The Epithelial Cell-Derived Atopic Dermatitis Cytokine TSLP Activates Neurons to Induce Itch
Sarah R. Wilson,1,2,3 Lydia The ́ ,1,3 Lyn M. Batia,1 Katherine Beattie,1 George E. Katibah,1 Shannan P. McClain,1 Maurizio Pellegrino,1 Daniel M. Estandian,1 and Diana M. Bautista1,2,*
1Department of Molecular and Cell Biology
2Helen Wills Neuroscience Institute
University of California, Berkeley, Berkeley, CA 94720, USA 3These authors contributed equally to this work *Correspondence: dbautista@berkeley.edu
http://dx.doi.org/10.1016/j.cell.2013.08.057
SUMMARY
Atopic dermatitis (AD) is a chronic itch and inflamma- tory disorder of the skin that affects one in ten peo- ple. Patients suffering from severe AD eventually progress to develop asthma and allergic rhinitis, in a process known as the ‘‘atopic march.’’ Signaling between epithelial cells and innate immune cells via the cytokine thymic stromal lymphopoietin (TSLP) is thought to drive AD and the atopic march. Here, we report that epithelial cells directly communicate to cutaneous sensory neurons via TSLP to promote itch. We identify the ORAI1/NFAT calcium signaling pathway as an essential regulator of TSLP release from keratinocytes, the primary epithelial cells of the skin. TSLP then acts directly on a subset of TRPA1-positive sensory neurons to trigger robust itch behaviors. Our results support a model whereby calcium-dependent TSLP release by keratinocytes activates both primary afferent neurons and immune cells to promote inflammatory responses in the skin and airways.
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