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首页> 外文期刊>Allergy >Temperature modulated histamine-itch in lesional and nonlesional skin in atopic eczema - a combined psychophysical and neuroimaging study.
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Temperature modulated histamine-itch in lesional and nonlesional skin in atopic eczema - a combined psychophysical and neuroimaging study.

机译：特应性湿疹的病变和非病变皮肤中温度调节的组胺痒-心理物理和神经影像学的联合研究。

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BACKGROUND: Itch is the major symptom of many allergic diseases; yet it is still difficult to measure objectively. The aim of this study was to use an evaluated itch stimulus model in lesional (LS) and nonlesional (NLS) atopic eczema (AE) skin and to characterize cerebral responses using functional magnetic resonance imaging (fMRI). METHODS: Thermal modulation was performed on a histamine stimulus in randomized order on LS or NLS in rapid alternating order from 32 degrees C (warm) to 25 degrees C (cold). Subjective itch ratings were recorded. Additionally, fMRI measurements were used to analyze the cerebral processing (n = 13). Healthy skin (HS) of age-matched volunteers served as control (n = 9). RESULTS: Mean VAS itch intensity was significantly (P < 0.0001) higher during the relative cold [55.2 +/- 8.3% (LS); 48.6 +/- 8.2% (NLS)] compared to the relative warm blocks [36.0 +/- 7.3% (LS); 33.7 +/- 7.6% (NLS)]. Compared to HS, the itch response was delayed in LS and NLS. Itch intensity was perceived highest in LS, followed by NLS and HS. For NLS, fMRI revealed at the beginning of the itch provocation a cerebral deactivation pattern in itch processing structures (thalamus, prefrontal, cingulate, insular, somatosensory and motor cortex). During the course of stimulation, the cerebral deactivation was reduced with time and instead an activation of the basal ganglia occurred. In contrast LS showed an activation instead of deactivation pattern already at the beginning of the stimulation in the above mentioned structures. CONCLUSIONS: Moderate short-term temperature modulation led to a reproducible, significant enhancement of histamine-induced itch with the strongest effect in LS. The differences in itch perception and itch kinetics between healthy volunteers and NLS in patients point towards an ongoing central inhibitory activity patients with AE, especially at the beginning of the itch provocation.
机译：背景：瘙痒是许多过敏性疾病的主要症状。但是仍然很难客观地衡量。这项研究的目的是在病变（LS）和非病变（NLS）特应性湿疹（AE）皮肤中使用经过评估的瘙痒刺激模型，并使用功能磁共振成像（fMRI）表征脑反应。方法：对组胺刺激物以随机顺序在LS或NLS上以从32摄氏度（热）到25摄氏度（冷）的快速交替顺序进行热调节。记录主观瘙痒等级。此外，功能磁共振成像测量被用来分析大脑的处理（n = 13）。年龄匹配的志愿者的健康皮肤（HS）作为对照（n = 9）。结果：相对寒冷时，平均VAS瘙痒强度显着升高（P <0.0001）[55.2 +/- 8.3％（LS）; 48.6 +/- 8.2％（NLS）]，而相对暖块[36.0 +/- 7.3％（LS）; 33.7 +/- 7.6％（NLS）]。与HS相比，LS和NLS的瘙痒反应延迟。 LS中瘙痒强度最高，其次是NLS和HS。对于NLS，fMRI在瘙痒激发的开始时揭示了瘙痒处理结构（丘脑，前额叶，扣带状，岛状，体感和运动皮层）的大脑失活模式。在刺激过程中，大脑的失活随着时间的推移而减少，取而代之的是基底神经节的激活。相反，在上述结构中，LS在刺激开始时就已经显示出激活而不是失活的模式。结论：适度的短期温度调节导致可重现的组胺诱导的瘙痒明显增强，在LS中最强。患者的健康志愿者与NLS之间的瘙痒知觉和瘙痒动力学的差异表明，正在进行中的AE的中心抑制活动患者，尤其是在瘙痒激发开始时。

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