Project Details
Projekt
Targeting Biological and Psychosocial Mechanisms of Generic and Pruritus-related Stress in Patients with Chronic Pruritus (SOMA.PRU.2)
Applicants
Professor Dr. Stefan Werner Schneider; Professorin Dr. Sonja Ständer; Privatdozentin Dr. Angelika Weigel
Subject Area
Public Health, Healthcare Research, Social and Occupational Medicine
Dermatology
Personality Psychology, Clinical and Medical Psychology, Methodology
Dermatology
Personality Psychology, Clinical and Medical Psychology, Methodology
Term
since 2021
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 445297796
Background: Chronic pruritus (CP) affects 22% of the population and leads to reduced quality of life and significant psychological burden. This burden includes psychological distress, which maintains a vicious ”itch-distress”-cycle through neuroimmune and psychological mechanisms. Modifiability of these mechanisms, including biological changes after psychological interventions, have not yet been sufficiently investigated in CP. Results of 1st funding phase: SOMA.PRU (N=166) examined biological and psychosocial factors in CP in patients with atopic dermatitis (AD), chronic pruritus on non-lesional skin (CPNL) and healthy controls in a 12-month observational study. Over 60% of patients with CP showed no pruritus improvement under standard care. Stress emerged as a key mediator, associated with higher itch intensity, an impaired skin barrier, and sensitization of peripheral skin nerves. Stress levels were particularly elevated in 16% of patients who met criteria for Somatic Symptom Disorder. Biomarker analyses identified systemic inflammation (e.g. suPAR) as a correlate of itch. Transdiagnostic analyses across AD, CPNL, and chronic liver and kidney diseases revealed largely overlapping treatment needs, supporting a mechanism-based approach. Collectively, findings demonstrate unmet treatment needs and emphasize stress-related mechanisms as key targets for future intervention development. Objectives: SOMA.PRU.2 will investigate the interplay between pruritus-related and generic stress and biomarkers in skin, saliva and blood in CP in patients with AD, CPG (chronic prurigo), and CPNL, along with a transdiagnostic validation in patients with chronic liver and kidney diseases. Combining self-report measures with biomarkers, ecological momentary assessment (EMA) and wearables, SOMA.PRU.2 will examine if a psychological intervention alongside standard care will be able to modulate this interplay. Work programme: Patients with AD, CPG, and CPNL (N=120) will be randomized to either receive an additional mechanism-based psychological intervention (SOMA.SYMP = pruritus-related stress, SOMA.COPE = generic stress) or standard care only. EMA and wearables will capture time dynamic associations between pruritus, stress and heart rate variability. Nanoscale 3-dimensional imaging will assess skin barrier changes. Sensory testing will reveal neuronal sensitization. Skin biopsies will enable skin layer specific proteomic profiling and analysis of nerve fiber changes. Blood and saliva will be analysed for stress-sensitive biomarkers. Expected impact: SOMA.PRU.2 will clarify how stress-related mechanisms influence CP and how exactly a psychological intervention reduces pruritus and stress by integrating biomarkers, EMA, and wearable data. Through collaboration within SOMACROSS.2, the transdiagnostic relevance of CP will be demonstrated.
DFG Programme
Research Units
