Abstract
Psoriasis is an incurable chronic skin disease. In addition to immune system participation, cutaneous nervous system has long been reported to play a role in psoriasis pathogenesis. However, the clinical application and underlying mechanism of how peripheral sensory nervous system works during psoriasis pathogenesis are largely unknown. Here we report a new and straight-forward clinical strategy using epidural injection of lidocaine to directly manipulate peripheral sensory nervous system, resulting in significant PASI score improvement of psoriasis patients. Imiquimod-induced rat model of psoriasis shows consistent therapeutic effect with epidural injection of lidocaine. Transcriptome analysis of lidocaine-treated rat primary sensory neurons indicates that lidocaine may function through calming down neuronal proinflammatory chemokines (CCL2, CCL7 and CCL21), cytokines (IL-34 and TSLP). Collectively, our results reveal that direct modulation of peripheral sensory nervous system by epidural treatment with lidocaine reveals a novel and promising therapy for psoriasis treatment.
