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Sun PY, Li HG, Xu QY, Zhang Z, Chen JW, Shen YH, Qi X, Lu JF, Tan YD, Wang XX, Li CX, Yang MY, Ma YZ, Lu Y, Xu TL, Shen JW, Li WG, Guo YF, Yao ZR. Lidocaine alleviates inflammation and pruritus in atopic dermatitis by blocking different population of sensory neurons. Br J Pharmacol 2022; 180:1339-1361. [PMID: 36521846 DOI: 10.1111/bph.16012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 11/07/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Atopic dermatitis is a common chronic pruritic inflammatory disease of the skin involving neuro-immune communication. Neuronal mechanism-based therapeutic treatments remain lacking. We investigated the efficacy of intravenous lidocaine therapy on atopic dermatitis and the underlying neuro-immune mechanism. EXPERIMENTAL APPROACH Pharmacological intervention, immunofluorescence, RNA-sequencing, genetic modification and immunoassay were performed to dissect the neuro-immune basis of itch and inflammation in atopic dermatitis-like mouse model and in patients. KEY RESULTS Lidocaine alleviated skin lesions and itch in both atopic dermatitis patients and calcipotriol (MC903)-induced atopic dermatitis model by blocking subpopulation of sensory neurons. QX-314, a charged NaV blocker that enters through pathologically activated large-pore ion channels and selectivity inhibits a subpopulation of sensory neurons, has the same effects as lidocaine in atopic dermatitis model. Genetic silencing NaV 1.8-expressing sensory neurons was sufficient to restrict cutaneous inflammation and itch in the atopic dermatitis model. However, pharmacological blockade of TRPV1-positive nociceptors only abolished persistent itch but did not affect skin inflammation in the atopic dermatitis model, indicating a difference between sensory neuronal modulation of skin inflammation and itch. Inhibition of activity-dependent release of calcitonin gene-related peptide (CGRP) from sensory neurons by lidocaine largely accounts for the therapeutic effect of lidocaine in the atopic dermatitis model. CONCLUSION AND IMPLICATIONS NaV 1.8+ sensory neurons play a critical role in pathogenesis of atopic dermatitis and lidocaine is a potential anti-inflammatory and anti-pruritic agent for atopic dermatitis. A dissociable difference for sensory neuronal modulation of skin inflammation and itch contributes to further understanding of pathogenesis in atopic dermatitis.
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Affiliation(s)
- Pei-Yi Sun
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Hua-Guo Li
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Qian-Yue Xu
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Zhen Zhang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jia-Wen Chen
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yi-Hang Shen
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xin Qi
- Centre for Brain Science of Shanghai Children's Medical Centre, Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jian-Fei Lu
- Centre for Brain Science of Shanghai Children's Medical Centre, Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yi-Dong Tan
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xiao-Xiao Wang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Chun-Xiao Li
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Meng-Ying Yang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yu-Zhi Ma
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Ying Lu
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Tian-Le Xu
- Centre for Brain Science of Shanghai Children's Medical Centre, Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jin-Wen Shen
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Wei-Guang Li
- Centre for Brain Science of Shanghai Children's Medical Centre, Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.,Department of Rehabilitation Medicine, Huashan Hospital, Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Centre for Brain Science, Fudan University, Shanghai, 200032, China
| | - Yi-Feng Guo
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Zhi-Rong Yao
- Department of Dermatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.,Institute of Dermatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
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