Center for the Study of Itch, Washington University School of Medicine, St. Louis, MO 63110, USA; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Center for the Study of Itch, Washington University School of Medicine, St. Louis, MO 63110, USA; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA. Electronic address: https://twitter.com/@itchdoctor.
Trends Immunol. 2018 Dec;39(12):980-991. doi: 10.1016/j.it.2018.10.001. Epub 2018 Nov 21.
Relentless, repetitive itching and scratching is a debilitating feature of many chronic inflammatory skin disorders such as atopic dermatitis. While well known clinically, this itch-scratch cycle has historically lacked in-depth mechanistic understanding. However, recent advances at the interface of itch neurobiology and skin immunology have shed new light on this phenomenon. In this review, we highlight recent advances in our understanding of the neuroimmunology of chronic itch centered around three key points of entry into the itch-scratch cycle: the epithelial barrier, the immune system, and the peripheral nervous system. Furthermore, we explore novel neuro-epithelial-immune interactions that may represent promising therapeutic paradigms.
持续不断、反复的瘙痒和搔抓是许多慢性炎症性皮肤疾病(如特应性皮炎)的一个致残特征。虽然临床上众所周知,但这一瘙痒-搔抓循环在历史上缺乏深入的机制理解。然而,瘙痒神经生物学和皮肤免疫学界面的最新进展为这一现象提供了新的认识。在这篇综述中,我们重点介绍了我们对慢性瘙痒的神经免疫学理解的最新进展,主要围绕进入瘙痒-搔抓循环的三个关键点:上皮屏障、免疫系统和周围神经系统。此外,我们还探讨了可能代表有前途的治疗范例的新型神经-上皮-免疫相互作用。