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Histamine-releasing factor(s) in sera of uraemic pruritus patients in a possible mechanism of UVB therapy

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Abstract

Uraemic pruritus is poorly understood despite the high incidence among chronic renal failure (CRF) patients undergoing haemodialysis. Serum histamine levels have been shown to be elevated in CRF patients with itching, and ultraviolet B (UVB) therapy, even if applied to only part of the body surface, has been reported to be beneficial for the generalized relief of the pruritus. A local mechanism of UVB action is suggested by evidence that UVB radiation is able to suppress histamine release from mast cells. However, detailed systemic mechanism(s) remain obscure. Sera from patients with or without uraemic pruritus were incubated with purified rat peritoneal mast cells and the resulting histamine release was compared. A higher histamine release was obtained with sera from uraemic pruritus patients (44.60 ± 6.32%, n=9, P<0.005) than with sera from patients without itching (19.71 ± 3.14%, n=5, P>0.25) and with normal control sera (23.62 ± 7.14%, n=6). This increased histamine release was dose-dependently restored to spontaneous release levels in five of seven patients by pre-exposure of the sera to UVB in vitro. From these results, sera of CRF patients with uraemic pruritus were considered to contain some histamine releasing factor(s) which was depleted or diminished by UVB irradiation, suggesting a possible systemic mechanism of UVB action.

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References

  1. Berne B, Vahlquist A, Fischer T, Danielson BG, Berne C (1984) UV treatment of uraemic pruritus reduces the vitamin A content of the skin. Eur J Clin Invest 14: 203–206

    Google Scholar 

  2. Campese VM (1990) Autonomic nervous dysfunction in uraemia. Nephrol Dial Transplant 1: 98–101

    Google Scholar 

  3. Danno K, Toda K, Horio T (1985) The effect of 8-methoxypsoralen plus long-wave ultraviolet (PUVA) radiation on mast cells: PUVA suppresses degranulation of mouse skin mast cells induced by compound 48/80 or concanavalin A. J Invest Dermatol 85: 110–114

    Google Scholar 

  4. Danno K, Toda K, Horio T (1986) Ultraviolet B radiation suppresses mast cell degranulation induced by compound 48/80. J Invest Dermatol 87: 775–778

    Google Scholar 

  5. Danno K, Fujii K, Tachibana T, Toda K, Horio T (1988) Suppressed histamine release from rat peritoneal mast cells by ultraviolet B irradiation: decreased diacylglycerol formation as a possible mechanism. J Invest Dermatol 90: 806–809

    Google Scholar 

  6. Denman ST (1986) A review of pruritus. J Am Acad Dermatol 14: 375–392

    Google Scholar 

  7. Fjellner B, HÄgermark O (1982) Histamine release from rat peritoneal mast cells exposed to ultraviolet light. Acta Derm Venereol (Stockh) 62: 215–220

    Google Scholar 

  8. Francos GC, Kauh YC, Gittlen SD, Schulman ES, Besarab A, Goyal S, Burke Jr JF (1991) Elevated plasma histamine in chronic uremia. Effects of ketotifen on pruritus. Int J Dermatol 30: 884–889

    Google Scholar 

  9. Gilchrest BA, Rowe JW, Brown RS, Steinman TI, Arndt KA (1977) Relief of uremic pruritus with ultraviolet phototherapy. N Engl J Med 297: 136–138

    Google Scholar 

  10. Gilchrest BA, Rowe JW, Brown RS, Steinman TI, Arndt KA (1979) Ultraviolet phototherapy of uremic pruritus. Long-term results and possible mechanism of action. Ann Intern Med 91: 17–21

    Google Scholar 

  11. Gilchrest BA, Rowe JW, Mihm MC (1980) Clinical and histological skin changes in chronic renal failure: evidence for a dialysis resistant, transplant-responsive microangiopathy. Lancet II: 1271–1275

    Google Scholar 

  12. Gilchrest BA, Stern RS, Steinman TI, Brown RS, Arndt KA, Anderson WW (1982) Clinical features of pruritus among patients undergoing maintenance hemodialysis. Arch Dermatol 118: 154–156

