Schmelz M
Karl Feuerstein Professur, Klinik für Anästhesiologie und Operative Intensivmedizin, Fakultät für Klinische Medizin Mannheim, Ruprecht-Karls-Universität Heidelberg, Mannheim.
Hautarzt. 2006 May;57(5):385-6, 388-9. doi: 10.1007/s00105-006-1121-z.
The discovery of specific pathways for the processing of itch has greatly enhanced our understanding of the physiology of pruritus. However, the complex interactions between itch and pain are only partly understood. This review focuses on the neurophysiological basis of itch under experimental and clinical conditions. Chronic inflammatory diseases can locally sensitize nerve endings and thereby contribute to itch. In addition, there is increasing evidence that also central processing of itch can be sensitized in pruritus patients. Interestingly, this pattern of peripheral and central sensitization in pruritus has striking similarities to the one observed in chronic pain patients. The presumed similarities in underlying sensitizing mechanisms between itch and pain has major therapeutic consequences as successful therapies for chronic pain might be used also in chronic itch.
瘙痒处理特定途径的发现极大地增进了我们对瘙痒生理学的理解。然而,瘙痒与疼痛之间的复杂相互作用仅得到部分理解。本综述聚焦于实验和临床条件下瘙痒的神经生理学基础。慢性炎症性疾病可使神经末梢局部敏感化,从而导致瘙痒。此外,越来越多的证据表明,瘙痒患者的瘙痒中枢处理过程也会敏感化。有趣的是,瘙痒中这种外周和中枢敏感化模式与慢性疼痛患者中观察到的模式有显著相似之处。瘙痒和疼痛潜在敏感化机制的推测相似性具有重大治疗意义,因为慢性疼痛的成功治疗方法可能也可用于慢性瘙痒。