Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO.
The Institute for Dermatopathology, Newtown Square, PA.
Am J Dermatopathol. 2021 Nov 1;43(11):773-775. doi: 10.1097/DAD.0000000000001902.
Chronic pruritus of unknown origin (CPUO) is described as chronic itch lasting longer than 6 weeks in the absence of a defined skin rash and any known causative disease process. A retrospective study was performed on biopsy samples from patients with CPUO and normal controls to compare the immune profiles of these patients with healthy individuals. We used dual CD3/T-bet and CD3/GATA3 immunohistochemical staining to assess for T-cells expressing Th1 versus Th2 transcription factors, respectively. Our data showed that CD3+ cells of patients with CPUO co-express significantly more GATA3 compared with normal controls. Meanwhile, the normal control skin showed a much more balanced T-bet/GATA3 ratio of co-expression. Our data suggest an enrichment of Th2 cells in CPUO skin by T cell/GATA3 co-staining, supporting that CPUO is increasingly considered a type 2/Th2 cell-associated disease. We thus speculate that type 2 cytokine blockade-based therapies may represent effective treatments for CPUO.
不明原因的慢性瘙痒症（CPUO）被定义为无明确皮疹和任何已知病因的慢性瘙痒，持续时间超过 6 周。对 CPUO 患者和正常对照者的活检样本进行了回顾性研究，以比较这些患者与健康个体的免疫特征。我们使用双 CD3/T-bet 和 CD3/GATA3 免疫组化染色来分别评估表达 Th1 与 Th2 转录因子的 T 细胞。我们的数据显示，与正常对照组相比，CPUO 患者的 CD3+细胞表达 GATA3 的比例显著更高。与此同时，正常对照组的皮肤显示出更为平衡的 T-bet/GATA3 共表达比例。我们的数据表明，通过 T 细胞/GATA3 共染色，CPUO 皮肤中 Th2 细胞明显富集，这支持 CPUO 越来越被认为是一种 2 型/Th2 细胞相关疾病。因此，我们推测基于 2 型细胞因子阻断的治疗方法可能是治疗 CPUO 的有效方法。
