Neural and vascular regulatory factors of the skin

Background Neural and vascular factors regulate many aspects of dermal function, including blood flow, inflammation, tissue repair and eccrine secretion. Abnormalities of neurovascular regulation may contribute to dermatological manifestations of a wide range of diseases including psoriasis, nodular prurigo and leprosy, diabetes mellitus and Raynaud's disease. Aims In this review we discuss evidence for roles played by neural and vascular regulatory factors in skin, with particular reference to the regulatory peptides substance P, calcitonin gene-related peptide. vasoactive intestinal polypeptide, neuropeptide Y and endothelin and to the important endothelial cell product nitric oxide. Conclusions An understanding of the anatomical basis of neurovascular regulation and the changes which occur during disease may lead to novel diagnostic and prognostic tests for dermatological conditions, while an understanding of specific receptors mediating the actions of regulatory peptides will lead to the development of specific antagonists as a novel approach in clinical dermatology.