Pub Date : 2019-07-01DOI: 10.1097/itx.0000000000000025
Taylor Follansbee, Yan Zhou, Xuesong Wu, Jeremy Delahanty, Amanda Nguyen, Dan Domocos, Mirela Iodi Carstens, Samuel T Hwang, Earl Carstens
Plaque psoriasis is a chronic inflammatory skin disease that affects a substantial proportion of the world population. This disorder is characterized by scaly, thick skin, intense ongoing itch, and itch from light touch (such as clothing contacting skin, called "alloknesis"). Imiquimod is a topical treatment for basal cell carcinomas and warts that has been used to create a mouse model of plaque psoriasis. Imiquimod-treated male, but not female, wildtype B6 mice showed significant increases in spontaneous scratching, while both sexes exhibited increased alloknesis, indicative of chronic itch. TRPV1 and TRPA1 knockout (KO) mice all exhibited numeric increases in spontaneous scratching which were significant for TRPV1KO mice and TRPA1KO males. Female TRPV1KO and TRPA1KO mice exhibited imiquimod-induced increases in alloknesis scores that did not significantly differ from wildtypes, while alloknesis scores in imiquimod-treated male TRPV1KO and TRPA1KO mice were significantly lower compared with wildtypes, suggesting that these ion channels are necessary for the development of alloknesis in males but not females in this model. Curiously, none of the groups exhibited any significant overall change in chloroquine-evoked scratching following imiquimod treatment, indicating that hyperknesis does not develop in this mouse model. Overall, the data indicate that there are sex differences in this mouse model of psoriasis, and that TRPV1 and TRPA1 ion channels have a small role in promoting the development of itch sensitization. This contrasts with the far greater role these channels play in the manifestation of skin changes in psoriatic dermatitis.
{"title":"Signs of chronic itch in the mouse imiquimod model of psoriasiform dermatitis: sex differences and roles of TRPV1 and TRPA1.","authors":"Taylor Follansbee, Yan Zhou, Xuesong Wu, Jeremy Delahanty, Amanda Nguyen, Dan Domocos, Mirela Iodi Carstens, Samuel T Hwang, Earl Carstens","doi":"10.1097/itx.0000000000000025","DOIUrl":"https://doi.org/10.1097/itx.0000000000000025","url":null,"abstract":"<p><p>Plaque psoriasis is a chronic inflammatory skin disease that affects a substantial proportion of the world population. This disorder is characterized by scaly, thick skin, intense ongoing itch, and itch from light touch (such as clothing contacting skin, called \"alloknesis\"). Imiquimod is a topical treatment for basal cell carcinomas and warts that has been used to create a mouse model of plaque psoriasis. Imiquimod-treated male, but not female, wildtype B6 mice showed significant increases in spontaneous scratching, while both sexes exhibited increased alloknesis, indicative of chronic itch. TRPV1 and TRPA1 knockout (KO) mice all exhibited numeric increases in spontaneous scratching which were significant for TRPV1KO mice and TRPA1KO males. Female TRPV1KO and TRPA1KO mice exhibited imiquimod-induced increases in alloknesis scores that did not significantly differ from wildtypes, while alloknesis scores in imiquimod-treated male TRPV1KO and TRPA1KO mice were significantly lower compared with wildtypes, suggesting that these ion channels are necessary for the development of alloknesis in males but not females in this model. Curiously, none of the groups exhibited any significant overall change in chloroquine-evoked scratching following imiquimod treatment, indicating that hyperknesis does not develop in this mouse model. Overall, the data indicate that there are sex differences in this mouse model of psoriasis, and that TRPV1 and TRPA1 ion channels have a small role in promoting the development of itch sensitization. This contrasts with the far greater role these channels play in the manifestation of skin changes in psoriatic dermatitis.</p>","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"4 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/itx.0000000000000025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39121773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01Epub Date: 2019-08-01DOI: 10.1097/itx.0000000000000028
Pang-Yen Tseng, Qin Zheng, Zhe Li, Xinzhong Dong
In this study, we sought to elucidate the molecular mechanism underlying human Mas-related G protein-coupled receptor X1 (MrgprX1) mediated itch sensation. We found that activation of MrgprX1 by BAM8-22 triggered robust action potential discharges in dorsal root ganglion (DRG) neurons. This neuronal excitability is not mediated by Transient receptor potential (TRP) cation channels, M-type potassium channels, or chloride channels. Instead, activation of MrgprX1 lowers the activation threshold of TTX-resistant sodium channels and induces inward sodium currents. These MrgprX1-elicited action potential discharges can be blocked by Pertussis toxin (PTX) and a Gβγ inhibitor - Gallein. Behavioral results showed that Nav1.9 knockout but not Trpa1 knockout significantly reduced BAM8-22 evoked scratching behavior. Collectively, these data suggest that activation of MrgprX1 triggers itch sensation by increasing the activity of TTX-resistant voltage-gated sodium channels.
