From the brain-skin connection: The neuroendocrine-immune misalliance of stress and itch
From the brain-skin connection: The neuroendocrine-immune misalliance of stress and itch
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DOI：
10.1159/000104863
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发表时间：
2006-01-01
影响因子：
2.4
通讯作者：
Paus, Ralf
中科院分区：
文献类型：
--
作者：
Arck, Petra;Paus, Ralf
长期以来，感觉到的压力与神经、内分泌和免疫系统之间建立的动态平衡失调有关，从而引发或加重疾病表现。目前已认识到，心理压力会使几种常见的皮肤病恶化，特别是免疫性皮肤病，如特应性皮炎、银屑病、脂溢性湿疹、结节性湿疹、扁平苔藓、慢性荨麻疹、斑秃和无物质性瘙痒症。瘙痒（瘙痒症）可能是与大多数这些炎性皮肤病相关的最常见症状，并且急性和慢性应激感知被认为会触发或增强瘙痒症。大量的介质释放全身或局部在皮肤中响应于应力增加感觉神经支配，上调其他致炎剂的产生，使（神经源性）炎症永久化并降低瘙痒阈值。在这篇综述中，我们探讨了压力和瘙痒研究的最新前沿，并将慢性皮肤炎症和瘙痒的持续描述为神经内分泌免疫的“失调”。我们认为，具有强烈致瘙痒潜力的应激反应的关键候选分子，如神经生长因子，促肾上腺皮质激素释放激素和P物质，以及肥大细胞，可能被认为是“致瘙痒炎症的中央细胞开关板”，需要进一步系统地探索，以开发更有效的治疗组合策略，用于慢性，易受压力影响的炎症性皮肤病版权所有（c）2006 S. Karger AG，巴塞尔。
Perceived stress has long been allied with disturbances of the dynamic equilibrium established between the nervous, endocrine and immune systems, thus triggering or aggravating disease manifestation. Several common skin diseases are now acknowledged to be worsened by psychological stress, particularly immunodermatoses such as atopic dermatitis, psoriasis, seborrheic eczema, prurigo nodularis, lichen planus, chronic urticaria, alopecia areata and pruritus sine materia. Itch ( pruritus) is perhaps the most common symptom associated with a majority of these inflammatory skin diseases, and acute as well as chronic stress perceptions are recognized to trigger or enhance pruritus. A wealth of mediators released systemically or locally in the skin in response to stress increase sensory innervation, upregulate the production of other pruritogenic agents, perpetuate ( neurogenic) inflammation and lower the itch threshold. In the present review, we explore recent frontiers in both stress and pruritus research and portray the perpetuation of chronic skin inflammation and itch as a neuroendocrine-immune 'misalliance'. We argue that key candidate molecules of the stress response with strong pruritogenic potential, such as nerve growth factor, corticotropin-releasing hormone and substance P, and mast cells, which may be considered as 'central cellular switchboards of pruritogenic inflammation', need to be further explored systematically in order to develop more effective therapeutic combination strategies for itch management in chronic, stress-vulnerable inflammatory skin diseases Copyright (c) 2006 S. Karger AG, Basel.