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Under chronic inflammatory conditions, the neurovascular unit undergoes structural remodeling, characterized by increased sensory nerve fiber density and impaired endothelial barrier function, which strengthens neuroimmunevascular coupling and provides a histopathological foundation for the persistence and therapeutic resistance of chronic pruritus in AD ( Upon activation, MCs rapidly release a repertoire of vasoactive mediators, including histamine, ATP, prostaglandin D 2 (PGD 2 ), leukotrienes (e.g., LTC 4 ), vascular endothelial growth factor (VEGF), and TNF- (46, 47)
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