Thus, kappa agonists inhibit itch mediated by MrgprA3/C11-expressing sensory neurons. Recent studies have revealed that histamine-induced itch is different than chloroquine-induced itch in that it is mediated by Protein Tyrosine Kinase inhibitor a distinct subset of primary afferents

(Roberson et al., 2013). We therefore tested the effect of KOR agonists on histamine-induced itch and found that scratching behavior was significantly reduced by nalfurafine, as previously reported (Togashi et al., 2002), as well as by U-50,488 (Figure 4E). Similarly, our experiments revealed that both nalfurafine and U-50,488 significantly reduced serotonin-induced itch (Figure 4F). Finally, we investigated a dry skin model of itch that develops following daily topical application of acetone/ether selleck products followed by water (AEW) (Akiyama et al., 2010b and Miyamoto et al., 2002). Both kappa agonists significantly reduced spontaneous scratching behavior produced by AEW treatment (Figure 4G). Importantly, neither U-50,488 (3 mg/kg) nor nalfurafine (20 μg/kg) had any significant effect on rotarod performance, indicating that their effects were not due to motor impairment (Figure S4A). Thus, KOR agonists significantly abate various types of pruritus, including histamine-dependent and histamine-independent itch. These findings raised the possibility that decreased kappa opioid signaling, due to

loss of dynorphin-expressing spinal interneurons, contributes to the abnormally elevated itch in Bhlhb5−/− mice. Thus, we reasoned that exogenous KOR agonists would relieve abnormal itch in these animals. As observed previously, we found that intradermal injection of Tolmetin chloroquine caused significantly more scratching in Bhlhb5−/− mice relative to littermate controls ( Figure 4H; Ross et al., 2010). Importantly, pretreatment with nalfurafine almost completely abrogated scratching behavior in Bhlhb5−/− mice, consistent with the idea that abnormally elevated itch responses in these mice are partly due to decreased kappa tone in spinal cord ( Figure 4H). A question that remained unclear was whether the elevated itch in Bhlhb5−/− mice

was simply due to the loss of dynorphin, or whether the absence of fast synaptic inhibition from B5-I neurons was also involved. To test whether constitutive loss of dynorphin was sufficient for abnormally elevated itch, we analyzed itch in mice lacking the dynorphin precursor PPD. We found that PPD−/− mice and their wild-type littermates showed no difference in pruritogen-induced itch behavior ( Figure 4I). This observation suggests that the abnormally elevated itch observed in Bhlhb5−/− mice is not due to loss of spinal dynorphin alone, hinting at a key role for GABA and/or glycine in the inhibition of itch by B5-I neurons. A consequence of the loss of B5-I neurons in Bhlhb5−/− mice is that these mice develop spontaneous skin lesions due to severe pathological itch.