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Klinische Neurophysiologie 2012; 43(04): 280-283
DOI: 10.1055/s-0032-1327674
Originalia
© Georg Thieme Verlag KG Stuttgart · New York

Neurophysiologie des Juckreizes

Neurophysiology of Itch
M. Schmelz
1   Klinik für Anästhesiologie und Intensivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg
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Publication History

Publication Date:
20 December 2012 (online)

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Zusammenfassung

Die neuronalen Verarbeitungswege für Juckreiz können in die Histamin-abhängigen und Histamin-unabhängigen unterteilt werden. Allerdings kann auch die Aktivierung von normalerweise schmerzverarbeitenden Neuronen Juckreiz auslösen; damit ist eine exakte Trennung von Neuronen in Nozizeptoren und Prurizeptoren nicht mehr einfach möglich. In dieser Übersicht werden die neurophysiologischen Mechanismen des Juckreizes unter physiologischen Bedingungen beschrieben, die jedoch auch bei Patienten mit chronischem Juckreiz bedeutsam sein können. Die Mediatoren für Juckreiz und Schmerz überlappen zu einem großen Teil und auch die Muster der peripheren und zentralen Sensibilisierung sind bei Juckreiz und Schmerz überraschend ähnlich. Es ist daher von großer klinischer Bedeutung, inwiefern die Ähnlichkeiten auch therapeutische Implikationen haben und damit Analgetika auch anti-pruritische Wirkung haben können.

Abstract

Histaminergic and non-histaminergic neuronal pathways for itch have been found in humans. However, even pathways normally involved in pain processing can cause itch. Thus, the differentiation between neuronal pathways for itch and pain has now become disputable. In this review neurophysiological mechanisms that underlie itch sensations under physiological conditions will be discussed that might also be operational in chronic itch conditions. Peripheral mediators of itch and pain overlap to a large extent, and also patterns of peripheral and central sensitisation are similar in chronic pain and chronic itch conditions. It will be of major interest to assess whether the underlying mechanisms for central sensitisation in the itch and pain pathways are also similar, as this might have major therapeutic implications.

Schlüsselwörter

Juckreiz - Mechanismen - Sensibilisierung - Cowhage

Key words

pruritus - mechanisms - sensitization - cowhage
 

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