Itch Processing in the Skin

Itching can result from activity of specialized primary afferent neurons (“pruriceptors”) that have been shown to express certain molecular markers such as B-type natriuretic peptide and several members of the Mrgpr-family in rodents. On the other hand, neurons involved in pain processing (“nocicept...

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Main Author: Martin Schmelz
Format: Article
Language:English
Published: Frontiers Media S.A. 2019-07-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fmed.2019.00167/full
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author Martin Schmelz
author_facet Martin Schmelz
author_sort Martin Schmelz
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description Itching can result from activity of specialized primary afferent neurons (“pruriceptors”) that have been shown to express certain molecular markers such as B-type natriuretic peptide and several members of the Mrgpr-family in rodents. On the other hand, neurons involved in pain processing (“nociceptors”) can also provoke itching when the activation site is restricted to an isolated tiny spot within the epidermis. Individuals classified as having sensitive skin report increased itching and pain sensations upon weak external stimuli that are not painful or itchy in the control group. Numerous possible factors could contribute to sensitive skin along the pathway of transduction of the external stimuli into peripheral neuronal signals, followed by neuronal processing, finally resulting in the perception: (a) reduced local protective factors leading to impaired skin barrier function, (b) increased production of excitatory skin mediators, (c) sensitized peripheral neurons, (d) facilitated spinal and central processing, and (e) reduced descending inhibition from the central nervous system. For all of those pathophysiological mechanisms there are clinical examples such as atopic dermatitis (a,b,c), neuropathic itching (c,e), and restless leg syndrome (d,e). However, none of these factors have been directly linked to the occurrence of sensitive skin. Moreover, individuals reporting sensitive skin are heterogeneous and a subpopulation with defined pathophysiology has not yet been identified. Given that the condition is reported in about 50% of women, and thereby includes many healthy individuals, it appears problematic to assign a definitive pathophysiological mechanism to it.
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spelling doaj.art-4c9f4686985e46599069cefa39d5d6922022-12-21T17:56:24ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2019-07-01610.3389/fmed.2019.00167472166Itch Processing in the SkinMartin SchmelzItching can result from activity of specialized primary afferent neurons (“pruriceptors”) that have been shown to express certain molecular markers such as B-type natriuretic peptide and several members of the Mrgpr-family in rodents. On the other hand, neurons involved in pain processing (“nociceptors”) can also provoke itching when the activation site is restricted to an isolated tiny spot within the epidermis. Individuals classified as having sensitive skin report increased itching and pain sensations upon weak external stimuli that are not painful or itchy in the control group. Numerous possible factors could contribute to sensitive skin along the pathway of transduction of the external stimuli into peripheral neuronal signals, followed by neuronal processing, finally resulting in the perception: (a) reduced local protective factors leading to impaired skin barrier function, (b) increased production of excitatory skin mediators, (c) sensitized peripheral neurons, (d) facilitated spinal and central processing, and (e) reduced descending inhibition from the central nervous system. For all of those pathophysiological mechanisms there are clinical examples such as atopic dermatitis (a,b,c), neuropathic itching (c,e), and restless leg syndrome (d,e). However, none of these factors have been directly linked to the occurrence of sensitive skin. Moreover, individuals reporting sensitive skin are heterogeneous and a subpopulation with defined pathophysiology has not yet been identified. Given that the condition is reported in about 50% of women, and thereby includes many healthy individuals, it appears problematic to assign a definitive pathophysiological mechanism to it.https://www.frontiersin.org/article/10.3389/fmed.2019.00167/fullneuropathic itchsensitizationpattern theoryitch pathwaydegenerationinflammation
spellingShingle Martin Schmelz
Itch Processing in the Skin
Frontiers in Medicine
neuropathic itch
sensitization
pattern theory
itch pathway
degeneration
inflammation
title Itch Processing in the Skin
title_full Itch Processing in the Skin
title_fullStr Itch Processing in the Skin
title_full_unstemmed Itch Processing in the Skin
title_short Itch Processing in the Skin
title_sort itch processing in the skin
topic neuropathic itch
sensitization
pattern theory
itch pathway
degeneration
inflammation
url https://www.frontiersin.org/article/10.3389/fmed.2019.00167/full
work_keys_str_mv AT martinschmelz itchprocessingintheskin