LaMotte RH, Shimada SG, Green BG, Zelterman D. Pruritic and nociceptive sensations and dysesthesias from a spicule of cowhage. J Neurophysiol 101: 1430 -1443, 2009. First published January 14, 2009 doi:10.1152/jn.91268.2008. Although the trichomes (spicules) of a pod of cowhage (Mucuna pruriens) are known to evoke a histamine-independent itch that is mediated by a cysteine protease, little is known of the itch and accompanying nociceptive sensations evoked by a single spicule and the enhanced itch and pain that can occur in the surrounding skin. The tip of a single spicule applied to the forearm of 45 subjects typically evoked 1) itch accompanied by nociceptive sensations (NS) of pricking/stinging and, to a lesser extent, burning, and 2) one or more areas of cutaneous dysesthesia characterized by hyperknesis (enhanced itch to pricking) with or without alloknesis (itch to stroking) and/or hyperalgesia (enhanced pricking pain). Itch could occur in the absence of NS or one or more dysesthesias but very rarely the reverse. The peak magnitude of sensation was positively correlated for itch and NS and increased (exhibited spatial summation) as the number of spicules was increased within a spatial extent of 6 cm but not 1 cm. The areas of dysesthesia did not exhibit spatial summation. We conclude that itch evoked by a punctate chemical stimulus can co-exist with NS and cutaneous dysesthesias as may occur in clinical pruritus. However, cowhage itch was not always accompanied by NS or dysesthesia nor was a momentary change in itch necessarily accompanied by a similar change in NS or vice versa. Thus there may be separate neural coding mechanisms for itch, nociceptive sensations, and each type of dysesthesia.
I N T R O D U C T I O NItch is recognized as a fundamental quality of somatic sensation, separate from others such as touch, temperature, and pain. Itch can be a significant clinical problem that sometimes accompanies not only pathologies of the skin but also many diseases and disorders that do not originate in the skin (Binder et al. 2008). For example, chronic neuropathic itch can occur after injuries or other dysfunctions of somatic afferent pathways (Brewer et al. 2008;Oaklander et al. 2003). Sometimes the itch is accompanied by nociceptive sensations such as burning or stinging, as in cases of notalgia paresthetica or postherpetic neuralgia (Yosipovitch and Samuel 2008).To further our knowledge of the neurobiology of itch and to identify targets for pharmacological treatment of itch, it is essential to identify the primary and central neurons mediating the sensation of itch and to discover how they code and transmit pruritic as opposed to other types of sensory information. For this to occur, there are two objectives. The first is to find and validate an animal model of itch. Certain neural mechanisms cannot be explored at the cellular level in humans and thus must be carried out in animals. For example, we have found that both the monkey and the mouse (CD1 strain) exhibit site-specific scratching to one or mo...