{"title":"MrgprX1 Mediates Neuronal Excitability and Itch Through Tetrodotoxin-Resistant Sodium Channels.","authors":"Pang-Yen Tseng, Qin Zheng, Zhe Li, Xinzhong Dong","doi":"10.1097/itx.0000000000000028","DOIUrl":"https://doi.org/10.1097/itx.0000000000000028","url":null,"abstract":"<p><p>In this study, we sought to elucidate the molecular mechanism underlying human Mas-related G protein-coupled receptor X1 (MrgprX1) mediated itch sensation. We found that activation of MrgprX1 by BAM8-22 triggered robust action potential discharges in dorsal root ganglion (DRG) neurons. This neuronal excitability is not mediated by Transient receptor potential (TRP) cation channels, M-type potassium channels, or chloride channels. Instead, activation of MrgprX1 lowers the activation threshold of TTX-resistant sodium channels and induces inward sodium currents. These MrgprX1-elicited action potential discharges can be blocked by Pertussis toxin (PTX) and a Gβγ inhibitor - Gallein. Behavioral results showed that Nav1.9 knockout but not Trpa1 knockout significantly reduced BAM8-22 evoked scratching behavior. Collectively, these data suggest that activation of MrgprX1 triggers itch sensation by increasing the activity of TTX-resistant voltage-gated sodium channels.</p>","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"4 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/itx.0000000000000028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38816758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-26DOI: 10.1097/itx.0000000000000026
F. Dominick, A. V. Van Laarhoven, A. Evers, E. Weisshaar
Supplemental Digital Content is available in the text. Introduction: Itch can be perceived differently across patients and it can affect daily life in various ways. It is essential to assess those aspects that are relevant for the individual patient’s needs to improve treatment of patients suffering from acute or chronic itch. The International Forum for the Study on Itch (IFSI) Special Interest Group on “Questionnaires” aims to propose tools to assess different dimensions of itch and improve patient care. As a first step, this study aimed at a systematically reviewing existing patients’ self-report questionnaires on itch. Materials and methods: The databases PubMed, PsycINFO, and CINAHL were systematically searched for any scientific publication describing patients’ self-report questionnaires that assess itch-related information (≥2 items). Information about the publication was extracted by 2 experts as well as which of the 14 predefined dimensions of itch (by the IFSI Special Interest Group) were assessed within the questionnaire, for instance, duration of itch, itch aggravating or relieving factors, and effects on quality of life. Results: From a total of 5282 records, 58 articles were derived describing 62 questionnaires. Over half of the questionnaires were developed for dermatological conditions, and the vast majority targeted at adults. Most questionnaires address itch-related disability and itch intensity. Affective qualities of itch, coping with itch, response to current itch treatment, and the opinion on the origin of itch are infrequently asked for. Discussion: The number and content of the items within a dimension vary greatly. Measurement properties of the questionnaires were not systematically addressed, as these were often not reported in the original publication. Future research should focus on selecting adequate and reliable (sub)scales to develop a modular questionnaire system in order to uniformly assess the individual patient’s demands and improve care.
