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Trends Immunol. 2018 Dec;39(12):980-991. doi: 10.1016/j.it.2018.10.001. Epub 2018 Nov 21.

The Itch-Scratch Cycle: A Neuroimmune Perspective.

Author information

1
Center for the Study of Itch, Washington University School of Medicine, St. Louis, MO 63110, USA; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
2
Center for the Study of Itch, Washington University School of Medicine, St. Louis, MO 63110, USA; Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA. Electronic address: https://twitter.com/@itchdoctor.

Abstract

Relentless, repetitive itching and scratching is a debilitating feature of many chronic inflammatory skin disorders such as atopic dermatitis. While well known clinically, this itch-scratch cycle has historically lacked in-depth mechanistic understanding. However, recent advances at the interface of itch neurobiology and skin immunology have shed new light on this phenomenon. In this review, we highlight recent advances in our understanding of the neuroimmunology of chronic itch centered around three key points of entry into the itch-scratch cycle: the epithelial barrier, the immune system, and the peripheral nervous system. Furthermore, we explore novel neuro-epithelial-immune interactions that may represent promising therapeutic paradigms.

KEYWORDS:

atopic dermatitis; cytokines; itch; neuroimmunity; proteases; scratch; skin barrier

PMID:
30471983
DOI:
10.1016/j.it.2018.10.001
[Indexed for MEDLINE]

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