EADV President’s Symposium
EADV President’s Symposium
EADV PRESIDENT’S SYMPOSIUM
Saturday, 12 October 2019, 10.15 – 11.45
Nicolas Gaudenzio (Toulouse, France) – Cross-talk between immune cells and nerve fibers in skin
The skin is highly innervated by a meshwork of heterogeneous peripheral neurons, including sensory neurons. Sensory neurons have been studied extensively in the context of their primary function of initiation of transmission of sensations and induction of appropriate behavioral response such as scratching (to remove irritant) or withdrawing (to avoid tissue injury). However, recent studies have shown that, despite their primary function of transmission of sensations to the spinal cord and brain, peripheral neurons (including nociceptive sensory neurons) could directly sense environmental alarms and consequently regulate the development of various type of inflammatory responses. We will discuss recent advances and future challenges in the field by taking into account the physiology of the skin, subtypes of neurons and immune cells and the development of skin diseases.
Christopher Griffiths (Manchester, United Kingdom) – The skin-brain axis in inflammatory skin disease
It is recognised that stress and stressful life events may exacerbate psoriasis and other inflammatory skin diseases including atopic eczema and acne. Emerging data indicate that close communication between peripheral epidermal nerve fibres, which are in apposition to Langerhans cells, may be important in promulgating stress-induced skin inflammation. Conversely, psoriasis is associated with depression and alexithymia both of which may in part be a consequence of changes in brain inflammation and blood flow. The improvement in mood in psoriasis patients on systemic therapies, such as biologics, may be associated with normalisation of brain inflammation. fMRI studies indicate that psoriasis patients have an inability to recognise the emotion disgust as compared to normal control subjects. Cognitive behavioural therapy and mindfulness can lead to independent improvement in psoriasis severity. The brain-skin axis is an important field of study that will lead to more holistic management of inflammatory skin disease if understood fully.
Sonja Ständer (Münster, Germany) –
Until today, chronic itch is a difficult to treat condition, which is in most cases refractory to conventional therapies. Antihistamines are effective only in histaminergic itch. All types of non-histaminergic itch require another pharmacological approach. For this, current guidelines recommend a step-wise approach starting with a therapy of the underlying etiology of itch, and, if present, use of topicals in dry skin and scratch lesions. Modern topical therapies comprise for example novel cold and warm receptor agonists/antagonists. Systemic therapies which interfere with the itch signaling in the peripheral and central nervous system are gabapentinoids, antidepressants, and mu-opioid-receptor antagonists. Novel pharmaceutical agents which are currently tested in phase II/III trials comprise systemic monoclonal antibodies, neurokinin-1 receptor antagonists and complex opioid receptor modulators. In phase II trials, these novel substances proofed meaningful antipruritic effects in chronic prurigo, psoriasis, atopic dermatitis, uraemic pruritus and cholestatic pruritus.