The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology (한방안이비인후피부과학회지)

The Society of Korean Medicine Ophthalmology, Otolaryngology & Dermatology (대한한방안이비인후피부과학회)
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A Review of the Latest Discussions on the Mechanism of Itching - A Study on Recent Research Trend and the Relationship between Gastrointestinal Tract and Itching

가려움증의 기전에 대한 최신 논의 고찰 - 최근의 연구 동향과 위장관계와의 연관성

  • Kim, Jundong (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Han, Chang-Yi (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Seo, Gwang-Yeel (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Kyu-Seok (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Yoon-Bum (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University)
  • 김준동 (경희대학교 한의과대학 안이비인후피부과) ;
  • 한창이 (경희대학교 한의과대학 안이비인후피부과) ;
  • 서광일 (경희대학교 한의과대학 안이비인후피부과) ;
  • 김규석 (경희대학교 한의과대학 안이비인후피부과) ;
  • 김윤범 (경희대학교 한의과대학 안이비인후피부과)
  • Received : 2021.07.02
  • Accepted : 2021.07.31
  • Published : 2021.08.25
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Abstract

Objectives : The purpose of this study is to review the latest discussions on the mechanism of Itching. Methods : Articles that reviewed the mechanism of itching were searched from Pubmed (January 2016 to June 2021). In addition, review articles discussing the gastrointestinal tract and the mechanisms of pruritus were searched seperately. Results : The articles are classified into three categories. These categories are the classification according to the passage of time (acute, chronic), the immune factors involved (inflammatory, non-inflammatory), and the neurophysiological mechanism (pruritoceptive itching, neuropathic itching, neurogenic itching, psychogenic itching). In each category, the articles over the past five years are summarized and reviewed. Also, how the status of the gastrointestinal tract is reflected in itching was discussed in terms of leaky gut syndrome, neuro/gastrointestinal peptides, and gut microbiota. Conclusions : This review introduces the recently discussed mechanism of itching, and in particular, examines how the gastrointestinal tract is related to skin itching. Based on these considerations, it is expected that more diverse therapeutic approaches can be explored in the future.