    Google Scholar 

  13. Gill DS, Fonseca VA, Barradas MA, Balliod R, Moorhead JF, Dandona P (1991) Plasma histamine in patients with chronic renal failure and nephrotic syndrome. J Clin Pathol 44: 243–245

    Google Scholar 

  14. Hampers CL, Katz Al, Wilson RE, Merrill JP (1968) Disappearance of “uremic” itching after subtotal parathyroidectomy. N Engl J Med 279: 695–697

    Google Scholar 

  15. Massry SG, Popovtzer MM, Coburn JW, Makoff DL, Maxwell MH, Kleiman CR (1968) Intractable pruritus as a manifestation of secondary hyperparathyroidism in uremia. Disappearance of itching after subtotal parathyroidectomy. N Engl J Med 279: 697–700

    Google Scholar 

  16. Matsumoto M, Ichimaru K, Horie A (1985) Pruritus and mast cell proliferation of the skin in end stage renal failure. Clin Nephrol 23: 285–288

    Google Scholar 

  17. Mettang T, Fritz P, Weber J, Machleidt C, Hübel E, Kuhlmann U (1990) Uremic pruritus in patients on hemodialysis or continuous ambulatory peritoneal dialysis. The role of plasma histamine and skin mast cells. Clin Nephrol 34: 136–141

    Google Scholar 

  18. Neiman RS, Bischel MD, Lukes RJ (1972) Uraemia and mast cell proliferation. Lancet I: 959

    Google Scholar 

  19. Pederson JA, Matter BJ, Czerwinsk AW, Llach F (1980) Relief of idiopathic generalized pruritus in dialysis patients treated with activated oral charcoal. Ann Intern Med 93: 446–448

    Google Scholar 

  20. Pincelli C, Fantini F, Baraldi A, Sevignani C, Spattini A, Gianetti A (1990) Neurochemical markers in skin from patients with uremic pruritus (abstract). J Invest Dermatol 95: 483

    Google Scholar 

  21. Shaff RE, Beaven MA (1979) Increased sensitivity of the enzymatic isotopic assay of histamine: measurement of histamine in plasma and serum. Anal Biochem 94: 425–430

    Google Scholar 

  22. Shultz BC, Roenigk HH (1980) Uremic pruritus treated with ultraviolet light. JAMA 243: 1836–1837

    Google Scholar 

  23. Silverberg DS, Iaina A, Reisin E, Rotzak R, Eliahou HE (1977) Cholestyramine in uraemic pruritus. BMJ 1: 752–753

    Google Scholar 

  24. Stockenhuber F, Kurz RW, Sertl K, Grimm G, Balcke P (1990) Increased plasma histamine levels in uraemic pruritus. Clin Sci 79: 477–482

    Google Scholar 

  25. Tapia L, Cheigh JS, David DS, Sullivan JF, Saal S, Reidenberg MM, Stenzel KH, Rubin AL (1977) Pruritus in dialysis patients treated with parenteral lidocaine. N Engl J Med 296: 261–262

    Google Scholar 

  26. Toda K, Danno K, Tachibana T, Horio T (1986) Effect of 8-methoxypsoralen plus long-wave ultraviolet (PUVA) radiation on mast cells. II — In vitro PUVA inhibits degranulation of rat peritoneal mast cells induced by compound 48/80. J Invest Dermatol 87: 113–116

    Google Scholar 

  27. Tsakalos ND, Theoharis TC, Kops SK, Askenase PW (1983) Induction of mast cell secretion by parathormone. Biochem Pharmacol 32: 355–360

    Google Scholar 

  28. Yatzidis H, Digenis P, Tountas C (1972) Heparin treatment of uremic itching. JAMA 222: 1183

    Google Scholar 

  29. Young AW, Sweeney EW, David DS, Cheigh J, Hochgelerent EL, Sakai S, Stenzel KH, Rubin AL (1973) Dermatologic evaluation of pruritus in patients on hemodialysis. N Y State J Med 15: 2670–2674

    Google Scholar 

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Imazu, L.E., Tachibana, T., Danno, K. et al. Histamine-releasing factor(s) in sera of uraemic pruritus patients in a possible mechanism of UVB therapy. Arch Dermatol Res 285, 423–427 (1993). https://doi.org/10.1007/BF00372137

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