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• Dermatology Research

Itch Research at the Department of Dermatology

Professor Gil Yosipovitch, MD has been Director of the Physiology Skin Laboratory since coming to Wake Forest University School of Medicine in 2002. The focus of the lab is to study skin physiology in humans and in particular itch in health and disease, using minimally invasive methods. Dr.Yosipovitch is the Principal Investigator for a RO1 NIH grant dedicated to the investigation of peripheral and central neural mechanisms of chronic pruritus. The studies conducted in our group employ brain imaging techniques (functional MRI), microdialysis, tape stripping, corneometry, TEWL measurements, heart rate variability (HRV) and assessment of skin innervation in chronic itch in humans and non-human primates.

Dr.Yosipovitch also directs the International Fellowship Program for clinical and research training of overseas dermatologists and researchers. He has trained over 20 postdoctoral fellows and undergaduate students since 2002.
Alexandru D.P. Papoiu, MD, PhD, graduate of "Carol Davila" University of Medicine & Pharmacy School of Medicine, Bucharest and of Polytechnic University Bucharest (BS, Organic Chemistry) earned his PhD in Pharmacology from Rutgers University & University of Medicine & Dentistry of New Jersey. Dr. Papoiu works closely with Prof. Gil Yosipovitch, MD, Robert Coghill, PhD from the departments of Neurobiology & Anatomy and Robert Kraft, PhD from Biomedical Engineering.

Current projects:

• Central nervous mechanisms of itch and scratching. Using experimental models of itch in various disease states as well as in healthy subjects, we investigate the brain networks involved in the processing of pruritus and scratching by functional MRI (Arterial Spin Labeling, ASL). The itch & scratch cycle underlie a compulsive behavior that reveals important similarities with addiction. This particular relay in the central mechanisms of itch is a target of our brain imaging studies, among other significant areas. Recently, we have assessed the effect of visual cues in the induction of "contagious" itch and scratching in atopic dermatitis and in healthy participants, finding that atopic dermatitis patients exhibited an increased susceptibility to visual cues of itch. This finding may shed light onto central mechanisms of pruritus in pathological states.
• The effect of autonomic nervous system (ANS) dysfunction in pruritic diseases. Itch can mirror or can be aggravated by stress and ensuing imbalances in the autonomic nervous system; sometimes itch can be seen as a manifestation of stress itself. Very commonly itch reflects complex, disturbing psychological experiences which may play a role in the course of pruritic diseases as aggravating factors. We recently employed heart rate variability (HRV) to investigate the response of the ANS to itch, scratching and stress in atopic dermatitis patients.
• Skin physiology and pruritus signaling. Using skin microdialysis, tape stripping, and other minimally invasive techniques to access skin environment, we assess the levels of inflammatory & signaling mediators involved in skin disease and in the mediation of pruritus.
• Innervation density of the skin in relation to chronic itch in humans and non-human primates, in collaboration with Wake Forest University Primate Center.
• The occurrence of itch and pain in skin cancer, in collaboration with the Wake Forest University Cancer Center.

Selected recent publications:

1. Papoiu AD, Wang H, Nattkemper L, Tey HL, Ishiuji Y, Chan YH, Schmelz M, Yosipovitch G. A study of serum concentrations and dermal levels of NGF in atopic dermatitis and healthy subjects. Neuropeptides. 2011 Sep 3. [Epub ahead of print]
2. Maddison B, Parsons A, Sangueza O, Sheehan DJ, Yosipovitch G. Retrospective study of intraepidermal nerve fiber distribution in biopsies of patients with nummular eczema.
   Am J Dermatopathol. 2011; 33(6):621-3.
3. Papoiu AD, Tey HL, Coghill RC, Wang H, Yosipovitch G. Cowhage-induced itch as an experimental model for pruritus. A comparative study with histamine-induced itch. PLoS One. 2011; 6(3):e17786.
4. O'Neill JL, Chan YH, Rapp SR, Yosipovitch G. Differences in itch characteristics between psoriasis and atopic dermatitis patients: results of a web-based questionnaire.
   Acta Derm Venereol. 2011;91(5):537-40.
5. Papoiu AD, Wang H, Coghill RC, Chan YH, Yosipovitch G. Contagious itch in humans: a study of visual 'transmission' of itch in atopic dermatitis and healthy subjects.
   Br J Dermatol. 2011;164(6):1299-303.
6. Tran B, Papoiu ADP, Russoniello CV, Wang H, Patel T, Chan YH and Yosipovitch G: The effect of itch, scratching and mental stress on autonomic nervous system function in atopic dermatitis Acta Derma Venereol 2010; 90(4):354-61.
7. Wang H, Papoiu AD, Coghill RC, Patel T, Wang N, Yosipovitch G. Ethnic differences in pain, itch and thermal detection in response to topical capsaicin: African Americans display a notably limited hyperalgesia and neurogenic inflammation. Br J Dermatol. 2010;162(5):1023-9.
8. Ishiuji Y, Coghill RC, Patel TS, Oshiro Y, Kraft RA, Yosipovitch G. Distinct patterns of brain activity evoked by histamine-induced itch reveal an association with itch intensity and disease severity in atopic dermatitis. Br J Dermatol. 2009; 161(5):1072-80.
9. Dawn A, Papoiu ADP, Chan YH, Rapp SR, Rassette N, Yosipovitch G. Itch characteristics in atopic dermatitis: results of a web-based questionnaire. Br J Dermatol. 2009;160(3):642-4.
10. Lim GJ, Ishiuji Y, Dawn A, Harrison B, Kim do W, Atala A, Yosipovitch G. In vitro and in vivo characterization of a novel liposomal butorphanol formulation for treatment of pruritus. Acta Derm Venereol. 2008; 88(4):327-30.
11. Yosipovitch G, Ishiuji Y, Patel TS, Hicks MI, Oshiro Y, Kraft RA, Winnicki E, Coghill RC. The brain processing of scratching. J Invest Dermatol. 2008; 128(7):1806-11.
12. Ishiuji Y, Coghill RC, Patel TS, Dawn A, Fountain J, Oshiro Y, Yosipovitch G.
    Repetitive scratching and noxious heat do not inhibit histamine-induced itch in atopic dermatitis. Br J Dermatol. 2008; 158(1):78-83.