Heyer G, Vogelgsang M, Hornstein O P
Department of Dermatology, University of Erlangen-Nuremberg, Germany.
J Dermatol. 1997 Oct;24(10):621-5. doi: 10.1111/j.1346-8138.1997.tb02305.x.
As previous experimental studies disproved histamine as the main mediator of eliciting pruritus in atopic eczema (AE), we examined the neurocutaneous sensations in 15 patients with AE and in 15 age- and sex-matched non-atopic controls after i.c. injection of acetylcholine (Ach, 0.5 M, 20 microliters) or buffered saline. The sensory perceptions were rated by the participants of the study with regard to their quality and intensity using a visual analogue scale. Simultaneously, the vascular reactions to Ach were recorded by the examinators via laser Doppler fluxmetry as well as flare and wheal planimetry. In contrast to the approximately equal flare and wheal extensions in either group, the cutaneous sensations differed significantly. The patients complained of 'pure' itching that developed shortly after Ach injection, whereas the control subjects reported only burning pain. Moreover, the patients perceived their sensations significantly earlier and significantly longer than did the controls. The study provides evidence that Ach plays an important role in the pathogeny of pruritus in patients with AE. Further investigations of the neuronal mechanisms involved in this atopy-related effect of Ach have to be performed.
由于先前的实验研究否定了组胺是特应性湿疹（AE）中引起瘙痒的主要介质，我们对15例AE患者以及15名年龄和性别匹配的非特应性对照者进行了皮内注射乙酰胆碱（Ach，0.5 M，20微升）或缓冲盐水后的神经皮肤感觉检查。研究参与者使用视觉模拟量表对感觉的性质和强度进行评分。同时，检查者通过激光多普勒血流仪以及风团和潮红面积测量法记录对Ach的血管反应。与两组中潮红和风团扩展程度大致相同相反，皮肤感觉存在显著差异。患者抱怨在注射Ach后不久出现“单纯”瘙痒，而对照者仅报告灼痛。此外，患者比对照者更早且更显著地感觉到这些感觉。该研究提供了证据表明Ach在AE患者瘙痒的发病机制中起重要作用。必须对Ach这种与特应性相关作用所涉及的神经元机制进行进一步研究。
