4.4 Review

Peripheral itch sensitization in atopic dermatitis

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Summary: This study provides evidence for a novel molecular signalling pathway for GS-induced pruritus, which involves the activation of both 5-HT2A receptor and TRPV4 in mouse sensory neurons. These findings reveal the molecular mechanism underlying GS-induced itching.

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Peripheral endomorphins drive mechanical alloknesis under the enzymatic control of CD26/DPPIV

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Summary: IL-33 signaling may play a critical role in the development of chronic itch, depending on the tissue microenvironment.

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Summary: The study found that specific beta-defensins may be endogenous pruritogens that can directly stimulate sensory neurons, and that their expression is increased in skin lesions.

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Summary: These preclinical findings indicate that IL-13 plays a direct enhancer role in multiple itch and neuroactive pathways as well as transcriptional downstream effects, providing insights into the mechanistic basis for lebrikizumab's anti-itch effects.

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A basophil-neuronal axis promotes itch

Fang Wang et al.

Summary: The study identifies that a large proportion of patients with atopic dermatitis (AD) harbor allergen-specific immunoglobulin E (IgE) and exhibit a propensity for acute itch flares. It also shows that in AD-associated inflammation, a previously unrecognized basophil-leukotriene (LT) axis emerges as critical for acute itch flares.
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Tick peptides evoke itch by activating MrgprC77/MRGPRX7 to sensitize TRPV7 in pruriceptors

Xueke Li et al.

Summary: This study identified tick salivary peptides as pruritogens that initiate itch through MrgprC11/X1-TRPV1 signaling in pruritoceptors. The findings provide potential drug targets for the prevention and treatment of pruritus induced by tick bites or other arthropods. IPDef1 was found to have a stronger pruritogenic potential than IRDef2 and induced itch in a histamine-independent manner.

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Connections between Immune-Derived Mediators and Sensory Nerves for Itch Sensation

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Summary: Recent studies have shown that non-histaminergic mediators such as proteases, neuropeptides, and cytokines play a role in evoking and modulating itch sensation, acting on sensory nerve fibers in the skin. Understanding the connections between immune cell-derived mediators and sensory nerve fibers has led to the development of new treatments for itch.

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Oncostatin M can sensitize sensory neurons in inflammatory pruritus

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Summary: The cytokine oncostatin M (OSM) is highly up-regulated in various inflammatory skin diseases and acts as an itch neuromodulator by sensitizing neurons to pruritogens. Antagonism of the OSMR complex effectively alleviates pruritus in experimental inflammatory dermatitis, indicating OSM signal transduction as a potential target for antipruritic therapy.

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Eileen Nguyen et al.

Summary: The study found that morphine-induced itch is caused by neurons rather than mast cells, and spinal dynorphin neurons play an important role in mice. Agonism of the kappa-opioid receptor can alleviate morphine-induced itch, challenging the long-standing use of antihistamines.

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Cutaneous Neuroimmune Interactions of TSLP and TRPV4 Play Pivotal Roles in Dry Skin-Induced Pruritus

Wook-Joo Lee et al.

Summary: The study reveals that the neuroimmune interactions of TSLP and TRPV4 play key roles in dry skin-induced pruritus. Treatment with a TRPV4 antagonist or knockout of the Trpv4 gene can alleviate dry skin symptoms and itching.

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Summary: Recent evidence on type 2 inflammation-associated itch in atopic dermatitis has been reported, highlighting the importance of neuroimmune interactions in research. Understanding bidirectional neuroimmune interactions is crucial in gaining insights into the pathogenesis of itch and its treatment. Improved management and treatment options for itch in atopic dermatitis are being explored through novel and targeted biologic agents in advanced clinical trials.

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Possible involvement of type 2 cytokines in alloknesis in mouse models of menopause and dry skin

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Summary: The phenomenon of alloknesis, an abnormal itch sensation induced by innocuous stimuli, is a key aspect in the itch-scratch cycle in patients with atopic dermatitis. Dry skin and pruritus, including alloknesis, are significant issues in peri- and post-menopausal women. Research has shown that impaired barrier function, in combination with type 2 cytokines from eosinophils and basophils in the skin, could trigger the development of alloknesis, suggesting potential therapeutic targets for sensitive skin.

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Giuseppe Ingrasci et al.

Summary: While the etiologies of chronic pruritus are diverse, recent research suggests that there are similar interactions between keratinocytes, nerves, and the immune system in many conditions. The type 2 immune response, involving Th2 T Cells and related cytokines, plays a significant role in the development of pruritus in various itchy conditions. Atopic dermatitis is a prominent example, but the evidence supporting its role in other itchy conditions is growing, with new treatments targeting this immune system pathway being developed.

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