Itching Not a Less Intense Form of Pain

TUESDAY Nov. 18, 2008 -- Pain and itching are regulated by different molecular mechanisms, according to a Washington University study that challenges the long-held belief that itching is a less intense version of the body's response to pain.

This finding could prove important in improving treatment of chronic itching and pain.

Zhou-Feng Chen, of Washington University's Pain Center, in St. Louis, and colleagues found that pain signals are not affected in mice bred without an itch gene called gastrin-releasing peptide receptor (GRPR) or when the gene's actions are blocked. When the mice without the GRPR gene were exposed to itchy stimuli, they scratched less than normal mice.

GRPR, previously identified by the same team of researchers, makes a receptor found in a small number of nerve cells in a region of the spinal cord that transmits itch and pain signals, as well as temperature sensation, from the skin to the brain.

"There are two major types of itching," explained Chen, an associate professor of anesthesiology, psychiatry and developmental biology. Histamine-dependent itching is caused by bug bites or allergic reactions and can be treated with antihistamine drugs. Chronic, severe itching often occurs as a side effect of spinal injections of opioid drugs, such as morphine, given to chronic pain patients. This type of itching can't be relieved by antihistamines.

"Most scientists believed that the itching could not be separated from the drug's pain-killing effects," Chen said. But he and his team thought GRPR may be responsible for the itching but involved in the pain response.

"If we inject a GRPR inhibitor and morphine into the mouse spinal cord, the drug still has its normal analgesic effect, but the mice don't scratch. This is very interesting, because it demonstrates that analgesia and itching can be separated. There may be itch-specific genetic pathways in the spinal cord that are not related to pain sensation," Chen said.

Like mice, humans also have GRPR genes, so it may be possible to treat chronic itching in humans using a similar approach.

"Our findings could have important therapeutic implications. More research needs to be done, but it may be possible to relieve itching in patients by blocking GRPR function without affecting the pain pathway," Chen said.

The study was presented Monday at the Society for Neuroscience annual meeting, in Washington, D.C.

More information

The American Academy of Dermatology has more about itching.

Posted: November 2008


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