Peripheral Sensitization and Loss of Descending Inhibition Is a Hallmark of Chronic Pruritus

Pogatzki-Zahn EM, Pereira MP, Cremer A, Zeidler C, Dreyer T, Riepe C, Wempe C, Lotts T, Segelcke D, Ringkamp M, Kremer A, Agelopoulos K, Ständer S (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Journal of Investigative Dermatology Elsevier

DOI: 10.1016/j.jid.2019.05.029

Abstract

Neurophysiological mechanisms leading to chronicity of pruritus are not yet fully understood and it is not known whether these mechanisms diverge between different underlying diseases of chronic pruritus (CP). This study aimed to detect such mechanisms in CP of various origins. A total of 120 patients with CP of inflammatory origin (atopic dermatitis), neuropathic origin (brachioradial pruritus), and chronic prurigo of nodular type, the latter as a model for chronic scratching, as well as 40 matched healthy controls participated in this study. Stimulation with cowhage induced a more intensive itch sensation compared with stimulation with other substances in all patient groups but not in healthy controls, arguing for sensitization of cutaneous mechano- and heat-sensitive C-fibers in CP. All patient groups showed a decreased intraepidermal nerve fiber density compared with controls. A decreased condition pain modulation effect was observed in all patient groups compared with controls, suggesting a reduced descending inhibitory system in CP. In sum, CP of different etiologies showed a mixed peripheral and central pattern of neuronal alterations, which might contribute to the chronicity of pruritus with no differences between pruritus entities. Our findings may contribute to the development of future treatment strategies targeting these pathomechanisms.

Authors with CRIS profile

Andreas Kremer Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology

Involved external institutions

Universitätsklinikum Münster DE Germany (DE) Johns Hopkins University (JHU) US United States (USA) (US)

How to cite

APA:

Pogatzki-Zahn, E.M., Pereira, M.P., Cremer, A., Zeidler, C., Dreyer, T., Riepe, C.,... Ständer, S. (2019). Peripheral Sensitization and Loss of Descending Inhibition Is a Hallmark of Chronic Pruritus. Journal of Investigative Dermatology. https://dx.doi.org/10.1016/j.jid.2019.05.029

MLA:

Pogatzki-Zahn, Esther M., et al. "Peripheral Sensitization and Loss of Descending Inhibition Is a Hallmark of Chronic Pruritus." Journal of Investigative Dermatology (2019).

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