NPF-Funded Research

Project Summary:

Many people with psoriasis continue to experience intense itch even after their skin has improved and inflammation is well controlled. This persistent itch can disrupt sleep and daily life, yet current treatments do not always address it directly. My project asks why itch persists in psoriasis.

I will study how sensory nerves in the skin respond to chemical and metabolic stress, then use new chemical biology tools to identify molecular changes that may sustain itch. These approaches allow us to see aspects of disease biology that are difficult to capture with traditional methods. By revealing previously hidden mechanisms of itch, this work aims to uncover new therapeutic targets focused directly on the symptoms patients continue to feel.

How will your project help improve the lives of the 125 million affected by psoriatic disease?

One of the lessons I have learned from caring for patients with psoriasis is that clear skin does not necessarily mean that the burden of disease has disappeared. So much of psoriasis can live beneath what we see on the surface. Psoriatic arthritis is perhaps the most familiar example, but I think itch is another important and underappreciated part of the disease.

Traditionally, psoriasis was even taught in contrast to atopic dermatitis. Atopic dermatitis was considered the “itchy” disease, while psoriasis was classically thought to be much less so. We now know that simply is not true. Itch can be profoundly disruptive for people with psoriasis, and it can persist even when modern biologic therapies have done an excellent job controlling visible inflammation. Clinical studies of therapies targeting pathways such as IL-17 and IL-23 show that a meaningful subset of patients continue to experience itch despite substantial improvement in their skin disease.

That tells us that inflammation is only part of the story. There may be other molecular pathways within the nerves of the skin that contribute to how itch is generated or sustained but are not addressed by our current treatments. This project uses a platform designed to discover those mechanisms without limiting ourselves to the pathways we already know. My hope is that by uncovering these previously invisible drivers of itch, we can open the door to new treatments that address not only what psoriasis looks like, but how it actually feels to live with it.

Why is psoriatic disease research important to you, personally? What role will this award play in your research efforts or career development?

Receiving the NPF award was particularly meaningful to me because it represented an investment in an idea I have been thinking about for many years: that at a fundamental level, chemistry is the language of biology. With newer technologies, we can now capture that chemistry at extraordinary scale and resolution and begin to understand what is actually happening inside a sensory neuron when a patient experiences itch. Many of our current treatments target pathways we already understand, and those approaches have been remarkably successful. But eventually, we hit a ceiling. I am interested in what lies beyond those established pathways and in the molecular mechanisms we have not yet discovered because we have not previously had the tools to see them.

The NPF’s support gives me protected time and resources to pursue those questions while developing deeper expertise in human sensory neuron models and chemoproteomics. It will help me generate the preliminary data needed to build this work into an independent research program. This award comes at a critical point as I transition from residency and postdoctoral training toward independence as a physician-scientist. It is also deeply validating to know that the NPF and the psoriasis community see promise in this approach and are willing to invest in it.

Researcher Profile:

Chirag Vasavda, MD, PhD, is a physician-scientist originally from the Bay Area in California. After graduating from Duke University with a BS in Chemical Biology, he pursued his MD and PhD in Neuroscience at the Johns Hopkins University School of Medicine under the mentorship of Dr. Solomon Snyder. At Hopkins, he set out to better understand what drives itch and pain. He first discovered that bilirubin binds and activates the receptor MRGPRX4 to cause severe itch in patients with cholestatic liver disease. He later went on to discover a new therapeutic strategy to treat trigeminal neuralgia, a debilitating facial pain syndrome.

After graduating from Hopkins, Chirag then completed his internship in Internal Medicine at Brigham and Women’s Hospital. He then joined the Harvard Combined Dermatology Residency Program, where he is now a senior dermatology resident and postdoctoral research fellow at Harvard Medical School. His research seeks to bridge chemistry to neuroscience in hopes of developing new tools and better therapies for itch and pain.

Chirag is passionate about advancing science in ways that improve patient care and help the benefits of scientific progress reach others equitably. He currently serves on the Massachusetts Medical Society Committee on LGBTQ Matters, the Young Investigator Council of the International Forum for the Study of Itch, and Duke University’s Boston regional board.