{"title":"A systematic review of questionnaires on itch by the Special Interest Group “Questionnaires” of the International Forum for the Study of Itch (IFSI)","authors":"F. Dominick, A. V. Van Laarhoven, A. Evers, E. Weisshaar","doi":"10.1097/itx.0000000000000026","DOIUrl":"https://doi.org/10.1097/itx.0000000000000026","url":null,"abstract":"Supplemental Digital Content is available in the text. Introduction: Itch can be perceived differently across patients and it can affect daily life in various ways. It is essential to assess those aspects that are relevant for the individual patient’s needs to improve treatment of patients suffering from acute or chronic itch. The International Forum for the Study on Itch (IFSI) Special Interest Group on “Questionnaires” aims to propose tools to assess different dimensions of itch and improve patient care. As a first step, this study aimed at a systematically reviewing existing patients’ self-report questionnaires on itch. Materials and methods: The databases PubMed, PsycINFO, and CINAHL were systematically searched for any scientific publication describing patients’ self-report questionnaires that assess itch-related information (≥2 items). Information about the publication was extracted by 2 experts as well as which of the 14 predefined dimensions of itch (by the IFSI Special Interest Group) were assessed within the questionnaire, for instance, duration of itch, itch aggravating or relieving factors, and effects on quality of life. Results: From a total of 5282 records, 58 articles were derived describing 62 questionnaires. Over half of the questionnaires were developed for dermatological conditions, and the vast majority targeted at adults. Most questionnaires address itch-related disability and itch intensity. Affective qualities of itch, coping with itch, response to current itch treatment, and the opinion on the origin of itch are infrequently asked for. Discussion: The number and content of the items within a dimension vary greatly. Measurement properties of the questionnaires were not systematically addressed, as these were often not reported in the original publication. Future research should focus on selecting adequate and reliable (sub)scales to develop a modular questionnaire system in order to uniformly assess the individual patient’s demands and improve care.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"4 1","pages":"e26 - e26"},"PeriodicalIF":0.0,"publicationDate":"2019-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/itx.0000000000000026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44906860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.1097/itx.0000000000000024
T. Ebata, Keiko Takahashi
We compared the status of chronic kidney disease-associated pruritus among outpatients of a hemodialysis (HD) clinic in 2008 and 2014, using identical questionnaires. All outpatients receiving HD participated in the study. The prevalence of pruritus over the week before questionnaire administration was not significantly different between 2008 (58.6%) and 2014 (50.0%). However, the percentage of patients with moderate to extreme itch decreased from 48.5% to 29.0% (P<0.01). The rate of patient satisfaction with the antipruritic treatment increased from 22.6% to 68.0% (P<0.01). Our experience may encourage physicians to modify antipruritic treatments for better patient care.
{"title":"Changes in prevalence and severity of chronic kidney disease-associated pruritus over 6 years in a community hemodialysis clinic: a retrospective observational study","authors":"T. Ebata, Keiko Takahashi","doi":"10.1097/itx.0000000000000024","DOIUrl":"https://doi.org/10.1097/itx.0000000000000024","url":null,"abstract":"We compared the status of chronic kidney disease-associated pruritus among outpatients of a hemodialysis (HD) clinic in 2008 and 2014, using identical questionnaires. All outpatients receiving HD participated in the study. The prevalence of pruritus over the week before questionnaire administration was not significantly different between 2008 (58.6%) and 2014 (50.0%). However, the percentage of patients with moderate to extreme itch decreased from 48.5% to 29.0% (P<0.01). The rate of patient satisfaction with the antipruritic treatment increased from 22.6% to 68.0% (P<0.01). Our experience may encourage physicians to modify antipruritic treatments for better patient care.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"4 1","pages":"e24 - e24"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/itx.0000000000000024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42315616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1097/itx.0000000000000019
A. C. Fostini, R. S. Golpanian, J. Rosen, R. Xue, G. Yosipovitch
Mosquito bites are the most common cause of acute itch in humans. The pathophysiology of itch in mosquito bites is not well understood, but 3 mechanisms have been hypothesized. These mechanisms are based on the assumption that mosquito salivary components are somehow implicated in the pruritus that results after a bite. In the first mechanism, salivary components such as histamine are said to directly induce itch via classic pruritic pathways. The second mechanism involves an IgE-dependent hypersensitivity response to salivary components. Finally, in the third mechanism, salivary components modulate an IgE-independent inflammatory response. Individuals’ susceptibility to being bitten relies on factors that may be altered by genetics, as certain immune-related loci have been associated with mosquito bite trait characteristics. Furthermore, certain disease states such as hematologic cancers and HIV may exaggerate the response to mosquito bites. Several preventative measures such as mosquito repellants should be used to prevent the bite of a mosquito, and in cases where bites cannot be avoided, most treatment options serve to relieve symptoms.
