Expression And Significance Of Serum IL-31, IL-33 And CCL27 In Chronic Urticaria

BackgroundUrticaria is a common disease caused by mast cells.The clinical manifestations are sudden wheal,erythema and severe pruritus,self-limited and easy to relapse,may be associated with nausea and vomiting,abdominal pain,diarrhea,joint pain,fever and other systemic symptoms.In severe cases,dyspnea and anaphylactic shock may occur.A broad consensus was reached based on the clinical classification of duration: acute and chronic urticaria,acute self-limiting urticaria tends to subside within 1-3 weeks,and any urticaria lasting more than 6 weeks is considered to be "chronic." The possibility of some exogenous pathogenic processes is very low,which is different from the cause of acute urticaria.Acute urticaria is usually caused by identifiable factors,such as allergies to food or drugs.The incidence of pediatric illness is mostly related to viral diseases.On the contrary,the external causes of chronic urticaria are almost never found.Chronic urticaria is classified into spontaneous and inducible.Chronic induced urticaria includes physical and nonphysical urticaria.Over the past few decades,different pathophysiological mechanisms have been investigated for the onset of CU,but the pathogenesis is not yet fully understood.It is currently recognized that the onset of CU is associated with abnormal immune function,especially the Th1/Th2 cell imbalance theory,in which Th2 cells dominate its immune response.Studies have found that interleukins and chemokines are involved in the pathophysiological process of chronic urticaria.Th2-related cytokines IL-31,33 and Th2-directed chemokine CCL27 are hot topics.ObjectiveTo quantify serum IL-31,IL-33,and CCL27 levels in chronic urticaria patients,and analyze their relations to disease severity,evaluate the association of IL-31 with pruritus in chronic urticaria,and explore the role of the three cytokines and chemokines in the pathogenesis of chronic urticaria.Methods73 patients that visit our dermatology clinic in January 2017-November 2017 with a clear diagnosis of chronic urticaria were included in the case group.At the same time,73 cases of healthy people in the medical examination department of our hospital were used as the normal control group."Guinea guidelines for urticaria in China(2014 Edition)" and "China Clinical Dermatology 2nd Edition" are used as diagnostic criteria for inclusion cases.Urticaria activity score was calculated in accordance with EAACI/GA2LEN/EDF guidelines which we improved.The age,gender,symptoms,and disease course of all cases were recorded and calculated by the same medical staff.About 5ml blood was obtained in the morning during a fasting state from all subjects,and serum samples were collected after centrifugation,and subsequently stored at-80?until analysis.The serum levels of IL-31,IL-33,and CCL27 were measured by ELISA both in the case group and the control group.SPSS for Windows version 22.0 was used for statistical analyses.Results1.Compared with the control group,the serum levels of IL-31,IL-33,and CCL27 in CU patients were significantly higher(P<0.05).2.There was a positive correlation between IL-31 and pruritus in CU.(P<0.01).3.The serum level of IL-31,IL-33,CCL27 in CU patients was positively correlated with the severity of the disease,with statistical significance(P<0.05).4.There was a correlation between the serum levels of IL-31,IL-23,and CCL27 in CU patients,and the positive correlation between the two of the three was statistically significant(P<0.05).Conclusions1.IL-31,IL-33 and CCL27 may promote the development of inflammation in the pathogenesis of chronic urticaria,and its expression level may be related to the severity of disease.2.IL-31 is positively associated with pruritus and may be an itching agent involved in the mechanism of pruritus.