Pain and itch are rooted in different molecular mechanisms

Washington, Nov 18 : Scientists have always considered itching as a less intense version of the body's response to pain, but now researchers at Washington University School of Medicine in St. Louis have shown that pain and itch actually are regulated by different molecular mechanisms.

According to the researchers, the findings could have important implications for treating both pain and chronic itching.

Last year, the research team, led by Zhou-Feng Chen, Ph.D., an investigator at Washington University's Pain Center, was the first to identify an itch gene - called GRPR (gastrin-releasing peptide receptor).

Now, further studies have shown that pain signals are not affected when mice are bred without the itch gene or the gene's actions are blocked.

GRPR makes a receptor found in a very small population of nerve cells in the spinal cord. That region of the spinal cord transmits pain and itch signals, as well as temperature sensation, from the skin to the brain. When exposed to itchy stimuli, mice without the gene scratched less than their normal littermates.

Many patients with chronic pain receive spinal injections of opioid drugs, such as morphine, to control their pain. One of the well-known side effects of that treatment is itchy skin.

"Most scientists believed that the itching could not be separated from the drug's pain-killing effects. This type of itching cannot be relieved by anti-histamine treatment. We hypothesized that GRPR may be responsible for the itching but not involved in the pain response," Chen said.

Therefore, the researchers went back to the mice bred with and without GRPR and compared both scratching behaviours and pain-killing effects following spinal injections of morphine.

They found all of the mice got relief from a mildly painful stimulus, but those without the GRPR gene did not scratch.

Next, the researchers studied normal mice treated with a small peptide that interferes with GRPR function. When injected with the GRPR blocker, mice still got morphine's pain-killing benefits, but they did not itch.

"If we inject a GRPR inhibitor and morphine into the mouse spinal cord, the drug still has its normal analgesic effect, but the mice don't scratch. This is very interesting because it demonstrates that analgesia and itching can be separated. There may be itch-specific genetic pathways in the spinal cord that are not related to pain sensation," Chen said.

The researchers reported their findings at Neuroscience 2008, the annual meeting of the Society for Neuroscience.

ANI