Department of Anatomy, Physiology and Biophysics, Faculty of Biology, University of Bucharest, Bucharest, Romania.
Institute of Physiology and Pathophysiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.
Eur J Pain. 2021 Jan;25(1):122-135. doi: 10.1002/ejp.1654. Epub 2020 Sep 23.
PUVA (psoralen UVA) therapy is used to treat a variety of skin conditions, such as vitiligo psoriasis, eczema and mycosis fungoides, but it is frequently accompanied by phototoxicity leading to burning pain, itch and erythema.
We used a combination of calcium and reactive oxygen species (ROS) imaging, patch clamp and neuropeptide release measurement to investigate whether certain ion channels involved in pain and itch signalling could be responsible for these adverese effects of PUVA.
Clinically used psoralen derivatives 8-methoxypsoralen (8-MOP) and 5-methoxypsoralen at physiologically relevant concentrations were able to activate and photosensitize two recombinant thermoTRP (temperature-gated Transient Receptor Potential) ion channels, TRPA1 (Transient Receptor Potential Ankyrin type 1) and TRPV1 (Transient Receptor Potential Vanilloid type 1). 8-MOP enhanced ROS production by UVA light, and the effect of 8-MOP on TRPA1 could be abolished by the antioxidant N-acetyl cysteine and by removal of critical cysteine residues from the N-terminus domain of the channel. Natively expressed mouse TRPA1 and TRPV1 both contribute to photosensitization of cultured primary afferent neurons by 8-MOP, while direct neuronal activation by this psoralen-derivative is mainly dependent on TRPV1. Both TRPA1 and TRPV1 are to a large extent involved in controlling 8-MOP-induced neuropeptide release from mouse trachea.
Taken together our results provide a better understanding of the phototoxicity reported by PUVA patients and indicate a possible therapeutic approach to alleviate the adverse effects associated with this therapy.
Our work provides evidence for the involvement of thermoTRP channels TRPA1 and TRPV1 in the activation and photosensitization of peripheral nociceptors during PUVA (Psoralen UVA) therapy.
PUVA(补骨脂素 UVA)疗法用于治疗各种皮肤疾病,如白癜风、银屑病、湿疹和蕈样肉芽肿,但它常伴有光毒性,导致灼痛、瘙痒和红斑。
我们使用钙和活性氧(ROS)成像、膜片钳和神经肽释放测量的组合来研究参与疼痛和瘙痒信号的某些离子通道是否可能是这些 PUVA 不良反应的原因。
临床上使用的补骨脂素衍生物 8-甲氧基补骨脂素(8-MOP)和 5-甲氧基补骨脂素在生理相关浓度下能够激活和光敏两种重组热 TRP(温度门控瞬时受体电位)离子通道,TRPA1(瞬时受体电位锚蛋白 1 型)和 TRPV1(瞬时受体电位香草素 1 型)。8-MOP 增强 UVA 光产生的 ROS,8-MOP 对 TRPA1 的作用可以被抗氧化剂 N-乙酰半胱氨酸和从通道的 N 端结构域去除关键半胱氨酸残基所消除。天然表达的小鼠 TRPA1 和 TRPV1 均有助于 8-MOP 敏化培养的初级传入神经元,而这种补骨脂素衍生物的直接神经元激活主要依赖于 TRPV1。TRPA1 和 TRPV1 在很大程度上参与控制 8-MOP 诱导的小鼠气管神经肽释放。
总的来说,我们的结果提供了对 PUVA 患者报告的光毒性的更好理解,并表明了一种可能的治疗方法来减轻与这种治疗相关的不良反应。
我们的工作为热 TRP 通道 TRPA1 和 TRPV1 在 PUVA(补骨脂素 UVA)治疗期间外周伤害感受器的激活和光敏化提供了证据。