Patients with liver diseases often suffer from chronic itch, yet the pruritogen(s) and receptor(s) remain largely elusive. Here, we identify bile acids as natural ligands for MRGPRX4. MRGPRX4 is expressed in human dorsal root ganglion (hDRG) neurons and co-expresses with itch receptor HRH1. Bile acids elicited Ca2+ responses in cultured hDRG neurons, and bile acids or a MRGPRX4 specific agonist induced itch in human subjects. However, a specific agonist for another bile acid receptor TGR5 failed to induce itch in human subjects and we find that human TGR5 is not expressed in hDRG neurons. Finally, we show positive correlation between cholestatic itch and plasma bile acids level in itchy patients and the elevated bile acids is sufficient to activate MRGPRX4. Taken together, our data strongly suggest that MRGPRX4 is a novel bile acid receptor that likely underlies cholestatic itch in human, providing a promising new drug target for anti-itch therapies.
- Yulong Li
- Yulong Li
- Wenqin Luo
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Human subjects: All experiments involving human subjects have been approved by institutional review board or ethics committee and the informed consent, and consent to publish, was obtained. Collection of DRG tissue from adult humans was approved by the Committee for Medical Science Research Ethics, Peking University Third Hospital (IRB00006761-2015238), and collection from human embryos was approved by the Reproductive Study Ethics Committee of Peking University Third Hospital (2012SZ-013 and 2017SZ-043) and Beijing Anzhen Hospital (2014012x). The human itch test studies were approved by the Committee for Protecting Human and Animal Subjects at the Department of Psychology, Peking University (#2018-05-02). Collection of blood samples from patients were approved by the Committee for Biomedical Ethics, Peking University First Hospital (2017-R-94).
- David D Ginty, Harvard Medical School, United States
- Received: May 13, 2019
- Accepted: September 2, 2019
- Accepted Manuscript published: September 10, 2019 (version 1)
© 2019, Yu et al.
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