Research Article
Uremic Pruritus Is Not Associated with
Endocannabinoid Receptor 1 Gene Polymorphisms
Monika Heisig,
1
Aukasz AaczmaNski,
2
Adam Reich,
1
Felicja Lwow,
3
and Jacek C. Szepietowski
1
1
Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 1 Chalubinskiego Street,
50-368 Wroclaw, Poland
2
Department of Endocrinology and Diabetology, Wroclaw Medical University, 4 Pasteura Street, 50-367 Wroclaw, Poland
3
Department of Health Promotion, University School of Physical Education, 35 Paderewskiego Street, 51-612 Wroclaw, Poland
Correspondence should be addressed to Jacek C. Szepietowski; jacek.szepietowski@umed.wroc.pl
Received 21 December 2015; Revised 24 January 2016; Accepted 1 February 2016
Academic Editor: Daniela Parolaro
Copyright © 2016 Monika Heisig et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Uremic pruritus (UP) is a frequent and bothersome symptom in hemodialysis patients. Its etiology is not fully understood and
that is why there is no specifc treatment. Te endocannabinoid system plays a role in many pathological conditions. Tere is
reliable evidence on the association between cannabinoid system and pruritus. In our study, we aimed to evaluate whether genetic
variations in the endocannabinoid receptor 1 (CNR1) gene can afect UP. Te rs12720071, rs806368, rs1049353, rs806381, rs10485170,
rs6454674, and rs2023239 polymorphisms of the CNR1 gene were genotyped in 159 hemodialysis patients and 150 healthy controls
using two multiplex polymerase chain reactions and the minisequencing technique. No statistically signifcant relationship was
found in any of the evaluated genotypes between patients with and without UP, even afer excluding patients with diabetes and
dyslipidemia. Tere were no diferences between patients with UP and the control group. However, in the group of all HD patients,
a signifcantly higher incidence of GA genotype and lower incidence in GG genotype in the polymorphism rs806381s were revealed
versus the control group ( = 0.04). It seems that polymorphisms of the CNR1 gene are not associated with uremic pruritus.
1. Introduction
Uremic pruritus (UP) is a frequent phenomenon and it
is regarded as one of the most bothersome symptoms in
patients with chronic renal disease [1]. Te prevalence of
UP is still high and reported in around 40% to 50% [2, 3].
UP has an important impact on patients’ quality of life
and sleep, depression, and increased mortality [3, 4]. Te
pathogenesis of UP remains blurry, although many diferent
factors have been indicated in the etiology of this symptom,
including increased systemic infammation, abnormal serum
parathyroid hormone, calcium, and phosphorus levels, an
imbalance in opiate receptors, a neuropathic process, or even
skin dryness [4, 5]. Tis is why until now there is no specifc
treatment for patients with UP and many of the available
therapeutic modalities are not satisfactory.
Te endocannabinoid system (EC) has an efect on
various physiological conditions and since its discovery at
the end of twentieth century it has attracted much attention
of researchers in diferent felds. It has already been proved
that the EC system plays a role in insulin resistance, fat
distribution, and metabolic disorders [6, 7]. Moreover, recent
studies provided data on the signifcant role of the EC in
the cutaneous physiology and pathology [8]. Te EC has two
identifed receptors: CNR1 (endocannabinoid receptor 1) and
CNR2 (endocannabinoid receptor 2). Both receptors have
their ligands which interact with endogenous and exogenous
cannabinoids [9]. Te most well-known natural ligands of
CNR1 are fatty acid amides (FAAs) or esters represented
by anandamide (AEA), N-palmitoylethanolamine (PEA), N-
oleoylethanolamine (OEA), or 2-arachidonoylglycerol (2-
AG) [7, 10]. Te frst receptor is mainly expressed in central
Hindawi Publishing Corporation
BioMed Research International
Volume 2016, Article ID 3567527, 5 pages
http://dx.doi.org/10.1155/2016/3567527