Separate peripheral pathways for pruritus in man.
Recent findings suggest that itch produced by intradermal insertion of cowhage spicules in human is histamine independent. Neuronal mechanisms underlying nonhistaminergic itch are poorly understood. To investigate which nerve fibers mediate cowhage induced itch in man, action potentials were recorded from cutaneous C-fibers of the peroneal nerve in healthy volunteers using microneurography. Mechano-responsive and -insensitive C-nociceptors were tested for their responsiveness to cowhage spicules, histamine, and capsaicin. Cowhage spicules induced itching and activated all tested mechano-responsive C-units (24/24), but no mechano-insensitive C-fibers (0/17). Histamine also induced itch, but in contrast to cowhage, it caused lasting activation only in mechano-insensitive units (8/12). In mechano-responsive C-units, histamine caused no or only short and weak responses unrelated to the time course of itching. Capsaicin injections activated four of six mechano-responsive fibers and three of four mechano-insensitive C-fibers. Cowhage and histamine activate distinctly different nonoverlapping populations of C-fibers while inducing similar sensations of itch. We hypothesize that cowhage activates a pathway for itch that originates peripherally from superficial mechano-responsive (polymodal) C-fibers and perhaps other afferent units. It is distinct from the pathway for histamine-mediated pruritus and does not involve the histamine-sensitive mechano-insensitive fibers.
Department of Physiology and Pathophysiology, University of Erlangen/Nürnberg, Germany.
Barbara
B
Namer
Richard
R
Carr
Lisa M
LM
Johanek
Martin
M
Schmelz
Hermann O
HO
Handwerker
Matthias
M
Ringkamp
D002211:Capsaicin / Q000494:pharmacology; D004558:Electric Stimulation; D004594:Electrophysiology; D006632:Histamine / Q000494:pharmacology; D006358:Hot Temperature; D006801:Humans; D008465:Mechanoreceptors / Q000502:physiology; D031299:Mucuna / Q000502:physiology; D036421:Nerve Fibers, Unmyelinated / Q000145:classification / Q000502:physiology; D009434:Neural Pathways / Q000503:physiopathology*; D009475:Neurons, Afferent / Q000187:drug effects; D010146:Pain / Q000503:physiopathology; D010525:Peripheral Nerves / Q000503:physiopathology*; D010812:Physical Stimulation; D011537:Pruritus / Q000209:etiology / Q000503:physiopathology*; D011601:Psychophysics; D012867:Skin / Q000294:innervation; D013268:Stimulation, Chemical
D006632:Histamine; D002211:Capsaicin