Iwamoto Shiho, Tominaga Mitsutoshi, Kamata Yayoi, Kawakami Tomohiro, Osada Taro, Takamori Kenji
Juntendo Itch Research Center (JIRC), Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine, Urayasu, Chiba, Japan.
Department of Gastroenterology, Juntendo University School of Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan.
Crohns Colitis 360. 2020 Feb 28;2(1):otaa012. doi: 10.1093/crocol/otaa012. eCollection 2020 Jan.
Inflammatory bowel disease (IBD) is often complicated by extraintestinal manifestations. We frequently encounter IBD patients with pruritus; however, clinical evidence for the association of these conditions is lacking. Therefore, the present study investigated the incidence of pruritus in IBD patients.
Seventy-one IBD outpatients, including 55 with ulcerative colitis (UC) and 16 with Crohn disease, and 39 healthy volunteers (HVs) were surveyed about their pruritus symptoms using a visual analogue scale (VAS). Disease activities in UC and Crohn disease patients were classified according to partial Mayo and IOIBD (International Organization for the Study of inflammatory Bowel Disease) scores, respectively. Skin barrier condition was examined by measuring transepidermal water loss and stratum corneum hydration. The distribution of intraepidermal nerve fibers in skin samples from 9 UC patients was examined immunohistochemically using an antiprotein gene product (PGP) 9.5 antibody.
Visual analogue scale scores were higher in IBD patients than in HV ( < 0.001). Active stage IBD patients had more severe pruritus VAS scores than those in the remission stage ( = 0.036). Transepidermal water loss was higher in IBD patients ( < 0.001) and active stage IBD patients ( 0.004), while stratum corneum hydration was lower in IBD patients ( 0.019) and active stage IBD patients than in HV ( = 0.019). A relationship was observed between the degree of pruritus and number of PGP9.5-immunoreactive intraepidermal nerve fibers in UC patients.
Inflammatory bowel disease patients, particularly active stage patients, frequently exhibit symptoms of pruritus and dry skin. This result may have predictive and therapeutic implications for the treatment of IBD symptoms.
炎症性肠病（IBD）常伴有肠外表现。我们经常遇到患有瘙痒症的IBD患者；然而，缺乏这些病症之间关联的临床证据。因此，本研究调查了IBD患者瘙痒症的发病率。
使用视觉模拟量表（VAS）对71名IBD门诊患者（包括55名溃疡性结肠炎患者和16名克罗恩病患者）以及39名健康志愿者（HV）进行瘙痒症状调查。溃疡性结肠炎和克罗恩病患者的疾病活动度分别根据部分梅奥评分和国际炎症性肠病研究组织（IOIBD）评分进行分类。通过测量经表皮水分流失和角质层水合作用来检查皮肤屏障状况。使用抗蛋白基因产物（PGP）9.5抗体对9名溃疡性结肠炎患者皮肤样本中的表皮内神经纤维分布进行免疫组织化学检查。
IBD患者的视觉模拟量表评分高于健康志愿者（<0.001）。活动期IBD患者的瘙痒VAS评分比缓解期患者更严重（=0.036）。IBD患者（<0.001）和活动期IBD患者（0.004）的经表皮水分流失较高，而IBD患者（0.019）和活动期IBD患者的角质层水合作用低于健康志愿者（=0.019）。在溃疡性结肠炎患者中观察到瘙痒程度与PGP9.5免疫反应性表皮内神经纤维数量之间的关系。
炎症性肠病患者，尤其是活动期患者，经常出现瘙痒和皮肤干燥症状。这一结果可能对IBD症状的治疗具有预测和治疗意义。