{"title":"Beat the bite: pathophysiology and management of itch in mosquito bites","authors":"A. C. Fostini, R. S. Golpanian, J. Rosen, R. Xue, G. Yosipovitch","doi":"10.1097/itx.0000000000000019","DOIUrl":"https://doi.org/10.1097/itx.0000000000000019","url":null,"abstract":"Mosquito bites are the most common cause of acute itch in humans. The pathophysiology of itch in mosquito bites is not well understood, but 3 mechanisms have been hypothesized. These mechanisms are based on the assumption that mosquito salivary components are somehow implicated in the pruritus that results after a bite. In the first mechanism, salivary components such as histamine are said to directly induce itch via classic pruritic pathways. The second mechanism involves an IgE-dependent hypersensitivity response to salivary components. Finally, in the third mechanism, salivary components modulate an IgE-independent inflammatory response. Individuals’ susceptibility to being bitten relies on factors that may be altered by genetics, as certain immune-related loci have been associated with mosquito bite trait characteristics. Furthermore, certain disease states such as hematologic cancers and HIV may exaggerate the response to mosquito bites. Several preventative measures such as mosquito repellants should be used to prevent the bite of a mosquito, and in cases where bites cannot be avoided, most treatment options serve to relieve symptoms.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"4 1","pages":"e19"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/itx.0000000000000019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48885019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1097/itx.0000000000000023
H. Mochizuki, L. Hernandez, G. Yosipovitch
Understanding the mechanism of itch as well as the pathophysiology of chronic itch is important for the development of effective treatments. In the past 25 years, researchers have investigated the cerebral mechanism of itch in healthy subjects and chronic itch patients using functional brain imaging techniques. These studies have demonstrated that a variety of cortical and subcortical areas are associated with itch. In addition, it has been found that there are differences in brain activity and brain anatomy between healthy subjects and chronic itch patients. In this review article, we discuss potential roles of those identified brain regions in itch perception, and associations of the functional and structural changes in the brain with chronic itch. Brain imaging studies of psychological modulations of itch are also discussed.
{"title":"What does brain imaging tell us about itch?","authors":"H. Mochizuki, L. Hernandez, G. Yosipovitch","doi":"10.1097/itx.0000000000000023","DOIUrl":"https://doi.org/10.1097/itx.0000000000000023","url":null,"abstract":"Understanding the mechanism of itch as well as the pathophysiology of chronic itch is important for the development of effective treatments. In the past 25 years, researchers have investigated the cerebral mechanism of itch in healthy subjects and chronic itch patients using functional brain imaging techniques. These studies have demonstrated that a variety of cortical and subcortical areas are associated with itch. In addition, it has been found that there are differences in brain activity and brain anatomy between healthy subjects and chronic itch patients. In this review article, we discuss potential roles of those identified brain regions in itch perception, and associations of the functional and structural changes in the brain with chronic itch. Brain imaging studies of psychological modulations of itch are also discussed.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"4 1","pages":"e23"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/itx.0000000000000023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48755376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.1097/itx.0000000000000022
T. Olivry, P. Bizikova
Introduction: Human atopic dermatitis (AD) keratinocytes overexpress nerve growth factor (NGF). Its inhibition, or that of its receptor, reduces itch in a mouse model of AD. In this study, we evaluated the expression of NGF in canine AD and assessed the effect of a caninized anti-NGF monoclonal antibody to delay flares of itch in dogs with natural AD. Methods: We used archived frozen skin biopsies from 6 house dust mite–sensitized atopic dogs after allergen challenge, 4 dogs with spontaneous AD and 1 dog with normal skin. The expression of NGF was evaluated by immunofluorescence. We also conducted a pilot crossover trial with 8 dogs with glucocorticoid-responsive AD. In both phases, the dogs were first treated for 28 days with oral prednisolone at 0.5 mg/kg/d. On the first day of the first phase, they received a saline subcutaneous injection, while on that of the second phase, they were injected with 0.2 mg/kg once of the caninized anti-dog NGF ranevetmab. The primary outcome measure was the time-to-flare, defined as the number of days between that of the last prednisolone administration and the day when the pruritus reached a score of at least 5.5/10, or 8 weeks, whichever came first. Results: In normal canine skin, the highest intensity of NGF staining was in stratum granulosum keratinocytes. After allergen challenge and in atopic canine skin, the NGF expression also extended downward to the upper stratum spinosum. In the pilot trial, the time-to-flare after prednisolone cessation was not significantly different between saline and ranevetmab-treated dogs. Discussion: While NGF is overexpressed in the atopic canine epidermis and after allergen challenge in sensitized dogs, the anti-NGF antibody ranevetmab did not delay pruritus flares after the discontinuation of prednisolone. Further studies are needed to assess if NGF is a relevant contributor for canine atopic itch.
