The long-held belief that stress worsens atopic dermatitis, commonly known as eczema, has now been linked to a specific neurological pathway, according to new research. This discovery offers potential targets for more precise treatments for the chronic inflammatory skin condition, which affects over 200 million people worldwide.
Researchers at Fudan University in China have identified how stress activates immune cells in the skin, exacerbating symptoms of atopic dermatitis. The findings, published on March 20 in the journal Science, could lead to new therapies focused on managing the neurological components of the disease.
The study analyzed skin and blood samples from 51 patients with atopic dermatitis. Participants reporting higher levels of psychological stress exhibited more severe skin inflammation and elevated levels of eosinophils – immune cells that trigger allergic reactions and inflammation, contributing to the characteristic itchiness of eczema.
These findings were corroborated by animal studies. When mice were exposed to psychological stress, they developed worsened symptoms of atopic dermatitis, including itching, skin redness, and inflammation. The number of eosinophils in the skin tissue of stressed mice was four times higher than in a control group.
The research pinpointed a specific type of nerve cell, called ‘Pdyn+ neurons,’ as central to the stress response. When the brain perceives stress, these neurons are activated. They then release inflammatory substances at the skin’s surface, attracting eosinophils to the itchy areas. These recruited eosinophils release proteins that cause redness and swelling, rapidly worsening the symptoms.
Interestingly, blocking the activity of these nerve cells halted the stress-induced worsening of symptoms. Mice genetically engineered to lack these neurons or eosinophils did not experience a worsening of atopic dermatitis symptoms even when exposed to stress.
“We have elucidated the process by which abstract psychological stress is translated into actual symptoms like skin inflammation,” researchers said, suggesting the potential for targeted treatments that focus on the stress response pathway or inflammatory molecules. The study highlights the complex interplay between the nervous system and the immune system in skin conditions.
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