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Trier AM, Ver Heul AM, Fredman A, Le V, Wang Z, Auyeung K, Meixiong J, Lovato P, Holtzman MJ, Wang F, Dong X, Ji AL, Kim BS. IL-33 potentiates histaminergic itch. J Allergy Clin Immunol 2024; 153:852-859.e3. [PMID: 37984799 PMCID: PMC10939899 DOI: 10.1016/j.jaci.2023.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Itch is a common symptom that can greatly diminish quality of life. Histamine is a potent endogenous pruritogen, and while antihistamines are often the first-line treatment for itch, in conditions like chronic spontaneous urticaria (CSU), many patients remain symptomatic while receiving maximal doses. Mechanisms that drive resistance to antihistamines are poorly defined. OBJECTIVES Signaling of the alarmin cytokine IL-33 in sensory neurons is postulated to drive chronic itch by inducing neuronal sensitization to pruritogens. Thus, we sought to determine if IL-33 can augment histamine-induced (histaminergic) itch. METHODS Itch behavior was assessed in response to histamine after IL-33 or saline administration. Various stimuli and conditional and global knockout mice were utilized to dissect cellular mechanisms. Multiple existing transcriptomic data sets were evaluated, including single-cell RNA sequencing of human and mouse skin, microarrays of isolated mouse mast cells at steady state and after stimulation with IL-33, and microarrays of skin biopsy samples from subjects with CSU and healthy controls. RESULTS IL-33 amplifies histaminergic itch independent of IL-33 signaling in sensory neurons. Mast cells are the top expressors of the IL-33 receptor in both human and mouse skin. When stimulated by IL-33, mouse mast cells significantly increase IL-13 levels. Enhancement of histaminergic itch by IL-33 relies on a mast cell- and IL-13-dependent mechanism. IL-33 receptor expression is increased in lesional skin of subjects with CSU compared to healthy controls. CONCLUSIONS Our findings suggest that IL-33 signaling may be a key driver of histaminergic itch in mast cell-associated pruritic conditions such as CSU.
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Affiliation(s)
- Anna M Trier
- Center for the Study of Itch and Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Aaron M Ver Heul
- Center for the Study of Itch and Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Avery Fredman
- Center for the Study of Itch and Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Victoria Le
- Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; Mark Lebwohl Center for Neuroinflammation & Sensation, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Zhen Wang
- Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; Mark Lebwohl Center for Neuroinflammation & Sensation, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kelsey Auyeung
- Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; Mark Lebwohl Center for Neuroinflammation & Sensation, Icahn School of Medicine at Mount Sinai, New York, NY
| | - James Meixiong
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Md
| | | | - Michael J Holtzman
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Fang Wang
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong, China
| | - Xinzhong Dong
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Md; Howard Hughes Medical Institute, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Andrew L Ji
- Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Brian S Kim
- Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; Mark Lebwohl Center for Neuroinflammation & Sensation, Icahn School of Medicine at Mount Sinai, New York, NY; Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Allen Discovery Center for Neuroimmune Interactions, New York, NY.
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Shacham E, Scroggins S, Little G, Fredman A, Ritter G. A Spatial Examination of COVID-19 Policies among Missouri School Districts. J Sch Health 2023; 93:169-175. [PMID: 36408772 DOI: 10.1111/josh.13260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 09/06/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND As the COVID-19 pandemic spread, school district administrators in the United States were faced with difficult decisions regarding the implementation of virtual or in-person learning to reduce risk of infection throughout student and staff populations. While a coordinated effort with surrounding districts would be most beneficial when encountering a highly infectious respiratory-based infectious disease, the determinants of type of education delivery is unclear. METHODS Data from the Missouri Department of Elementary and Secondary Education assessing education delivery method at each school district across the state of Missouri (n = 514) from August 2020 were used. This cross-sectional study, using results from a school district-level survey, local COVID-19 rates, and community-level sociodemographic characteristics, conducted a spatially adjusted analysis of variance (ANOVA) to determine associations between education delivery type and geographic-level sociogeographic characteristics. RESULTS Among Missouri school districts, 172 (33.4%) reported starting the 2020-2021 academic year with an in-person policy, 52 (10.1%) with a distant/virtual policy, 242 (47.1%) in-person with a distance option, and 48 (9.3%) with a blended policy. This study found districts with lower household income levels were less likely to offer students any virtual learning options. Additionally, community COVID-19 infection rates were not associated with the selection of virtual or in-person education delivery. CONCLUSIONS These findings suggest the presence of a specific school policy was spatially random in regard to neighboring community policies, even when accounting for community characteristics. The efficacy of policy is likely to benefit upon application of a spatial framework when addressing a crisis fundamentally tied to location. Future planning that highlights and focuses on regional coordination for community resilience in the face of a pandemic should incorporate data sources that inform decisions made for families, students, and communities.