{"title":"Investigations on the expression and relevance of nerve growth factor in dogs with atopic dermatitis","authors":"T. Olivry, P. Bizikova","doi":"10.1097/itx.0000000000000022","DOIUrl":"https://doi.org/10.1097/itx.0000000000000022","url":null,"abstract":"Introduction: Human atopic dermatitis (AD) keratinocytes overexpress nerve growth factor (NGF). Its inhibition, or that of its receptor, reduces itch in a mouse model of AD. In this study, we evaluated the expression of NGF in canine AD and assessed the effect of a caninized anti-NGF monoclonal antibody to delay flares of itch in dogs with natural AD. Methods: We used archived frozen skin biopsies from 6 house dust mite–sensitized atopic dogs after allergen challenge, 4 dogs with spontaneous AD and 1 dog with normal skin. The expression of NGF was evaluated by immunofluorescence. We also conducted a pilot crossover trial with 8 dogs with glucocorticoid-responsive AD. In both phases, the dogs were first treated for 28 days with oral prednisolone at 0.5 mg/kg/d. On the first day of the first phase, they received a saline subcutaneous injection, while on that of the second phase, they were injected with 0.2 mg/kg once of the caninized anti-dog NGF ranevetmab. The primary outcome measure was the time-to-flare, defined as the number of days between that of the last prednisolone administration and the day when the pruritus reached a score of at least 5.5/10, or 8 weeks, whichever came first. Results: In normal canine skin, the highest intensity of NGF staining was in stratum granulosum keratinocytes. After allergen challenge and in atopic canine skin, the NGF expression also extended downward to the upper stratum spinosum. In the pilot trial, the time-to-flare after prednisolone cessation was not significantly different between saline and ranevetmab-treated dogs. Discussion: While NGF is overexpressed in the atopic canine epidermis and after allergen challenge in sensitized dogs, the anti-NGF antibody ranevetmab did not delay pruritus flares after the discontinuation of prednisolone. Further studies are needed to assess if NGF is a relevant contributor for canine atopic itch.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"4 1","pages":"e22"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/itx.0000000000000022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61764982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/itx.0000000000000020
Seema P. Kini, Kuang‐Ho Chen, Suephy C. Chen
Introduction: Chronic pruritus (CP) is a common symptom, but can be a diagnostic and therapeutic challenge. Our objective was to determine how personality traits, and more specifically personality styles, influence quality of life (QoL) impact of CP. Methods: Cross-sectional study of patients with CP from 2 main groups: (1) National Eczema Association and (2) US Veterans Health Administration (VHA) National Patient Care Database. Participants (N=483) answered questions regarding demographics, characteristics of CP, personality traits (NEO Five-Factor Model) and pruritus impact (ItchyQoL). A multivariate linear regression was performed to determine which of 15 covariates (age, race, marital status, itch duration, itch frequency, and each of the 10 personality styles) were significantly associated with greater total mean ItchyQoL score (ie, greater burden of CP). Secondary outcome measures included the 3 ItchyQoL subscale scores (symptom, emotion, function). Results: The Lethargic personality style (low extraversion, low conscientiousness) was significantly associated with greater total mean ItchyQoL score (&bgr;=11.65, P=0.04) while the Overcontrolled (high neuroticism, high conscientiousness) and Undercontrolled (high neuroticism, low conscientiousness) styles were significantly associated with greater symptomatic impact from CP (&bgr;=2.76, P=0.01 and &bgr;=2.34, P=0.03), respectively. African American race was significantly associated with greater mean ItchyQoL score (&bgr;=8.14, P=0.002), ItchyQoL emotional score (&bgr;=2.98, P=0.02) and trended to significance for ItchyQoL symptom score (&bgr;=1.23, P=0.06). Curiously, white race was associated with higher ItchyQoL scores for the function construct (&bgr;=1.2, P=0.04). “Single” marital status trended to significance for higher mean ItchyQoL score (&bgr;=3.79, P=0.06). Discussion: Our results highlight certain personality styles (Lethargic, Overcontrolled, Undercontrolled) and important demographics (ie, African American race, single marital status) that may influence itch-related QoL impact. In the clinical setting these findings may suggest a role for support structures and other integrative measures (eg, support groups, cognitive and mindfulness based therapies) to augment traditional therapeutics for CP.
