الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Uremic pruritus or called chronic kidney disease-associated pruritus (CKD-aP) has been defined as itching that is directly related to kidney disease, without another comorbid condition such as a comorbid liver or skin condition that includes itching.
Multiple hypotheses and parameters have been postulated for the pathophysiology of uremic pruritus. Among them, some evidence supports a central role of an immune hypothesis, based on the findings that serum levels of high-sensitivity C-reactive protein (hsCRP) and some inflammatory cytokines, such as interleukin IL-2 and IL-6, which were elevated in patients with uremic pruritus However, a consensus has not yet been reached among these studies, and uremic pruritus remains poorly characterized
Lipocalin-2 (LCN2), also known as neutrophil gelatinase-binding lipocalin (NGAL), is a member of lipocalin superfamily secreted with established role in innate immunity. LCN2 is secreted mainly by immune cells especially neutrophils in addition to other tissues as bone, liver, intestines and kidney.
Regarding LCN2 role in kidney diseases, a systematic review and meta-analysis investigating more than 50 studies of acute kidney injury (AKI) concluded that blood LCN2 could be used as a diagnostic marker for AKI in newborns. LCN2 is considered as one of the most induced proteins in the kidney of animal models in the process of acute kidney injury (AKI), data also suggested that LCN2 could serve as a biomarker in chronic kidney disease (CKD). Few studies showed an association between LCN2 level and itching. One of them declared that LCN2 derived from spinal astrocytes enhanced itching in a mouse model of atopic dermatitis. As the pathogenic mechanisms of pruritus in CKD patients has not been explained clearly till now, and the link between LCN2 and pruritus in those patients has not been determined; This study examined the role of LCN2 in pruritus in patients with CKD, to evaluate the serum level and immunohistochemical expression of lipocalin-2 (LCN2) in chronic kidney disease (CKD) pruritic patients and their correlation with the available studied clinico-pathologic parameters.
This is a case-control study carried out on 50 subjects that were divided into 2 main groups: 25 patients with uremic pruritus as patient’s group (10 of them were subjected to treatment with narrow band ultraviolet type B (NBUVB) for 12 weeks) and 25 age and gender matched healthy volunteers as a control group. Cases were selected from the inpatient and outpatient clinics of Internal Medicine department, faculty of Medicine, Menoufia University. While the control subjects were collected from Plastic Surgery Department, Menoufia University hospitals. A written informed consent form approved by Committee of Human Rights in Research in our University was obtained from every participant before the study initiation. All patients were free from dermatological diseases and other systemic diseases causing pruritus. Every participant in this study was subjected to both blood sampling and skin biopsy taking in the same session, then each sample was processed separately and blindly at the Biochemistry and molecular biology and Pathology departments as for measuring LCN2 serum levels by enzyme linked immunosorbent assay (ELISA) and Immunohistochemical (IHC) staining of skin biopsies respectively.