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Affiliation(s)
- Enbal Shacham
- College of Public Health and Social Justice, Saint Louis University Geospatial Institute, Saint Louis, MO
| | - Stephen Scroggins
- College of Public Health and Social Justice, Saint Louis University Geospatial Institute, Saint Louis, MO
| | - Germysha Little
- College of Public Health and Social Justice, Saint Louis University Geospatial Institute, Saint Louis, MO
| | - Avery Fredman
- College of Arts and Sciences, Washington University in St. Louis, Saint Louis, MO
| | - Gary Ritter
- School of Education, Saint Louis University, Saint Louis, MO
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Trier AM, Mack MR, Fredman A, Tamari M, Ver Heul AM, Zhao Y, Guo CJ, Avraham O, Ford ZK, Oetjen LK, Feng J, Dehner C, Coble D, Badic A, Joshita S, Kubo M, Gereau RW, Alexander-Brett J, Cavalli V, Davidson S, Hu H, Liu Q, Kim BS. IL-33 signaling in sensory neurons promotes dry skin itch. J Allergy Clin Immunol 2021; 149:1473-1480.e6. [PMID: 34560104 DOI: 10.1016/j.jaci.2021.09.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Chronic pruritus, or itch, is common and debilitating, but the neuroimmune mechanisms that drive chronic itch are only starting to be elucidated. Recent studies demonstrate that the IL-33 receptor (IL-33R) is expressed by sensory neurons. However, whether sensory neuron-restricted activity of IL-33 is necessary for chronic itch remains poorly understood. OBJECTIVES We sought to determine if IL-33 signaling in sensory neurons is critical for the development of chronic itch in 2 divergent pruritic disease models. METHODS Plasma levels of IL-33 were assessed in patients with atopic dermatitis (AD) and chronic pruritus of unknown origin (CPUO). Mice were generated to conditionally delete IL-33R from sensory neurons. The contribution of neuronal IL-33R signaling to chronic itch development was tested in mouse models that recapitulate key pathologic features of AD and CPUO, respectively. RESULTS IL-33 was elevated in both AD and CPUO as well as their respective mouse models. While neuron-restricted IL-33R signaling was dispensable for itch in AD-like disease, it was required for the development of dry skin itch in a mouse model that mirrors key aspects of CPUO pathology. CONCLUSIONS These data highlight how IL-33 may be a predominant mediator of itch in certain contexts, depending on the tissue microenvironment. Further, this study provides insight into future therapeutic strategies targeting the IL-33 pathway for chronic itch.
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Affiliation(s)
- Anna M Trier
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Madison R Mack
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Avery Fredman
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Masato Tamari
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Aaron M Ver Heul
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Yonghui Zhao
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Department of Anesthesiology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Changxiong J Guo
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Department of Anesthesiology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Oshri Avraham
- Department of Neuroscience, Washington University School of Medicine, St Louis, Mo
| | - Zachary K Ford
- Department of Anesthesiology and Neuroscience Program, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Landon K Oetjen
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Jing Feng
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Department of Anesthesiology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Carina Dehner
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Dean Coble
- Division of Biostatistics, Washington University School of Medicine, St Louis, Mo
| | - Asima Badic
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Satoru Joshita
- Division of Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Masato Kubo
- Laboratory of Cytokine Regulation, Center for Integrative Medical Science (IMS), RIKEN Yokohama Institute, Yokohama, Japan; Division of Molecular Pathology, Research Institute for Biomedical Science, Tokyo University of Science, Tokyo, Japan
| | - Robert W Gereau
- Department of Anesthesiology, Department of Medicine, Washington University School of Medicine, St Louis, Mo; Department of Neuroscience, Washington University School of Medicine, St Louis, Mo; Washington University Pain Center, Washington University School of Medicine, St Louis, Mo
| | - Jennifer Alexander-Brett
- Division of Pulmonary and Critical Care, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Valeria Cavalli
- Department of Neuroscience, Washington University School of Medicine, St Louis, Mo
| | - Steve Davidson
- Department of Anesthesiology and Neuroscience Program, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Hongzhen Hu
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Department of Anesthesiology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Qin Liu
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Department of Anesthesiology, Department of Medicine, Washington University School of Medicine, St Louis, Mo
| | - Brian S Kim
- Center for the Study of Itch & Sensory Disorders, Washington University School of Medicine, St Louis, Mo; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Mo; Department of Anesthesiology, Department of Medicine, Washington University School of Medicine, St Louis, Mo; Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Mo.
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