Pathophysiology of Prurigo Nodularis: Neuroimmune Dysregulation and the Role of Type 2 Inflammation.

Shawn G Kwatra, Sonja Ständer, Gil Yosipovitch, Brian S Kim, Noah A Levit, John T O'Malley
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Abstract

Prurigo nodularis (PN) is a chronic, inflammatory skin condition characterized by multiple, intensely pruritic, distinctive nodular lesions. Subsequent scratching can further intensify the pruritus, culminating in a self-reinforcing itch-scratch cycle, which drives lesion development. The latest data indicate dysregulation of the neuroimmune axis in PN pathogenesis, including the involvement of sensory neurons, key effector immune cells, proinflammatory cytokines, dermal fibroblasts, and pruritogens. In this review, we highlight evidence supporting the role of type 2 immune axis dysregulation in driving the clinical presentation of PN and discuss how related signaling pathways may offer effective therapeutic targets to control PN signs and symptoms.

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结节性瘙痒症的病理生理学:神经免疫失调与 2 型炎症的作用。
结节性瘙痒症(Prurigo nodularis,PN)是一种慢性炎症性皮肤病,以多发性、剧烈瘙痒、明显的结节性皮损为特征。随后的搔抓会进一步加剧瘙痒,最终形成自我强化的瘙痒-搔抓循环,促使皮损发展。最新数据表明,神经免疫轴在 PN 发病机制中失调,包括感觉神经元、关键效应免疫细胞、促炎细胞因子、真皮成纤维细胞和瘙痒原的参与。在本综述中,我们将重点介绍支持 2 型免疫轴失调在 PN 临床表现中的作用的证据,并讨论相关信号通路如何为控制 PN 体征和症状提供有效的治疗靶点。
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