Department of Dermatology and Cutaneous Surgery and Miami Itch Center Miller School of Medicine University of Miami, Miami, Fla.
Department of Dermatology and Cutaneous Surgery and Miami Itch Center Miller School of Medicine University of Miami, Miami, Fla.
J Allergy Clin Immunol. 2018 Nov;142(5):1375-1390. doi: 10.1016/j.jaci.2018.09.005.
Itch is a common sensory experience that is prevalent in patients with inflammatory skin diseases, as well as in those with systemic and neuropathic conditions. In patients with these conditions, itch is often severe and significantly affects quality of life. Itch is encoded by 2 major neuronal pathways: histaminergic (in acute itch) and nonhistaminergic (in chronic itch). In the majority of cases, crosstalk existing between keratinocytes, the immune system, and nonhistaminergic sensory nerves is responsible for the pathophysiology of chronic itch. This review provides an overview of the current understanding of the molecular, neural, and immune mechanisms of itch: beginning in the skin, proceeding to the spinal cord, and eventually ascending to the brain, where itch is processed. A growing understanding of the mechanisms of chronic itch is expanding, as is our pipeline of more targeted topical and systemic therapies. Our therapeutic armamentarium for treating chronic itch has expanded in the last 5 years, with developments of topical and systemic treatments targeting the neural and immune systems.
瘙痒是一种常见的感觉体验，普遍存在于炎症性皮肤病患者以及系统性和神经性疾病患者中。在这些情况下，瘙痒通常很严重，严重影响生活质量。瘙痒由 2 种主要的神经元通路编码：组胺能（急性瘙痒）和非组胺能（慢性瘙痒）。在大多数情况下，角质形成细胞、免疫系统和非组胺能感觉神经之间的串扰负责慢性瘙痒的病理生理学。这篇综述概述了瘙痒的分子、神经和免疫机制的最新认识：从皮肤开始，延伸到脊髓，最终上升到大脑，在那里处理瘙痒。对慢性瘙痒机制的认识不断加深，针对神经和免疫系统的更靶向的局部和全身治疗方法也在不断增加。在过去的 5 年中，我们治疗慢性瘙痒的方法有了很大的扩展，开发了针对神经和免疫系统的局部和全身治疗方法。
