The Complexity of Pruritus Requires a Variety of Treatment Strategies

N. Helge Meyer, Nika Kotnik, Volker Meyer, Bernhard F. Gibbs, Ulrike Raap*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of the review: There are numerous causes of chronic pruritus (itch) which is associated with a variety of inflammatory skin diseases, including many primarily extracutaneous disorders. This review provides an overview of typical skin and systemic diseases involving pruritus. We focus on relevant molecular mechanisms of pruritus and the current therapeutic strategies.

Recent findings: IL-31, released by eosinophil granulocytes, may play an important role in the neuromodulation of pruritus. Consequently, the anti-IL-31 antibody nemolizumab shows promising results in clinical trials. The novel IL-4 receptor antagonist dupilumab is already approved for the treatment of atopic dermatitis and significantly inhibits inflammation and pruritus. Further, novel treatment approaches include the H4-receptor pathway which has been successfully investigated in a recent clinical trial in patients with atopic dermatitis.

Summary: The emergence, transmission, and perception of pruritus are complex processes that greatly depend on the underlying condition. As more and more specific molecular pathways of these processes are understood, the development of effective treatment strategies for pruritus is becoming increasingly available. Future research should thus focus on the less well-understood forms of pruritus and their underlying mechanisms.

Original languageEnglish
Pages (from-to)189-199
Number of pages11
JournalCurrent Treatment Options in Allergy
Volume6
Issue number3
DOIs
Publication statusPublished - Sept-2019
Externally publishedYes

Keywords

  • Eosinophils
  • H4 receptor
  • IL-31
  • Neuromediators
  • Neurophysiology
  • Pruritus

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