Keywords

References

  1. Song J, Xian D, Yang L, Xiong X, Lai R, Zhong J. Pruritus: Progress toward Pathogenesis and Treatment. BioMed research international. 2018;2018:9625936. https://doi.org/10.1155/2018/9625936
  2. Weisshaar E, Szepietowski J, Dalgard F, Garcovich S, Gieler U, Gimenez-Arnau Ana, et al. European S2k Guideline on Chronic Pruritus. Acta dermato-venereologica. 2019; 99(5):469-506. https://doi.org/10.2340/00015555-3164
  3. Whang K, Khanna R, Williams K, Mahadevan, Varun S, Yevgeniy K, Shawn G, et al. Health-Related QOL and Economic Burden of Chronic Pruritus. J Invest Dermatol 2021;141(4):754-60. https://doi.org/10.1016/j.jid.2020.08.020
  4. Besner Morin C, Misery L. Emerging Treatments and Novel Pathways in Pruritus. Journal of Cutaneous Medicine and Surgery 2019;23(5):528-36. https://doi.org/10.1177/1203475419852050
  5. Park JG, Park HJ, Chae Y, Kim YK, Lee H, Kim K, et al. Acupuncture Treatment for Symptom Management in Atopic Dermatitis: A Study Protocol for a Randomized, Participant- and Assessor-Blind, ShamControlled Trial. Evidence-based Complement Altern Med. 2019;2019:1907578.
  6. Dong X, Dong X. Peripheral and Central Mechanisms of Itch. Neuron 2018; 98(3): 482-94. https://doi.org/10.1016/j.neuron.2018.03.023
  7. Wong LS, Wu T, Lee CH. Inflammatory and Noninflammatory Itch: Implications in Pathophysiology-Directed Treatments. Int J Mol Sci. 2017;18(7):1-13.
  8. Green D, Dong X. The cell biology of acute itch. J Cell Biol. 2016;213(2):155-61. https://doi.org/10.1083/jcb.201603042
  9. Maglie R, Araujo D, Antiga E, Geppetti P, Nassini R, Logu F, et al. The role of trpa1 in skin physiology and pathology. International Journal of Molecular Sciences 2021;22 (6):1-13.
  10. Xie B, Li X. Inflammatory mediators causing cutaneous chronic itch in some diseases via transient receptor potential channel subfamily V member 1 and subfamily A member 1. J Dermatol 2019;46(3):177-85. https://doi.org/10.1111/1346-8138.14749
  11. Silverman H, Chen A, Kravatz N, Chavan, Sangeeta S, Chang E, et al. Involvement of Neural Transient Receptor Potential Channels in Peripheral Inflammation. Front Immunol. 2020;11:590261. https://doi.org/10.3389/fimmu.2020.590261
  12. Tsuda M. Spinal dorsal horn astrocytes: New players in chronic itch. Allergol Int. 2017;66(1):31-5. https://doi.org/10.1016/j.alit.2016.07.007
  13. Shiratori H, Tsuda M. Role of reactive astrocytes in the spinal dorsal horn under chronic itch conditions. Journal of Pharmacological Sciences. 2020;144(3): 147-50. https://doi.org/10.1016/j.jphs.2020.07.010
  14. Garcovich S, Maurelli M, Gisondi P, Peris K, Yosipovitch G, Girolomoni G, et al. Pruritus as a distinctive feature of type 2 inflammation. Journal of Pharmacological Sciences. 2021;9(3):1-16.
  15. Oetjen LK, Mack MR, Feng J, Whelan T, Niu H, Guo C, et al. Sensory Neurons Co-opt Classical Immune Signaling Pathways to Mediate Chronic Itch. Cell. 2017;171(1): 217-28. https://doi.org/10.1016/j.cell.2017.08.006
  16. Xu J, Zanvit P, Hu L, Tseng P, Liu N, Wang F, et al. The Cytokine TGF-β Induces Interleukin-31 Expression from Dermal Dendritic Cells to Activate Sensory Neurons and Stimulate Wound Itching. Immunity. 2020;53(2):371-83. https://doi.org/10.1016/j.immuni.2020.06.023
  17. Wang F, Yang T, Kim BS. The Return of the Mast Cell: New Roles in Neuroimmune Itch Biology. J Invest Dermatol. 2020; 140(5): 945-51. https://doi.org/10.1016/j.jid.2019.12.011
  18. Landucci E, Laurino A, Cinci L, Gencarelli M, Raimondi L. Thyroid Hormone, Thyroid Hormone Metabolites and Mast Cells: A Less Explored Issue. Front Cell Neurosci 2019; 13(79):1-7.
  19. Kim HS, Kawakami Y, Kasakura K, Toshiaki K, et al. Recent advances in mast cell activation and regulation. F1000Research. 2020;19(9):1-11.
  20. Gupta K, Harvima I. Mast cell-neural interactions contribute to pain and itch. Immunol Rev. 2018;282(1):168-87. https://doi.org/10.1111/imr.12622
