The role of psychological stress in atopic dermatitis through an increase of IL-31

Introduction: Atopic dermatitis occurs due to multifactorial interactions such as genetic, environmental, impaired skin barrier function, immunological factors, infection and post-psychological stress. Th1 cells and some proinflammatory cytokines such as IL-6, IL-10 and others play a role in the pathogenesis of atopic dermatitis, also IL-31. IL-31, including cytokines of the IL-6 family expressed mainly on CD4 T cells. Many researchers also associate stress with the occurrence of atopic dermatitis, stress will trigger the release of these cytokines from immune cells (e.g. IL-6, TNF ?). The aim of the study is determine correlation between stress and increase in IL-31 level in person with atopic dermatitis Method: We designed a case-control study including 58 patient, range from 14-65 years old. Diagnosis of atopic dermatitis is established based on Hanifin and Rajka criteria, and the severity based on SCORAD. Venous blood was collected for IL-31 examination, stress index was measured by interview according to the Holmes-Rahe stress scale test method. Result: In this study, the stress index in atopic dermatitis was 102.26 + 11.71, and in control 61.35 + 19.87 there was a significant difference with p <0.005. IL-31 levels in atopic dermatitis were 274.44 + 95.35, higher than controls 129.44 + 85.45, significantly with p<0.005. The results of linear regression between stress index and severity of dermatitis (SCORAD), appeared to have a moderate positive correlation with r = 0.04. OR 4.56 (95% CI 2.78-11.56). Conclusions: From this study it can be concluded that stress increases IL-31 levels and positively correlates with the severity of atopic dermatitis.