Atopic dermatitis (AD) is characterized by chronic, eczematous, severe pruritic skin lesions caused by skin barrier dysfunction and T helper (Th)2 cell-mediated immunity.Interleukin (IL)-31 is a potent pruritogenic cytokine primarily produced by Th2 cells. [21] Human basophils serve as a source of IL-31 in the skin of chronic spontaneous urticaria patients.[17]
| THE RECEP TOR OF IL-31The receptor for IL-31 consists of a heterodimer of IL-31 receptor α-chain (IL-31RA) and oncostatin M receptor β-chain (OSMR β).Intracellular signalling involving binding of the IL-31 receptor by IL-31 is mediated by the Janus kinase (JAK)-signal transducer and activator of transcription (STAT), phosphatidylinositol-3 kinase (PI3K)/ AKT (also known as protein kinase B or PKB) and mitogen-activated protein kinase (MAPK) pathways (Figure 1). [15,22] Phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) alone is insufficient to activate JAK1/JAK2 and STAT3. [23,24] Furthermore, it has been reported that missense mutations in the OSMR β gene were identified in the patients of familial primary localized cutaneous amyloidosis (FPLCA), hereditary skin disease associated with severe pruritus and deposition of amyloid material in the dermis. [25][26][27] OSMRβ
| TARG E T CELL S AND EFFEC TS OF IL-31IL-31RA is expressed by immune cells such as activated macrophages, dendritic cells, eosinophils and basophils, as well as by epidermal keratinocytes and cutaneous peripheral nerves ( Figure 2). [12,17,19,28]
| Immune cellsThe levels of IL-31RA expressed on human monocytes and macrophages are significantly elevated by Staphylococcal exotoxins. [29] Human dendritic cells significantly upregulate IL-31RA expression upon stimulation with interferon (IFN)-γ, and IL-31-stimulated dendritic cells release several pro-inflammatory cytokines such as tumor necrosis factor TNF)-α, IL-6, CXCL8, CCL2 CCL5 and CCL22. [30] IL-31RA expression by human mast cells is also upregulated by FcεRI aggregation. [31] Human basophils also express IL-31 receptors.IL-31 was shown to induce the secretion of IL-4 and IL-13 by basophils in vitro and to stimulate basophil chemotaxis.[17] IL-31-stimulated human eosinophils produced pro-inflammatory cytokines (IL-6and IL-1α) and chemokines (eg CXCL1, CCL2 and CCL5). Moreover, these phenomena were significantly upregulated in eosinophils cocultured with fibroblasts or keratinocytes in conjunction with IL-31 stimulation. [19,20]
| Epidermal keratinocytesHuman epidermal keratinocytes abundantly express IL-31RA andOSMRβ. Epidermal keratinocytes of AD patients express high levels of IL-31RA compared with those of healthy subjects. IL-31 upregulates the expression levels of various chemokines, such as CCL17/TARC, CCL19/MIP-3β, CCL22/MDC, CCL23/MIP-3, CCL4/ MIP-1β and CXCL1/GRO1α in normal human epidermal keratinocytes (NHEKs). [1] In addition, IL-31 affects keratinocyte differentiation. IL-31 was shown to reduce the expression of epidermal keratinocyte differentiation-associated molecules such as filaggrin, c...