  21. Green D, Limjunyawong N, Gour N, Pundir P, Dong X. A mast-cell-specific receptor mediates neurogenic inflammation and pain. Neuron. 2019;101(3):412-20. https://doi.org/10.1016/j.neuron.2019.01.012
  22. Petra A, Panagiotidou S, Stewart J, Conti P, Theoharides T. Spectrum of mast cell activation disorders. Expert Review of Clinical Immunology. 2014;10(6):729-39. https://doi.org/10.1586/1744666X.2014.906302
  23. Kimata H. Enhancement of allergic skin wheal responses in patients with atopic eczema/dermatitis syndrome by playing video games or by a frequently ringing mobile phone. Eur J Clin Invest. 2003; 33(6):513-17. https://doi.org/10.1046/j.1365-2362.2003.01177.x
  24. Lee JC, Park SK, Bang JK. Study on the Relationship between Dae-Jang-Jung-Gyeok (大腸正格) and Leaky Gut Syndrome. J Korean Med Class. 2013; 26(4):105-16. https://doi.org/10.14369/skmc.2013.26.4.105
  25. Fasano A. All disease begins in the (leaky) gut: Role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases. F1000Research. 2020; 9:69. https://doi.org/10.12688/f1000research.20510.1
  26. Farshchi M, Azad F, Salari R, Mirsadraee M, Anushiravani M, et al. A Viewpoint on the Leaky Gut Syndrome to Treat Allergic Asthma: A Novel Opinion. J Evidence-Based Complement Altern Med 2017;22(3):378-80. https://doi.org/10.1177/2156587216682169
  27. Odenwald M, Turner J. Intestinal Permeability Defects: Is It Time to Treat? Clin Gastroenterol Hepatol. 2013;11(9): 1075-83. https://doi.org/10.1016/j.cgh.2013.07.001
  28. Zhu T, Zhu T, Tran K, Sivamani R, Shi V. Epithelial barrier dysfunctions in atopic dermatitis: a skin-gut-lung model linking microbiome alteration and immune dysregulation. British Journal of Dermatology. 2018;179(3):570-581. https://doi.org/10.1111/bjd.16734
  29. Basci I, Ruzicka T. IL-31: A new key player in dermatology and beyond. Journal of Allergy and Clinical Immunology. 2018;141 (3): 858-66. https://doi.org/10.1016/j.jaci.2017.10.045
  30. Shamsi B, Chatoo M, Xu X, Xu X, Chen X, et al. Versatile Functions of Somatostatin and Somatostatin Receptors in the Gastrointestinal System. Frontiers in Endocrinology. 2021;12:652363. https://doi.org/10.3389/fendo.2021.652363
  31. Fatima M, Ren X, Pan H, Slade H, Asmar A, Xiong C, et al. Spinal somatostatin-positive interneurons transmit chemical itch. Pain. 2019;160(5):1166-74. https://doi.org/10.1097/j.pain.0000000000001499
  32. Weber HC. Gastrointestinal peptides and itch sensation. Current Opinion in Endocrinology, Diabetes and Obesity. 2015;22(1):29-33. https://doi.org/10.1097/MED.0000000000000122
  33. Hagstromer L, Emtestam L, Stridsberg M, Talme T. Expression pattern of somatostatin receptor subtypes 1-5 in human skin: An immunohistochemical study of healthy subjects and patients with psoriasis or atopic dermatitis. Exp Dermatol. 2006;15 (12):950-7. https://doi.org/10.1111/j.1600-0625.2006.00487.x
  34. Sanders K, Nattkemper L, Yosipovitch G. The gut-itch connection. Experimental Dermatology. 2016;25(5):344,345. https://doi.org/10.1111/exd.12994
  35. Kim HS, Yosipovitch G. The Skin Microbiota and Itch: Is There a Link? J Clin Med. 2020;9(4):1190. https://doi.org/10.3390/jcm9041190
  36. Salem I, Ramser A, Isham N, Ghannoum M. The gut microbiome as a major regulator of the gut-skin axis. Frontiers in Microbiology. 2018;9:1459. https://doi.org/10.3389/fmicb.2018.01459
  37. O'Neill C, Monteleone G, McLaughlin J, Paus R. The gut-skin axis in health and disease: A paradigm with therapeutic implications. BioEssays. 2016;38(11):1167-76. https://doi.org/10.1002/bies.201600008
  38. Ogawa M, Saiki A, Matsui Y, Tsuchimoto N, Nakakita Y, Takata Y, et al. Effects of oral intake of heat-killed Lactobacillus brevis SBC8803 (SBL88TM) on dry skin conditions: A randomized,double-blind,placebo-controlled study. Exp Ther Med. 2016;12(6):3863-72. https://doi.org/10.3892/etm.2016.3862
  39. Song H, Yoo Y, Hwang JH, Na YC, Kim HN. Faecalibacterium prausnitzii subspecies-level dysbiosis in the human gut microbiome underlying atopic dermatitis. J Allergy Clin Immunol. 2016;137(3):852-60. https://doi.org/10.1016/j.jaci.2015.08.021