Bircher A J, Meier-Ruge W
Department of Dermatology, University of Basel, Switzerland.
Arch Dermatol. 1988 Jan;124(1):84-9. doi: 10.1001/archderm.124.1.84.
Four patients with aquagenic pruritus (AP), one patient with polycythemia rubra vera, one patient with cold urticaria, and three normal control volunteers were studied to better understand the pathophysiology of water-induced itching. Punch biopsy specimens were taken before and after water contact; the specimens were immediately frozen, sectioned, and stained histochemically for acetylcholinesterase (AChE) activity. This was localized in the nerve fibers surrounding eccrine sweat glands and was quantified by microspectrophotometry. In AP and polycythemia rubra vera after water exposure a significantly increased AChE activity suggesting acetylcholine release was observed, whereas in the patient with cold urticaria and the controls, a significant decrease was noted. Two related patients with AP had an inherited abnormality of serum cholinesterase, which, however, had no obvious correlation with their particular disease. The proof of AChE activation might support the clinical diagnosis and indicate a hypothetical involvement of eccrine sweat glands in the pathogenesis of AP.
为了更好地理解水诱导瘙痒的病理生理学，对4例水源性瘙痒（AP）患者、1例真性红细胞增多症患者、1例冷性荨麻疹患者和3名正常对照志愿者进行了研究。在接触水之前和之后采集打孔活检标本；标本立即冷冻、切片，并进行乙酰胆碱酯酶（AChE）活性的组织化学染色。AChE定位于外分泌汗腺周围的神经纤维中，并通过显微分光光度法进行定量。在AP和真性红细胞增多症患者接触水后，观察到AChE活性显著增加，提示乙酰胆碱释放，而在冷性荨麻疹患者和对照组中，AChE活性显著降低。2例相关的AP患者存在血清胆碱酯酶的遗传性异常，然而，这与他们的特定疾病并无明显关联。AChE激活的证据可能支持临床诊断，并表明外分泌汗腺在AP发病机制中可能起作用。
