Department of Dermatology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
Exp Dermatol. 2021 Dec;30(12):1745-1753. doi: 10.1111/exd.14422. Epub 2021 Jul 3.
Alloknesis, an abnormal itch sensation induced by innocuous stimuli, is a key phenomenon in the vicious itch-scratch cycle in patients with atopic dermatitis. Dry skin and pruritus, including alloknesis, are major health problems in peri- and post-menopausal women. We recently reported permeability barrier dysfunction in ovariectomized (OVX) mice-a model of menopause-and found that the dysfunction was related to dry skin. However, the mechanism of the itch remains unknown. Therefore, we examined touch- and pruritogen-evoked alloknesis and epidermal innervation in OVX mice and acetone, diethyl ether and water (AEW)-treated mice, for the experimental dry skin model. Both alloknesis and epidermal innervation were comparable in OVX and AEW mice. Neutralizing antibodies against IL-4 and IL-13 inhibited alloknesis in both OVX and AEW mice as early as 30 min after intradermal administration. Comparable values close to the measurement limit of IL-4 were found in the skin of HRT and Sham mice as well as AEW and the control mice, but the levels of IL-4 were within the measurement limit in OVX mice. We could not detect mRNAs of IL-4 or IL-13 in any groups of mice. On the other hand, the number of eosinophils and basophils was increased in OVX and AEW mice. These results suggest that impaired barrier function in cooperation with type 2 cytokines derived from eosinophils and basophils in the skin or with endogenous type 2 cytokine may trigger the development of alloknesis, and thus, these cytokines could be a therapeutic target for sensitive skin.
感觉异常,即由无害刺激引起的异常瘙痒感,是特应性皮炎患者瘙痒-搔抓恶性循环中的一个关键现象。皮肤干燥和瘙痒,包括感觉异常,是绝经前后妇女的主要健康问题。我们最近报道了卵巢切除(OVX)小鼠——一种绝经模型中的渗透性屏障功能障碍,并发现该功能障碍与皮肤干燥有关。然而,瘙痒的机制仍不清楚。因此,我们研究了 OVX 小鼠和丙酮、二乙醚和水(AEW)处理小鼠的触摸和致痒原诱发的感觉异常和表皮神经支配,以建立实验性皮肤干燥模型。OVX 和 AEW 小鼠的感觉异常和表皮神经支配相似。在皮内注射后 30 分钟内,针对 IL-4 和 IL-13 的中和抗体即可抑制 OVX 和 AEW 小鼠的感觉异常。在 HRT 和 Sham 小鼠以及 AEW 和对照小鼠的皮肤中,也发现了接近 IL-4 测量限值的类似数值,但在 OVX 小鼠中,IL-4 的水平在测量限值内。我们在任何一组小鼠中都无法检测到 IL-4 或 IL-13 的 mRNA。另一方面,OVX 和 AEW 小鼠中的嗜酸性粒细胞和嗜碱性粒细胞数量增加。这些结果表明,皮肤中来源于嗜酸性粒细胞和嗜碱性粒细胞的 2 型细胞因子或内源性 2 型细胞因子的屏障功能受损可能会引发感觉异常的发生,因此,这些细胞因子可能是敏感皮肤的治疗靶点。