Association Between Inflammatory Bowel Disease and Pruritus.
Association Between Inflammatory Bowel Disease and Pruritus.
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DOI：
10.1093/crocol/otaa012
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发表时间：
2020-01
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炎症性肠病（IBD）常伴有肠外表现。我们经常遇到IBD患者瘙痒症，然而，缺乏这些条件的相关性的临床证据。因此，本研究调查了IBD患者瘙痒的发生率。71例IBD门诊患者，包括55例溃疡性结肠炎（UC）和16例克罗恩病，和39名健康志愿者（HV）的瘙痒症状进行了调查，使用视觉模拟量表（VAS）。UC和克罗恩病患者的疾病活动分别根据部分马约和IOIBD（国际炎症性肠病研究组织）评分进行分类。通过测量经表皮水分损失和角质层水合作用来检查皮肤屏障状况。应用抗蛋白基因产物（PGP）9.5抗体，对9例UC患者皮肤标本表皮内神经纤维的分布进行了免疫组化检查。IBD患者的视觉模拟量表评分高于HV患者（P < 0.001）。活动期IBD患者瘙痒VAS评分较缓解期患者严重（P = 0.036）。IBD患者（P < 0.001）和活动期IBD患者（P = 0.004）的经表皮水分丢失量较高，而IBD患者（P = 0.019）和活动期IBD患者的角质层水合作用低于HV（P = 0.019）。观察到UC患者瘙痒程度与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，特别是活动期患者，经常表现出瘙痒和皮肤干燥的症状。这一结果可能对IBD症状的治疗具有预测和治疗意义。
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 (P < 0.001). Active stage IBD patients had more severe pruritus VAS scores than those in the remission stage (P = 0.036). Transepidermal water loss was higher in IBD patients (P < 0.001) and active stage IBD patients (P = 0.004), while stratum corneum hydration was lower in IBD patients (P = 0.019) and active stage IBD patients than in HV (P = 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.