Immune Triggers Linked to Chronic Pruritus and Elevated Type 2 Inflammation
Chronic pruritus (CP), characterized by severe itching without an underlying skin condition, is increasingly observed following immune system stimulation. A recent study published in the Journal of the American Academy of Dermatology sheds light on the triggers and immune mechanisms driving CP, especially in older adults.
Researchers analyzed data from 15 patients who developed CP after immune stimuli, such as checkpoint inhibitor therapy or vaccination. Among patients undergoing immunotherapy, CP commonly emerged during treatment or within 21 to 60 days of its initiation. In contrast, vaccine-induced pruritus occurred within a week of administration.
Plasma cytokine profiling revealed a distinct inflammatory signature in patients with CP compared to healthy controls. Elevated levels of 12 cytokines were identified, with notable increases in Th2-related cytokines IL-5 (2.65-fold) and thymic stromal lymphopoietin (1.61-fold). Additionally, increased blood eosinophil counts and IgE levels further underscored the prominence of a type 2 immune response in CP.
“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,” concluded the study authors.
Reference
Manjunath J, Liao V, Kambala A, et al. Immune stimulus exposure as a trigger for the development of chronic pruritus and circulating blood type 2 inflammation. JAAD Int. 2024;16:97-102. doi:10.1016/j.jdin.2024.03.022
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