title: Interleukin-31 is associated with uremic pruritus in patients receiving hemodialysis.
abstract: BACKGROUND
  Interleukin (IL)-31 induces severe pruritus and dermatitis in transgenic mice, and is associated with many itching skin diseases.
  
  
  OBJECTIVE
  We sought to investigate the association of serum IL-31 levels with uremic pruritus in patients undergoing hemodialysis.
  
  
  METHODS
  Patients receiving maintenance hemodialysis in a referral medical center were recruited. Serum IL-31 levels were determined by the enzyme-linked immunosorbent assay methodology. The various characteristics of pruritus were assessed using an interview questionnaire.
  
  
  RESULTS
  Among the 178 study participants, 34.8% had uremic pruritus. The patients with pruritus had higher serum IL-31 levels than those without pruritus symptoms (median 8.68 [first quartile 0.43, third quartile 35.04] vs 4.91 [0, 15.78], P = .04). A multivariate linear regression analysis showed that higher serum levels of IL-31, high-sensitivity C-reactive protein, and alanine transaminase, and a lower dialysis dose assessed by Kt/V, were independent predictors for higher pruritus intensity. The generalized additive model also showed a positive exposure-response relationship between serum levels of IL-31 and visual analog scale scores of pruritus intensity.
  
  
  CONCLUSIONS
  The cause-effect relationship between IL-31 and uremic pruritus could not be assessed by the cross-sectional study design.
  
  
  CONCLUSIONS
  IL-31 may play an important role in the pathophysiology of uremic pruritus.
authors.affiliation: Department of Dermatology, Taipei City Hospital, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Mei-Ju
authors.initials: MJ
authors.lastname: Ko
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yu-Sen
authors.initials: YS
authors.lastname: Peng
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Hung-Yuan
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Shih-Ping
authors.initials: SP
authors.lastname: Hsu
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Mei-Fen
authors.initials: MF
authors.lastname: Pai
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Ju-Yeh
authors.initials: JY
authors.lastname: Yang
authors.affiliation: Department of Dermatology, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Su-Ying
authors.initials: SY
authors.lastname: Wen
authors.affiliation: Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Shiou-Hwa
authors.initials: SH
authors.lastname: Jee
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: honyenwu@ntu.edu.tw.
authors.forename: Hon-Yen
authors.initials: HY
authors.lastname: Wu
authors.affiliation: Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Hsien-Ching
authors.initials: HC
authors.lastname: Chiu
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007378:Interleukins / Q000097:blood* / Q000502:physiology; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011537:Pruritus / Q000378:metabolism* / Q000503:physiopathology; D006435:Renal Dialysis; D011795:Surveys and Questionnaires; D014511:Uremia / Q000378:metabolism* / Q000503:physiopathology
chemical_list: C502187:IL31 protein, human; D007378:Interleukins
keywords: cytokines; hemodialysis; interleukin-31; itching; pruritogen; uremic pruritus