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John Evans

Low metabolite biomarkers linked to chronic pruritus of unknown origin



Photo by Orrling and Tomer S via Wikimedia Commons

New findings show that patients with chronic pruritus of unknown origin (CPUO) have lower-than-normal levels of some metabolite biomarkers in their blood plasma. These findings could help explain the cause of the itching condition.


The research was published in Scientific Reports (July 29, 2024).


“Our study found a distinct deficit in certain metabolite biomarkers, including several important amino acids and other metabolites involved in immune system regulation in patients with CPUO compared to a healthy control group,” said study principal investigator Shawn Kwatra, MD, in a press release. “This is an exciting finding because it provides novel insights into the cause of this condition and identifies potential future therapeutic targets to consider.”


Dr. Kwatra is the Joseph W. Burnett Endowed Professor and Chair of Dermatology at the University of Maryland School of Medicine and Chief of Service Dermatology at the University of Maryland Medical Center.


In the release, the authors note chronic pruritus of unknown origin is most prevalent among older adults and causes severe itching lasting longer than six weeks. Current therapies used to help manage symptoms are off-label and have poor efficacy, with many patients having a significantly impaired quality of life.


In the latest study, Dr. Kwatra and his colleagues compared blood plasma samples from patients with CPUO and matched healthy control patients. They found lower levels of nine amino acids in the CPUO patients compared to the control group and that the lower levels correlated with itch severity.


Dr. Kwatra and his colleagues write that previous animal studies have correlated low levels of these amino acids with itch symptoms in mice. These amino acids serve as building blocks for neurotransmitters that play a role in the body’s itch response and other allergic skin reactions. Those prior studies showed providing mice with medications such as antidepressants to boost neurotransmitters, including serotonin, reduced itch symptoms.


“Many of these biomarkers that we found in depleted amounts in the blood of CPUO patients, like tryptophan and glycine, could contribute to the underlying pathogenesis of this condition, but we certainly need larger studies to investigate this further,” said Dr. Kwatra.

Study co-authors also included faculty from Johns Hopkins University School of Medicine and Duke University Medical Center.

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