Emerging Therapeutic Options for Chronic Pruritus

Reszke, Radomir; Krajewski, Piotr; Szepietowski, Jacek C.

doi:10.1007/s40257-020-00534-y

Cited by 24 publications

(18 citation statements)

References 207 publications

(219 reference statements)

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“…In contrast, clinical studies revealed no significant differences between aprepitant treatment and placebo concerning reduction in pruritus, improvement in pruriginous lesions or quality of life ( 168 , 169 ). However, another clinical study has shown that the NK1R antagonist serlopitant has potential as a therapeutic agent for the treatment of patients with chronic pruritus by significantly reducing the pruritus symptom ( 170 – 172 ). A phase II clinical study concluded that serlopitant reduced pruritus in patients with mild to moderate psoriasis ( 173 ).…”

Section: Receptors In Neuro-immune Interactionsmentioning

confidence: 99%

“…Tradipitant treatment improved pruritus and sleep in mild AD ( 174 ). Several NK1R antagonists that potentially reduce pruritus activity in dermatological diseases are reviewed by Pojawa-Goła et al ( 146 ) and Reszke et al ( 172 ). Thus, targeting SP and/or NK1R with regard to neuro-immune crosstalk seems to be a promising approach in the treatment of pruritus.…”

Section: Receptors In Neuro-immune Interactionsmentioning

confidence: 99%

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Involvement of Neuro-Immune Interactions in Pruritus With Special Focus on Receptor Expressions

et al. 2021

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Pruritus is a common, but very challenging symptom with a wide diversity of underlying causes like dermatological, systemic, neurological and psychiatric diseases. In dermatology, pruritus is the most frequent symptom both in its acute and chronic form (over 6 weeks in duration). Treatment of chronic pruritus often remains challenging. Affected patients who suffer from moderate to severe pruritus have a significantly reduced quality of life. The underlying physiology of pruritus is very complex, involving a diverse network of components in the skin including resident cells such as keratinocytes and sensory neurons as well as transiently infiltrating cells such as certain immune cells. Previous research has established that there is a significant crosstalk among the stratum corneum, nerve fibers and various immune cells, such as keratinocytes, T cells, basophils, eosinophils and mast cells. In this regard, interactions between receptors on cutaneous and spinal neurons or on different immune cells play an important role in the processing of signals which are important for the transmission of pruritus. In this review, we discuss the role of various receptors involved in pruritus and inflammation, such as TRPV1 and TRPA1, IL-31RA and OSMR, TSLPR, PAR-2, NK1R, H1R and H4R, MRGPRs as well as TrkA, with a focus on interaction between nerve fibers and different immune cells. Emerging evidence shows that neuro-immune interactions play a pivotal role in mediating pruritus-associated inflammatory skin diseases such as atopic dermatitis, psoriasis or chronic spontaneous urticaria. Targeting these bidirectional neuro-immune interactions and the involved pruritus-specific receptors is likely to contribute to novel insights into the underlying pathogenesis and targeted treatment options of pruritus.

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Section: Receptors In Neuro-immune Interactionsmentioning

confidence: 99%

Section: Receptors In Neuro-immune Interactionsmentioning

confidence: 99%

Involvement of Neuro-Immune Interactions in Pruritus With Special Focus on Receptor Expressions

et al. 2021

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“…There remains hope with preliminary data available on monoclonal antibodies and Janus kinase inhibitors in NP. 5 However, at present based on our findings, patients with NP who showed improvements were on a combination of treatments that manage the skin and the mind concurrently, which is the main point we hope this study emphasizes.…”

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confidence: 75%

Patients with nodular prurigo commonly have pre‐existing psychological disease that requires treatment concomitant with cutaneous therapies

et al. 2021

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causality inferences. It is possible that ascertainment bias was present.In conclusion, survivors of cancer, especially survivors of haematological malignancies, had a higher co-occurrence of psoriasis. There is a high risk that the findings are due to surveillance bias. The relative contributions of initial misdiagnosis and possible effects of systemic medication on the immune system need further study.

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“…32 Itch is a complex, multidimensional sensation involving the crosstalk between the nervous system, cutaneous immune system and keratinocyte populations. 33 Here, the possible pathomechanism of scabies itch is discussed in detail.…”

Section: The Proposed Pathophysiology Of Scabies Itchmentioning

confidence: 99%

Scabies itch: an update on neuroimmune interactions and novel targets

Kim

Hashimoto

Fischer

et al. 2021

Acad Dermatol Venereol

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Frequently described as 'the worst itch' one can ever experience scabies itch is the hallmark of Sarcoptes scabiei mite infestation. Notably, the itchiness often persists for weeks despite scabicides therapy. The mechanism of scabies itch is not yet fully understood, and effective treatment modalities are still missing which can severely affect the quality of life.The aim of this review is to provide an overview of the scope of itch in scabies and highlight candidate mechanisms underlying this itch. We herein discuss scabies itch, with a focus on the nature, candidate underlying mechanisms and treatment options. We also synthesize this information with current understanding of the mechanisms contributing to non-histaminergic itch in other conditions. Itch is a major problem in scabies and can lead to grave consequences. We provide the latest insights on host-mite interaction, secondary microbial infection and neural sensitization with special emphasis on keratinocytes and mast cells to better understand the mechanism of itch in scabies. Also, the most relevant current modalities remaining under investigation that possess promising perspectives for scabies itch (i.e. proteaseactivated receptor-2 (PAR-2) inhibitor, Mas-related G protein-coupled receptor X2 (MRGPRX2) antagonist) are discussed. Greater understanding of these diverse mechanisms may provide a rational basis for the development of improved and targeted approaches to control itch in individuals with scabies.

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Emerging Therapeutic Options for Chronic Pruritus

Cited by 24 publications

References 207 publications

Involvement of Neuro-Immune Interactions in Pruritus With Special Focus on Receptor Expressions

Involvement of Neuro-Immune Interactions in Pruritus With Special Focus on Receptor Expressions

Patients with nodular prurigo commonly have pre‐existing psychological disease that requires treatment concomitant with cutaneous therapies

Scabies itch: an update on neuroimmune interactions and novel targets

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