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Abstract：
Patients with primary cutaneous T-cell lymphoma (CTCL) often experience severe and difficult-to-treat pruritus that negatively affects their quality of life (QoL). However, the mechanisms of pruritus in CTCL, including mycosis fungoides (MF), remain largely unknown, and detailed characteristics of CTCL-associated pruritus is not fully elucidated. To characterize pruritus in CTCL, cutaneous B-cell lymphoma (CBCL), and large plaque parapsoriasis (LPP), and to identify potential itch mediators involved in the pathogenesis of pruritus in CTCL patients. Clinical data and blood samples were collected from 129 healthy subjects and 142 patients. Itch intensity, QoL impairment, psychological distress, and sleep quality were assessed using validated questionnaires and instruments. Blood levels of BDNF, CCL24, GRP, IL-31, IL-33, sST2, substance P, TSLP, tryptase and total IgE were measured using ELISA or ImmunoCAP. Pruritus was prevalent in CTCL, LPP and CBCL patients, with higher prevalence and severity observed in CTCL. In CTCL, pruritus correlated with significant impairment in QoL, sleep, psychological distress. Compared to healthy controls, elevated levels of IL-31, IL-33, substance P, total IgE, tryptase, and TSLP were found in MF patients. A comparison of MF patients with and without pruritus revealed higher levels of IL-31, substance P, GRP, and CCL24 in the former. Itch intensity positively correlated with IL-31, GRP, CCL24, and tryptase levels. Pruritus significantly burdens CTCL patients, necessitating appropriate therapeutic management. Our findings suggest that various non-histaminergic mediators such as tryptase and IL-31 could be explored as novel therapeutic targets for managing pruritus in MF patients.
摘要：
原发性皮肤T细胞淋巴瘤（CTCL）患者通常会出现严重且难以治疗的瘙痒，从而对其生活质量（QoL）产生负面影响。然而,CTCL瘙痒的机制，包括霉菌病（MF），基本上是未知的，CTCL相关瘙痒的详细特征尚未完全阐明。为了表征CTCL中的瘙痒，皮肤B细胞淋巴瘤（CBCL），和大斑块副银屑病（LPP），并确定CTCL患者瘙痒发病机制中潜在的瘙痒介质。从129名健康受试者和142名患者收集临床数据和血液样本。瘙痒强度,QoL受损，心理困扰,使用经过验证的问卷和工具评估睡眠质量。BDNF的血液水平，CCL24,GRP,IL-31，IL-33，sST2，P物质，TSLP,使用ELISA或ImmunoCAP测量类胰蛋白酶和总IgE。瘙痒在CTCL中普遍存在，LPP和CBCL患者，在CTCL中观察到较高的患病率和严重程度。在CTCL中,瘙痒与QoL显著受损相关，睡眠,心理困扰。与健康对照相比，IL-31，IL-33，P物质的水平升高，总IgE,胰蛋白酶,在MF患者中发现TSLP。有和没有瘙痒的MF患者的比较显示更高水平的IL-31，P物质，GRP,和CCL24在前者。瘙痒强度与IL-31、GRP、CCL24和类胰蛋白酶水平。瘙痒显著加重CTCL患者的负担，需要适当的治疗管理。我们的发现表明，可以探索各种非组胺能介质，例如类胰蛋白酶和IL-31，作为治疗MF患者瘙痒的新治疗靶标。
