Chu Liuxi, Shu Xin, Wu Yan, Yang Haoran, Lu Qin, Deng Huihua
School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China.
Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China.
Front Physiol. 2022 Jun 28;13:835269. doi: 10.3389/fphys.2022.835269. eCollection 2022.
It has been suggested that cortisol levels are abnormal in chronic urticaria and atopic dermatitis, but other steroids, such as dehydroepiandrosterone (DHEA) and testosterone, are still unknown, and whether these hormones affect the maintenance of skin homeostasis or the pathogenesis of skin diseases is not fully understood. Limited data are available on steroid levels in prurigo nodularis (PN)-related research, and no study has examined the association between pruritus severity and steroid levels in PN patients. This pilot study aimed to investigate the differences in the levels of five steroids combined with their ratios in plasma between PN patients and controls and to examine the associations between the biomarkers and pruritus severity. Plasma concentrations of five steroids, including cortisol, cortisone, testosterone, progesterone, and dehydroepiandrosterone (DHEA), in 36 patients with PN were compared with concentrations in thirty-six and matched healthy controls. The concentrations of steroids were quantitated using liquid chromatography-tandem mass spectrometry. The PN symptoms, including pruritus severity, pain, and life quality, were assessed with the use of the visual analog scale, prurigo score index, numerical rating scale, and verbal rating scale and dermatology life quality index scores. In comparison with controls, PN patients had lower levels of plasma cortisol and cortisone, which negatively correlated with PN symptoms. PN patients had higher levels of cortisone and testosterone to cortisol, which positively correlated with pruritus severity. Additionally, there were no significant differences in plasma concentrations of DHEA and testosterone between the two groups. We found no correlation between plasma concentrations of DHEA and testosterone and pruritus severity. This pilot study suggests that there may be abnormalities in peripheral blood levels of cortisol, and cortisone and the ratios of cortisone and testosterone to cortisol in patients with PN, and they are related to pruritus severity. The plasma concentrations of testosterone and DHEA may be not abnormal in PN patients and may not be associated with pruritus severity.
有人提出，慢性荨麻疹和特应性皮炎患者的皮质醇水平异常，但其他类固醇，如脱氢表雄酮（DHEA）和睾酮，情况仍不明朗，而且这些激素是否影响皮肤内环境稳定的维持或皮肤病的发病机制尚未完全清楚。关于结节性痒疹（PN）相关研究中的类固醇水平，可用数据有限，且尚无研究探讨PN患者瘙痒严重程度与类固醇水平之间的关联。这项初步研究旨在调查PN患者与对照组之间血浆中五种类固醇水平及其比值的差异，并研究这些生物标志物与瘙痒严重程度之间的关联。将36例PN患者血浆中皮质醇、可的松、睾酮、孕酮和脱氢表雄酮（DHEA）这五种类固醇的浓度与36例匹配的健康对照者的浓度进行比较。使用液相色谱 - 串联质谱法定量类固醇浓度。使用视觉模拟量表、痒疹评分指数、数字评定量表、言语评定量表和皮肤病生活质量指数评分来评估PN症状，包括瘙痒严重程度、疼痛和生活质量。与对照组相比，PN患者血浆皮质醇和可的松水平较低，且与PN症状呈负相关。PN患者可的松与睾酮相对于皮质醇的水平较高，且与瘙痒严重程度呈正相关。此外，两组之间DHEA和睾酮的血浆浓度无显著差异。我们发现DHEA和睾酮的血浆浓度与瘙痒严重程度之间无相关性。这项初步研究表明，PN患者外周血中皮质醇、可的松水平以及可的松和睾酮相对于皮质醇的比值可能存在异常，且它们与瘙痒严重程度相关。PN患者睾酮和DHEA的血浆浓度可能无异常，且可能与瘙痒严重程度无关。
