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International Association for the Study of Pain
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Gil Yosipovitch , Wake Forest University Health Sciences
This comment was coauthored by Leigh Nattkemper.
Han et al. have provided a thorough and novel investigation that demonstrates the existence of itch-specific nerve fibers in mice skin. These MrgprA3 nerve fibers explain the missing link of why itch emanates from C nerve fibers in upper layers of the skin while similar fibers transmit pain from deeper layers of skin. However the applicability of this model in chronic itch in humans requires further studies. My clinical understanding in recent years is that there is an overlap with pain in chronic itch, as sufferers complain also of features of burning pain sensations albeit less than in chronic pain. Therefore a simple model of chronic itch transmission via several so called specific receptors is an over-simplification of the complexity of chronic itch. The fact that MrgprA3 has a unique role for cholorquine-induced itch, which has limited effect on itch in humans except in African ethnicity, suggest that this receptor may have a different role in chronic itch in humans.