Conditioning of histamine by bradykinin alters responses of rat nociceptor and human itch sensation.

The effect of a conditioning bradykinin application on histamine induced excitation of cutaneous nociceptors and on histamine induced sensations of volunteers was studied. Using an in vitro skin nerve preparation, unmyelinated polymodal nociceptor units of rats (n = 11) were tested by bathing their receptive fields from the corium side with 10(-5) M solutions of bradykinin and histamine. Following bradykinin superfusion the histamine induced discharges were enhanced, and previously unresponsive units were excited by histamine. Corresponding psychophysical experiments were carried out in 13 healthy volunteers. Histamine iontophoresis (30 mC) induced predominantly itching sensations after an intracutaneous control injection of physiological saline. However, following bradykinin injections (100 microliters of a 10(-7) M solution) histamine induced little itch but rather a burning sensation lasting 1-2 min. Itching remained suppressed even after the burning sensations had subsided. These data support a hypothesis according to which itching is mediated by a sub-population of polymodal nociceptor units, and pain is induced whenever a larger nociceptor population is recruited. In the CNS itch processing is either occluded (masked) by pain processing, or suppressed by inhibitory processes.