Kawamura Mayu, Kamata Yayoi, Komiya Eriko, Moniaga Catharina Sagita, Takahashi Nobuaki, Kaneko Takahide, Suga Yasushi, Tominaga Mitsutoshi, Takamori Kenji
Juntendo Med J. 2025 Apr 18;71(3):195-201. doi: 10.14789/ejmj.JMJ24-0043-OA. eCollection 2025.
Although the opioid system is critical for regulating itch within the central nervous system, its role in managing severe, treatment-resistant itch related to skin diseases is unclear. Serum lipocalin-2 (LCN-2) levels are associated with the visual analogue scale score of itch in patients with psoriasis vulgaris (PSO), but not other itchy skin diseases. Therefore, we herein investigated the relationship between opioids and LCN-2 with itch in pruritic skin diseases.
We assessed plasma levels of β-endorphin and dynorphin A and serum levels of LCN-2 in patients with pruritic skin diseases using enzyme-linked immunosorbent assays.
Plasma dynorphin A levels were significantly reduced in patients with urticaria, and asteatotic dermatitis (AsD), while β-endorphin levels were significantly elevated in those with AsD. The plasma β-endorphin-to-dynorphin A ratio was markedly higher in AsD patients than in healthy controls. Among the patients examined, only those with PSO had significantly elevated serum LCN-2 levels, which correlated with VAS and severity index scores and also with the area of affected skin.
The present results suggest that the ratio of plasma opioids is involved in itch control in AsD patients, and serum LCN-2 levels may be a biomarker for itch and its severity in those with PSO.
尽管阿片类系统对于调节中枢神经系统内的瘙痒至关重要，但其在管理与皮肤疾病相关的严重、难治性瘙痒中的作用尚不清楚。血清脂质运载蛋白2（LCN-2）水平与寻常型银屑病（PSO）患者的瘙痒视觉模拟评分相关，但与其他瘙痒性皮肤病无关。因此，我们在此研究了阿片类物质与LCN-2在瘙痒性皮肤病中与瘙痒的关系。
我们使用酶联免疫吸附测定法评估了瘙痒性皮肤病患者血浆中β-内啡肽和强啡肽A的水平以及血清中LCN-2的水平。
荨麻疹和乏脂性皮炎（AsD）患者的血浆强啡肽A水平显著降低，而AsD患者的β-内啡肽水平显著升高。AsD患者的血浆β-内啡肽与强啡肽A的比值明显高于健康对照组。在检查的患者中，只有PSO患者的血清LCN-2水平显著升高，这与视觉模拟评分和严重程度指数评分相关，也与受影响皮肤的面积相关。
目前的结果表明，血浆阿片类物质的比例参与了AsD患者的瘙痒控制，血清LCN-2水平可能是PSO患者瘙痒及其严重程度的生物标志物。
