Immune stimulus exposure as a trigger for the development of chronic pruritus and circulating blood type 2 inflammationCapsule Summary

Jaya Manjunath, BS; Viviane Liao, BS; Anusha Kambala, BS; Aaron Bao, BA; Alexander L. Kollhoff, MD; Emily Z. Ma, BS; Brenda Umenita Imo, MS; Hannah Cornman, BS; Sriya V. Reddy, BS; Kevin K. Lee, BS; Weiying Lu, BS; Selina M. Yossef, BA; Madan M. Kwatra, PhD; Shawn G. Kwatra, MD

JAAD International (Sep 2024)

Immune stimulus exposure as a trigger for the development of chronic pruritus and circulating blood type 2 inflammationCapsule Summary

Jaya Manjunath, BS,
Viviane Liao, BS,
Anusha Kambala, BS,
Aaron Bao, BA,
Alexander L. Kollhoff, MD,
Emily Z. Ma, BS,
Brenda Umenita Imo, MS,
Hannah Cornman, BS,
Sriya V. Reddy, BS,
Kevin K. Lee, BS,
Weiying Lu, BS,
Selina M. Yossef, BA,
Madan M. Kwatra, PhD,
Shawn G. Kwatra, MD

Affiliations

Jaya Manjunath, BS: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Viviane Liao, BS: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Anusha Kambala, BS: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland
Aaron Bao, BA: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Alexander L. Kollhoff, MD: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Emily Z. Ma, BS: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Brenda Umenita Imo, MS: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland
Hannah Cornman, BS: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland
Sriya V. Reddy, BS: Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
Kevin K. Lee, BS: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Weiying Lu, BS: Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
Selina M. Yossef, BA: Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
Madan M. Kwatra, PhD: Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
Shawn G. Kwatra, MD: Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland; Department of Dermatology, Maryland Itch Center, University of Maryland School of Medicine, Baltimore, Maryland; Correspondence to: Shawn G. Kwatra, MD, Joseph W. Burnett Professor and Chair, Department of Dermatology, University of Maryland School of Medicine, Office: 419 West Redwood Street, Baltimore, MD 21201.

Journal volume & issue: Vol. 16
pp. 97 – 102

Abstract

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Background: Chronic pruritus (CP) is a poorly characterized condition associated with intense pruritus without a primary skin eruption. This condition tends to emerge more commonly in older adults, and there is limited research on triggering factors. Objective: To explore the clinical characteristics and pathophysiology of CP following exposure to an immune stimulus. Methods: Clinical characteristics and plasma samples were collected from 15 patients who developed CP following an immune stimulus such as checkpoint inhibitors or vaccination. A multiplex panel was used to analyze plasma cytokine concentrations within these patients. Results: Most immunotherapy-treated patients experienced CP during treatment or after 21 to 60 days of receiving treatment, while vaccine-stimulated patients developed pruritus within a week of vaccination. Plasma cytokine analysis revealed elevated levels of 12 cytokines in patients with immune-stimulated CP compared to healthy controls. Notably, T helper 2 (Th2) related cytokines interleukin (IL)-5 (fold change 2.65; q < 0.25) and thymic stromal lymphopoietin (fold change 1.61 q < 0.25) were upregulated. Limitations: Limitations of this study include limited sample size, particularly in the plasma cytokine assay. Conclusions and Relevance: This study reveals triggers of CP development and describes alterations in blood Th2 markers in patients with CP, including IgE, increased blood eosinophils, and cytokines IL-5 and thymic stromal lymphopoietin.

Published in JAAD International

ISSN: 2666-3287 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Dermatology
Website: https://www.journals.elsevier.com/jaad-international

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Abstract

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