title: There is no functional small-fibre neuropathy in prurigo nodularis despite neuroanatomical alterations.
abstract: Prurigo nodularis (PN) is a pruritic condition with altered epidermal neuroanatomy as demonstrated previously. Here we elucidated neuroimmunological mechanisms by combining functional, morphological and gene expression experiments in twelve subjects with PN and eight healthy controls. Subjects with PN showed a reduced intra-epidermal nerve fibre density (IENFD) in lesional skin. Quantitative sensory testing indicated maintenance of somatosensory function compared to controls. None of the tested molecular markers including the neuron-distracting SEMA3A and neuron-attracting NGF were altered in lesional vs non-lesional skin in PN subjects. Accordingly, we speculate that scratching may contribute to reduced IENFD rather than an authentic endogenous neuropathy.
authors.affiliation: Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany.
authors.forename: Manuel P
authors.identifier: 0000-0001-5649-2698
authors.initials: MP
authors.lastname: Pereira
authors.affiliation: Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Esther
authors.initials: E
authors.lastname: Pogatzki-Zahn
authors.affiliation: Health, Medical and Neuropsychology Unit, Institute of Psychology, University of Leiden, Leiden, The Netherlands.
authors.forename: Chantal
authors.initials: C
authors.lastname: Snels
authors.affiliation: Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany.
authors.forename: Thai-Ha
authors.initials: TH
authors.lastname: Vu
authors.affiliation: Department of Neurology, University of Würzburg, Würzburg, Germany.
authors.forename: Nurcan
authors.initials: N
authors.lastname: Üçeyler
authors.affiliation: Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Loser
authors.affiliation: Department of Neurology, University of Würzburg, Würzburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Sommer
authors.affiliation: Health, Medical and Neuropsychology Unit, Institute of Psychology, University of Leiden, Leiden, The Netherlands.
authors.forename: Andrea Walburga Maria
authors.initials: AWM
authors.lastname: Evers
authors.affiliation: Health, Medical and Neuropsychology Unit, Institute of Psychology, University of Leiden, Leiden, The Netherlands.
authors.forename: Antoinette I M
authors.initials: AIM
authors.lastname: van Laarhoven
authors.affiliation: Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Agelopoulos
authors.affiliation: Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Ständer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004817:Epidermis / Q000294:innervation*; D005260:Female; D015870:Gene Expression; D006801:Humans; D007378:Interleukins / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology* / Q000502:physiology; D020932:Nerve Growth Factor / Q000235:genetics; D010525:Peripheral Nerves / Q000473:pathology* / Q000503:physiopathology; D011536:Prurigo / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D040121:Semaphorin-3A / Q000235:genetics
chemical_list: C502187:IL31 protein, human; D007378:Interleukins; C108639:SEMA3A protein, human; D040121:Semaphorin-3A; D020932:Nerve Growth Factor
keywords: SEMA3A; chronic pruritus; interleukin-31; quantitative sensory testing; small-fibre neuropathy