Emollients With Endocannabinoids in the Treatment of Uremic Pruritus: Discussion of the Therapeutic Options

Szepietowski, Jacek; Reich, Adam; Szepietowski, T

doi:10.1111/j.1774-9987.2005.00271.x

Cited by 42 publications

(26 citation statements)

References 10 publications

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“…Systemic cannabinoid agonists reduced ear-scratching elicited by systemic administration of a 5-HT-2A/C agonist (Darmani, 2001). However, only one brief clinical study reported reduced itch in uremic pruritus patients following topical treatment with an emollient containing endocannabinoids, although the emollient itself may have contributed to the antipruritic effect (Szepietowski et al, 2005). Thus, modulation of peripheral endocannabinoids may prove to be a useful approach to treat itch.…”

Section: Introductionmentioning

confidence: 99%

Differences in peripheral endocannabinoid modulation of scratching behavior in facial vs. spinally-innervated skin

et al. 2012

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Cannabinoids suppress nocifensive behaviors in rodents. We presently investigated peripheral endocannabinoid modulation of itch- and pain-related behaviors elicited from facial vs. spinally-innervated skin of rats. Intradermal (id) injection of the pruritogen serotonin (5-HT) elicited significantly more hindlimb scratch bouts, and longer cumulative time scratching, when injected in the rostral back compared to the cheek. Pretreatment of skin with inhibitors of degrading enzymes for the endocannabinoids anandamide (URB597) or 2-arachidonoylglycerol (JZL184) significantly reduced scratching elicited by 5-HT in the rostral back. These effects were prevented by co-treatment with antagonists of the CB1 (AM251) or CB2 receptor (AM630), implicating both receptor subtypes in endocannabinoid suppression of scratching in spinally-innervated skin. Conversely, pretreatment with either enzyme inhibitor, or with AM630 alone, increased the number of scratch bouts elicited by id 5-HT injection in the cheek. Moreover, pretreatment with JZL184 also significantly increased pain-related forelimb wipes directed to the cheek following id injection of the algogen, allyl isothiocyanate (AITC; mustard oil). Thus, peripheral endocannabinoids have opposite effects on itch-related scratching behaviors in trigeminally- vs. spinally-innervated skin. These results suggest that increasing peripheral endocannabinoid levels represents a promising therapeutic approach to treat itch arising from the lower body, but caution that such treatment may not relieve, and may even exacerbate, itch and pain arising from trigeminally-innervated skin of the face or scalp.

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Section: Introductionmentioning

confidence: 99%

Differences in peripheral endocannabinoid modulation of scratching behavior in facial vs. spinally-innervated skin

et al. 2012

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“…Their activation by cutaneous application of a cannabinoid agonist could significantly suppress experimentally induced pain as well as itch sensation and erythema 34 . Up to now, several papers report on case series applying a cream containing low concentration of N-palmitoylethanolamine which relieved pruritus due to hemodialysis 35 , atopic dermatitis 36 , pruritus of unknown origin and pruritus in prurigo nodularis and lichen simplex 37 . It may be speculated that creams with another concentration or another type of cannabinoid will have analogic or even higher antipruritic properties.…”

Section: Topical Therapymentioning

confidence: 99%

Chronic Pruritus: Clinics and Treatment

Grundmann

Ständer

2011

Ann Dermatol

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Chronic pruritus, one of the main symptoms in dermatology, is often intractable and has a high impact on patient's quality of life. Beyond dermatologic disorders, chronic pruritus is associated with systemic, neurologic as well as psychologic diseases. The pathogenesis of acute and chronic (＞6 weeks duration) pruritus is complex and involves in the skin a network of resident (e.g., sensory neurons) and transient inflammatory cells (e.g., lymphocytes). In the skin, several classes of histamine-sensitive or histamine-insensitve C-fibers are involved in itch transmission. Specific receptors have been discovered on cutaneous and spinal neurons to be exclusively involved in the processing of pruritic signals.Chronic pruritus is notoriously difficult to treat. Newer insights into the underlying pathogenesis of pruritus have enabled novel treatment approaches that target the pruritusspecific pathophysiological mechanism. For example, neurokinin-1 antagonists have been found to relieve chronic pruritus. (Ann Dermatol 23(1) 1∼11, 2011)

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“…However, it still remains uncertain whether alterations in dialysis therapy including changes in dialysis membrane can reduce pruritus [24] [25] or not [26]. Hiroshige et al [27] analyzed data on 59 HD patients, who did not have disorders in calcium and phosphate metabolism, and found that more than 60% of them suffered from disabling pruritus possibly related to chronic uremia.…”

Section: Modification Of Dialysis Techniquesmentioning

confidence: 99%

Recent Advances in Treatment for Uremic Pruritus

Suzuki¹,

Omata²,

Kumagai³

2015

OJNeph

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This review highlights recent advances in pathophysiology and treatment for uremic pruritus, especially focusing on various interventions. Pruritus in patients on hemodialysis (HD) and peritoneal dialysis (PD) still remains an unresolved issue. Recently, the efficacy and safety of nalfurafine hydrochloride have been reported in Japan, and at present, more than thirty thousand patients receive this new drug. In comparison with the efficacy of this new drug, acupuncture, a form of traditional Japanese therapy, has been validated for relief of symptoms of pruritus. In this review, various interventions for relief of symptoms of pruritus as well as recent studies on its pathophysiology will be introduced. This review will be helpful for treatment of pruritus in patients on dialyzed therapy in clinical practice.

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Emollients With Endocannabinoids in the Treatment of Uremic Pruritus: Discussion of the Therapeutic Options

Cited by 42 publications

References 10 publications

Differences in peripheral endocannabinoid modulation of scratching behavior in facial vs. spinally-innervated skin

Differences in peripheral endocannabinoid modulation of scratching behavior in facial vs. spinally-innervated skin

Chronic Pruritus: Clinics and Treatment

Recent Advances in Treatment for Uremic Pruritus

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