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Common and discrete mechanisms underlying chronic pain and itch: peripheral and central sensitization

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Abstract

Normally, an obvious antagonism exists between pain and itch. In normal conditions, painful stimuli suppress itch sensation, whereas pain killers often generate itch. Although pain and itch are mediated by separate pathways under normal conditions, most chemicals are not highly specific to one sensation in chronic pathologic conditions. Notably, in patients with neuropathic pain, histamine primarily induces pain rather than itch, while in patients with atopic dermatitis, bradykinin triggers itch rather than pain. Accordingly, repetitive scratching even enhances itch sensation in chronic itch conditions. Physicians often prescribe pain relievers to patients with chronic itch, suggesting common mechanisms underlying chronic pain and itch, especially peripheral and central sensitization. Rather than separating itch and pain, studies should investigate chronic itch and pain including neuropathic and inflammatory conditions. Here, we reviewed chronic sensitization leading to chronic pain and itch at both peripheral and central levels. Studies investigating the connection between pain and itch facilitate the development of new therapeutics against both chronic dysesthesias based on the underlying pathophysiology.

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Funding

This research was supported by the National Science Foundation for Young Scientists of China program, funded by the National Natural Science Foundation of China (NSFC), Project No. 81901150 (H0903).

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  1. Jiangxi Provincial Key Lab of System Biomedicine, Jiujiang University, 17 Lufeng Road, Jiujiang, 332000, China

    Chengjin Li

  2. Division of Biological Science and Technology, Science and Technology College, Yonsei University Wonju Campus, Wonju, Korea

    Hee Jin Kim

  3. Department of Biomedical Laboratory Science, College of Medical Science, Konyang University, Daejeon, 35365, Korea

    Seung Keun Back

  4. Neuroscience Research Institute and Department of Physiology, Korea University College of Medicine, Seoul, 02841, Korea

    Heung Sik Na

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Li, C., Kim, H.J., Back, S.K. et al. Common and discrete mechanisms underlying chronic pain and itch: peripheral and central sensitization. Pflugers Arch - Eur J Physiol 473, 1603–1615 (2021). https://doi.org/10.1007/s00424-021-02599-y

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