Targeting the Receptor at Synapse of Keratinocyte and Peripheral Nerve Ending: A Therapeutic Hope for Post-Burn Pruritus

Abstract

Chronic itch or Pruritus is an unpleasant sensation that provokes the desire to scratch. In post burn patients, it is a significant health burden with few effective treatments. Pruritus is a common distressing consequence of postburn scars which affects burn survivors’ quality of life by causing sleep disturbance, daily activity impairment, and psychological problems. The mechanism of such abnormal scars with pruritus is not yet clear. The field of pruritus research is a dynamic field which involves neural component and various receptors at skin. The receptor present at the synapse of keratinocytes and peripheral nerve ending are responsible for itching. Many recent studies have worked to define the various receptors and the itch mediations in skin. However, considering that post-burn patients mainly report itch to be localized in the burn scars, spontaneous itch might be strongly based on peripheral input. The detailed characteristic and the factors for persistence of pruritus in post burn patients have not yet been clearly understood. Experimental evidences suggest that transient receptor potential (TRP) channels in skin and their expression patterns, activation mechanisms play regulatory roles in pruritus pathogenesis. In this article author collected the pruritus related data from post burn pruritus patients, isolated keratinocytes checked the receptor expression by immunocytochemistry and discussed the complex interplay between the central and peripheral factors that causes pruritus. It would be helpful to identify novel anti-pruritic agents that target the molecular itch pathogenesis pathways and the clinical assessment for burn patients with pruritus.