{"doi":"10.3389/fmed.2022.1011142","title":"Circulating plasma IL-13 and periostin are dysregulated type 2 inflammatory biomarkers in prurigo nodularis: A cluster analysis","abstract":"Importance Prurigo nodularis (PN) is a chronic heterogeneous inflammatory skin disease. Objective To elucidate which components of type 2 inflammation are dysregulated systemically in PN. Design Whole blood was obtained from PN patients with uncontrolled disease and control patients without pruritus. Plasma was assayed for IL-4, IL-5, IL-13, IgE, and periostin. ANOVA was utilized to compare PN and control patients and multiple-hypothesis adjusted p- value was calculated with the significance threshold at 0.05. Clustering was performed using K-means clustering. Participants PN patients ( n = 29) and controls ( n = 18) from Johns Hopkins Dermatology had similar age sex, and race distributions. Results Single-plex assays of the biomarkers demonstrated elevated circulating plasma IL-13 (0.13 vs. 0.006 pg/mL, p = 0.0008) and periostin (80.3 vs. 60.2 ng/mL, p = 0.012) in PN compared to controls. IL-4 (0.11 vs. 0.02 pg/mL, p = 0.30) and IL-5 (0.75 vs. 0.40 pg/mL, p = 0.10) were not significantly elevated, while IgE approached significance (1202.0 vs. 432.7 ng/mL, p = 0.08). Clustering of PN and control patients together revealed two clusters. Cluster 1 ( n = 36) consisted of 18 PN patients and 18 controls. Cluster 2 ( n = 11) consisted entirely of PN patients ( p < 0.01). Cluster 2 had higher levels of IL-13 (0.33 vs. 0.008 pg/mL, p = 0.0001) and IL-5 (1.22 vs. 0.43 pg/mL, p = 0.03) compared to cluster 1. Conclusion and relevance This study demonstrates elevation of IL-13 and periostin in the blood of PN patients, with distinct clusters with varying degrees of type 2 inflammation. Given this heterogeneity, future precision medicine approaches should be explored in the management of PN.","journal":"Frontiers in Medicine","year":2022,"id":244652,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":28,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9647,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":747274,"name":"Karen Cravero","orcid":"0000-0001-7309-9425","position":1,"is_corresponding":false},{"id":666927,"name":"Junwen Deng","orcid":"0000-0001-8393-8915","position":2,"is_corresponding":false},{"id":878445,"name":"Zhe Sun","orcid":"0000-0002-4633-7675","position":3,"is_corresponding":false},{"id":762084,"name":"Sarah Engle","orcid":"0000-0002-8349-5197","position":4,"is_corresponding":false},{"id":879074,"name":"Autum N. Auxier","orcid":null,"position":5,"is_corresponding":false},{"id":878446,"name":"Nathan Hahn","orcid":"0000-0003-0289-6261","position":6,"is_corresponding":false},{"id":762086,"name":"Jonathan T. Sims","orcid":"0000-0001-8599-2157","position":7,"is_corresponding":false},{"id":878447,"name":"Angela J. Okragly","orcid":"0000-0002-1041-8000","position":8,"is_corresponding":false},{"id":623612,"name":"Martin P. Alphonse","orcid":"0000-0003-3447-1284","position":9,"is_corresponding":false},{"id":323965,"name":"Shawn G. Kwatra","orcid":"0000-0003-3736-1515","position":10,"is_corresponding":false},{"id":517928,"name":"Varsha Parthasarathy","orcid":"0000-0002-1422-772X","position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":null,"created_at":"2026-07-19T00:23:30.364338Z","pmid":"36561717","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}