Garcovich, Simone
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  orcidid: 0000-0001-7492-8010
  surname: Maurelli
  fullname: Maurelli, Martina
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  orcidid: 0000-0002-1777-9001
  surname: Gisondi
  fullname: Gisondi, Paolo
– sequence: 4
  givenname: Ketty
  surname: Peris
  fullname: Peris, Ketty
– sequence: 5
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  surname: Yosipovitch
  fullname: Yosipovitch, Gil
– sequence: 6
  givenname: Giampiero
  orcidid: 0000-0001-8548-0493
  surname: Girolomoni
  fullname: Girolomoni, Giampiero
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33807098$$D View this record in MEDLINE/PubMed
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Issue 3
Keywords interleukin-4
pruritogenic mediator
itch
atopic dermatitis
prurigo
T-helper type 2 cells
chronic pruritus
interleukin-13
skin diseases
dupilumab
interleukin 31
Language English
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Snippet Pruritus is a common symptom of several skin diseases, both inflammatory and neoplastic. Pruritus might have a tremendous impact on patients’ quality of life...
Pruritus is a common symptom of several skin diseases, both inflammatory and neoplastic. Pruritus might have a tremendous impact on patients' quality of life...
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SubjectTerms chronic pruritus
interleukin 31
itch
pruritogenic mediator
Review
skin diseases
T-helper type 2 cells
Title Pruritus as a Distinctive Feature of Type 2 Inflammation
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