{"title":"Personality traits and styles may affect the reporting of chronic pruritus: a cross-sectional study","authors":"Seema P. Kini, Kuang‐Ho Chen, Suephy C. Chen","doi":"10.1097/itx.0000000000000020","DOIUrl":"https://doi.org/10.1097/itx.0000000000000020","url":null,"abstract":"Introduction: Chronic pruritus (CP) is a common symptom, but can be a diagnostic and therapeutic challenge. Our objective was to determine how personality traits, and more specifically personality styles, influence quality of life (QoL) impact of CP. Methods: Cross-sectional study of patients with CP from 2 main groups: (1) National Eczema Association and (2) US Veterans Health Administration (VHA) National Patient Care Database. Participants (N=483) answered questions regarding demographics, characteristics of CP, personality traits (NEO Five-Factor Model) and pruritus impact (ItchyQoL). A multivariate linear regression was performed to determine which of 15 covariates (age, race, marital status, itch duration, itch frequency, and each of the 10 personality styles) were significantly associated with greater total mean ItchyQoL score (ie, greater burden of CP). Secondary outcome measures included the 3 ItchyQoL subscale scores (symptom, emotion, function). Results: The Lethargic personality style (low extraversion, low conscientiousness) was significantly associated with greater total mean ItchyQoL score (&bgr;=11.65, P=0.04) while the Overcontrolled (high neuroticism, high conscientiousness) and Undercontrolled (high neuroticism, low conscientiousness) styles were significantly associated with greater symptomatic impact from CP (&bgr;=2.76, P=0.01 and &bgr;=2.34, P=0.03), respectively. African American race was significantly associated with greater mean ItchyQoL score (&bgr;=8.14, P=0.002), ItchyQoL emotional score (&bgr;=2.98, P=0.02) and trended to significance for ItchyQoL symptom score (&bgr;=1.23, P=0.06). Curiously, white race was associated with higher ItchyQoL scores for the function construct (&bgr;=1.2, P=0.04). “Single” marital status trended to significance for higher mean ItchyQoL score (&bgr;=3.79, P=0.06). Discussion: Our results highlight certain personality styles (Lethargic, Overcontrolled, Undercontrolled) and important demographics (ie, African American race, single marital status) that may influence itch-related QoL impact. In the clinical setting these findings may suggest a role for support structures and other integrative measures (eg, support groups, cognitive and mindfulness based therapies) to augment traditional therapeutics for CP.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"3 1","pages":"e20"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/itx.0000000000000020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45327889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/itx.0000000000000017
T. Hashimoto, J. Rosen, K. M. Sanders, G. Yosipovitch
Interactions between keratinocytes, immune cells, and sensory nerve endings strongly influence the sensation of itch. Mast cells, eosinophils, and T cells are commonly mentioned as immune cells involved in itch, meanwhile the role of neutrophils in pruritus is rarely discussed. However, neutrophils are capable of producing and releasing a variety of pruritogens such as histamine, proteases (neutrophil elastase and cathepsin S), prostaglandin E2, leukotriene B4, and platelet-activating factor. The purpose of this review is to highlight the role of neutrophils in the pathogenesis of several pruritic diseases, such as psoriasis, palmoplantar pustulosis, atopic dermatitis, malignant skin tumors (squamous cell carcinoma and basal cell carcinoma), bullous pemphigoid, dermatitis herpetiformis, chronic prurigo/prurigo nodularis, subacute prurigo, and prurigo pigmentosa.
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