What's the Mystery Behind the Urge to Scratch a Head Itch?

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Highlights:

• Itching is a sensory reflux to scratch at the source point which occurs primarily due to inflammatory skin diseases
• A new study reveals that Staphylococcus aureus on the skin causes itching, by triggering a molecular-neural chain reaction between skin and brain
• These findings redefine the treatment and therapeutic management of skin diseases

Itching, also called pruritus, is a sensory experience that causes an impulse or reflex to scratch at the point of itch.

An itch demands a scratch, yet the scientific reason behind the causes of itching remains elusive. The itch that occurs with inflammatory skin diseases was believed to arise from the accompanying inflammation of the skin.

‘Staphylococcus aureus solves the missing link in the itch-scratch cycle which is common among chronic skin diseases. #itching #itchscratch #skindiseases #dermatology #medindia’

However, according to the latest research, Staphylococcus aureus, a common skin bacterium, is the one that generates itching by starting a chemical chain reaction that ultimately results in the desire to scratch (1^✔).

Solving the Missing Link in the Itch- Scratch Puzzle

Immune cells, such as mast cells and basophils-which are often known to cause itching and are associated with skin allergies-failed to do so after being exposed to bacteria. Neither did pro-inflammatory chemicals called interleukins or white blood cells, which are known to be triggered during allergic reactions in skin disorders including eczema and atopic dermatitis.

S. aureus which is stimulated by innocuous stimuli triggers a hyperactive response, a condition called alloknesis. Alloknesis is the itchy or pruriceptive sensation evoked by a stimulus that is normally non-pruriceptive. Alloknesis is common in patients with chronic skin conditions and also in anonymous conditions like itching from a wool sweater.

The stimulated S. aureus releases a bacterial enzyme called protease V8. This V8 protease enzyme works by activating a protein called PAR1, which is present on skin neurons that come from the spinal cord and send several signals from the skin to the brain, including touch, heat, pain, and itching (2^✔). This sets up a vicious cycle of itching, inflammation, and itching again.

The enzyme protease V8 was single-handedly responsible for initiating itch.

Beyond Itch-Scratch Cycle

The protein PAR1, which is triggered by S. aureus, is also connected to blood clotting.

Administering anti-coagulants stops the activation of the protein PART1 and subsequently curbs the crucial phase of the scratch-itch cycle. The therapy can reduce skin damage and alleviate discomfort.

These potential findings can retransform the design of oral medicines and topical creams to treat persistent itch associated with skin conditions linked to an imbalance in the skin microbiome, such as atopic dermatitis, prurigo nodularis, and psoriasis.

In conclusion, it is not necessary to have inflammation for the microbe to cause an itch, but the presence of microbes can ignite an itch and exacerbate inflammation on the skin.

References:

1. S. aureus drives itch and scratch-induced skin damage through a V8 protease-PAR1 axis - (https:www.cell.com/cell/fulltext/S0092-8674(23)01164-9)
2. Physiology and Pathophysiology of Itch - (https:journals.physiology.org/doi/full/10.1152/physrev.00017.2019)

Source: Medindia

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