Background. There continues to be uncertainty on the ideal treatment of pruritus in chronic liver disease. The aim of this study was to gather the latest information on the evidence-based management of pruritus in chronic liver disease. Methodology. A literature search for pruritus in chronic liver disease was conducted using Pubmed and Embase database systems using the MeSH terms “pruritus,” “chronic liver disease,” “cholestatic liver disease,” and “treatment.” Results. The current understanding of the pathophysiology of pruritus is described in addition to detailing research into contemporary treatment options of the condition. These medical treatments range from bile salts, rifampicin, and opioid receptor antagonists to antihistamines. Conclusion. The burden of pruritus in liver disease patients persists and, although it is a common symptom, it can be difficult to manage. In recent years there has been greater study into the etiology and treatment of the condition. Nonetheless, pruritus remains poorly understood and many patients continue to suffer, reiterating the need for further research to improve our understanding of the etiology and treatment for the condition.

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Background: Natriuretic peptides have a vast array of different actions at numerous sites throughout the human body. There have been rapid advances in understanding their mechanism of action in recent years and this review aimed to collate all available information on this field in order to present the current evidence-base. Method: A two-step process utilising a Medline/PubMed systematic search was conducted. The initial search was undertaken using elementary phrases. The search produced over 4000 published papers on the topic of the mechanisms of action of natriuretic peptides. The resultant abstracts were analysed and appropriate papers were selected. The secondary search was performed by (1) using the reference lists of the chosen articles and (2) by using PubMed weblink for related articles. The studies were selected if they were in English language published in the past 30 years and included the appropriate topics. All of the reports regarding the intracellular and pharmacological mechanisms of action of natriuretic peptides were selected. Conclusions: This review has collected all information on the recent advances in our understanding of the intracellular pathways that allow these peptides to bring about natriuresis, vasodilatation and their many other effects. Although offering significant pharmacological potential, Review Articlethis field remains poorly understood and there is a need for more research using newer research techniques.

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