Neurogenic control of blood flow and histamine release in psoriatic skin
Abstract
The manifestation of psoriasis represents an interaction between a genetically predisposed individual and environmental influences such as infections, trauma, stress, endocrine factors, sunlight and drugs. The cutaneous lesions are characterised by marked epidermal proliferation, complex alterations in epidermal differentiation, multiple biochemical, immunological, inflammatory and vascular abnormalities and a poorly understood relationship with the central and peripheral nervous system function. Hypothesis : Multiple observations are compatible with the existence of a peptidergic neurogenic mechanism in the pathophysiology of psoriatic plaque. Our hypothesis was that afferent nociceptive nerve-fibre endings in lesional skin are sensitised and activated by an unknown mediator. Via an axon-reflex mechanism in afferent C and A-delta fibre endings, these nerves release neuropeptides, which themselves have dilating effects and, in addition, may induce mast-cell degranulation/histamine release causing further vasodilatation. A pathological axon-reflex mechanism may thus contribute to the high blood flow and stimulate histamine release in lesional psoriatic skin. To test this hypothesis, a series of functional studies was conducted to elucidate whether local neurogenic peptidergic mechanisms are of importance for the maintenance of the increase in blood flow and whether such mechanisms may induce histamine release in psoriatic plaque. Methods : Healthy subjects and patients with…
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