aDepartment of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami, Miami, FL, USA bDepartment of Dermatology, Temple University, Philadelphia, PA, USA cDepartment of Microbiology and Immunology, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA.
Pain. 2017 Nov;158(11):2196-2202. doi: 10.1097/j.pain.0000000000001025.
Psoriasis is often accompanied by itch, but the mechanisms behind this symptom remain elusive. Dynamic changes in epidermal innervation have been observed under chronic itch conditions. Therefore, we investigated whether epidermal innervation is altered in the imiquimod-induced psoriasis mouse model, whether blockade of neurotrophic growth factor signaling can reduce these changes, and whether this system can impact psoriatic itch. Over the 7-day time course of imiquimod treatment, the density of epidermal nonpeptidergic nerves significantly increased, whereas the density of peptidergic nerves significantly decreased. The nonpeptidergic epidermal nerves expressed glial cell line-derived neurotrophic factor (GDNF) family receptor GFRα-1 and GFRα-2, the ligand-binding domains for GDNF and neurturin (NRTN). The NRTN mRNA expression was elevated in the skin of imiquimod-treated mice, whereas the GDNF mRNA expression was decreased. Treatment of imiquimod-challenged mice with an NRTN-neutralizing antibody significantly reduced nonpeptidergic nerve density as well as spontaneous scratching. These results indicate that NRTN contributes to an increase in the epidermal density of nonpeptidergic nerves in the imiquimod-induced psoriasis model, and this increase may be a factor in chronic itch for these mice. Therefore, inhibition of NRTN could be a potential treatment for chronic itch in psoriasis.
银屑病常伴有瘙痒,但这种症状的机制仍难以捉摸。在慢性瘙痒的情况下,已经观察到表皮神经支配的动态变化。因此,我们研究了在咪喹莫特诱导的银屑病小鼠模型中表皮神经支配是否发生改变,神经生长因子信号阻断是否可以减少这些变化,以及该系统是否会影响银屑病瘙痒。在咪喹莫特治疗的 7 天时间内,表皮非肽能神经的密度显著增加,而肽能神经的密度显著降低。非肽能表皮神经表达胶质细胞源性神经营养因子(GDNF)家族受体 GFRα-1 和 GFRα-2,它们是 GDNF 和神经调节蛋白(NRTN)的配体结合域。在咪喹莫特处理的小鼠皮肤中,NRTN mRNA 的表达上调,而 GDNF mRNA 的表达下调。用 NRTN 中和抗体治疗咪喹莫特处理的小鼠可显著减少非肽能神经的密度以及自发性搔抓。这些结果表明,NRTN 有助于咪喹莫特诱导的银屑病模型中表皮非肽能神经密度的增加,这种增加可能是这些小鼠慢性瘙痒的一个因素。因此,抑制 NRTN 可能是治疗银屑病慢性瘙痒的一种潜在方法。