Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha 410013.
Xiangya School of Medicine, Central South University, Changsha 410013.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Feb 28;49(2):190-196. doi: 10.11817/j.issn.1672-7347.2024.230397.
One of the most common and significant symptoms for skin disorders is pruritus. Additionally, it serves as a significant catalyst for the exacerbation or reoccurrence of skin diseases. Pruritus seriously affects patients' physical and mental health, and even the quality of life. It brings a heavy burden to the patients, the families, even the whole society. The pathogenesis and regulation mechanisms for pruritus are complicated and have not yet been elucidated. Previous clinical studies have shown that itch worsens at night in scabies, chronic pruritus, atopic dermatitis, and psoriasis, suggesting that skin pruritus may change with circadian rhythm. Cortisol, melatonin, core temperature, cytokines, and prostaglandins are the main regulatory factors of the circadian rhythm of pruritus. Recent studies have shown that some CLOCK genes, such as , , , and , play an important role in the regulation of the circadian rhythm of pruritus by regulating the Janus tyrosine kinase (JAK)-signal transducer and activator of transcription (STAT) and nuclear factor kappa-B (NF-κB) signaling pathways. However, the mechanisms for circadian clock genes in regulation of circadian rhythm of pruritus have not been fully elucidated. Further studies on the mechanism of circadian clock genes in the regulation of circadian rhythm of pruritus will lay a foundation for elucidating the regulatory mechanisms for pruritus, and also provide new ideas for the control of pruritus and the alleviation of skin diseases.
瘙痒是皮肤疾病最常见和最重要的症状之一。此外,它也是皮肤疾病恶化或复发的重要诱因。瘙痒严重影响患者的身心健康,甚至生活质量。它给患者、家庭甚至整个社会带来了沉重的负担。瘙痒的发病机制和调节机制复杂,尚未阐明。既往临床研究表明,疥疮、慢性瘙痒、特应性皮炎和银屑病患者的瘙痒在夜间加重,表明皮肤瘙痒可能随昼夜节律变化。皮质醇、褪黑素、核心体温、细胞因子和前列腺素是瘙痒昼夜节律的主要调节因素。最近的研究表明,一些时钟基因,如 、 、 、 和 ,通过调节 Janus 酪氨酸激酶(JAK)-信号转导和转录激活因子(STAT)和核因子 kappa-B(NF-κB)信号通路,在瘙痒的昼夜节律调节中发挥重要作用。然而,昼夜节律钟基因在瘙痒昼夜节律调节中的机制尚未完全阐明。进一步研究昼夜节律钟基因在瘙痒昼夜节律调节中的作用机制,将为阐明瘙痒的调节机制奠定基础,也为瘙痒的控制和皮肤病的缓解提供新的思路。