Complementary integrative approach for treating pruritus

Pfab, Florian; Schalock, Peter C.; Napadow, Vitaly; Athanasiadis, Georgios; Yosipovitch, Gil; Ring, Johannes

doi:10.1111/dth.12031

Cited by 11 publications

(7 citation statements)

References 75 publications

(92 reference statements)

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“…Pruritus (synonymous with "itch") can be defined as "an unpleasant sensation that provokes the desire to scratch" (Pfab et al 2013 ). It is a common feature of many inflammatory skin diseases such as atopic dermatitis, irritant and allergic dermatitis, scabies, and lichen planus, but may also be seen in a large number of systemic conditions, including cholestasis, thyroid disorders, and kidney failure.…”

Section: Introductionmentioning

confidence: 99%

“…The pathophysiology of itch is nearly as diverse as its causes: there are both central and peripheral mechanisms involved, and a number of different pathways have been identified Chapter 15 Pruritus 206 (Pfab et al 2013 ). Conventional approaches to therapybeyond treating the underlying disease when known-are somewhat lacking in clinical efficacy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Handbook of Integrative Dermatology

Lio¹,

Patel²,

Peters³

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Handbook of Integrative Dermatology

Lio¹,

Patel²,

Peters³

et al. 2015

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“…On the other hand, complementary and alternative medicine is a conservative and increasingly popular approach to treat pruritus for both patients and medical providers [6], especially the traditional Chinese-Japanese medicines (also Kampo medicines). In recent years, a Kampo formula, yokukansankachimpihange (YKH) has been demonstrated to be effective in the treatment of itching of AD [7,8] or chronic urticaria and xerotic eczema patients [9] with psychoneurotic symptoms such as insomnia in Japan, however, few know about its pharmacological mechanism.…”

Section: Introductionmentioning

confidence: 99%

Inhibitory Activity of Yokukansankachimpihange against Nerve Growth Factor-Induced Neurite Growth in Cultured Rat Dorsal Root Ganglion Neurons

Murayama¹,

Watanabe²,

Nakamura

et al. 2015

Molecules

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Chronic pruritus is a major and distressing symptom of many cutaneous diseases, however, the treatment remains a challenge in the clinic. The traditional Chinese-Japanese medicine (Kampo medicine) is a conservative and increasingly popular approach to treat chronic pruritus for both patients and medical providers. Yokukansankachimpihange (YKH), a Kampo formula has been demonstrated to be effective in the treatment of itching of atopic dermatitis in Japan although its pharmacological mechanism is unknown clearly. In an attempt to clarify its pharmacological actions, in this study, we focused on the inhibitory activity of YKH against neurite growth induced with nerve growth factor (NGF) in cultured rat dorsal root ganglion (DRG) neurons because epidermal hyperinnervation is deeply related to itch sensitization. YKH showed approximately 200-fold inhibitory activity against NGF-induced neurite growth than that of neurotropin (positive control), a drug used clinically for treatment of chronic pruritus. Moreover, it also found that Uncaria hook, Bupleurum root and their chemical constituents rhynchophylline, hirsutine, and saikosaponin a, d showed inhibitory activities against NGF-induced neurite growth, suggesting they should mainly contribute to the inhibitory activity of YKH. Further study on the effects of YKH against epidermal nerve density in "itch-scratch" animal models is under investigation.

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“…Acupuncture is a complementary integrative approach that has been successful in helping to treat pruritus. 114 Studies have shown that acupuncture controls autonomic nervous system function and involves areas such as the periaqueductal gray and the RVM. 115,116 Randomized controlled trials investigating the effects of acupuncture on itch have yielded promising results.…”

Section: Stress Itch and The Brainmentioning

confidence: 99%

Effects of Stress on Itch

Golpanian

Kim

Yosipovitch

2020

Clinical Therapeutics

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Psychological stress and ensuing modulation of the immune and nervous systems can have a significant impact on itch. Stress can exacerbate itch and vice versa, resulting in a vicious cycle that can greatly impair a patient's quality of life. This review summarizes the association between stress and itch, elucidates the mechanism by which these two phenomena influence one another, and explores treatment modalities that aim to reduce stress-induced itch. Methods: A complete search of the PubMed and Google Scholar databases was completed and literature pertinent to this review was compiled. Findings: Both acute and chronic stress can significantly affect itch in healthy individuals and in those diagnosed with itchy skin diseases as well as systemic diseases, thus resulting in a vicious cycle in which stress exacerbates itch and vice versa. The mechanisms by which stress induces or aggravates itch include both central and peripheral activation of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. Activation of these systems, in turn, affects the mast cells, keratinocytes, and nerves that secrete neuropeptides, such as substance P, nerve growth factor, acetylcholine, histamine, and itchy cytokines. A dysfunctional parasympathetic response is thought to be involved in the chronic stress/itch response. Brain structures associated with emotion, such as the limbic system and periaqueductal gray, which work on the descending facilitation of itch, play a significant role in stress-induced itch. Implications: As specific brain structures are associated with stress, drug treatments targeting these areas (ie, g-aminobutyric acideergic drugs, serotonin and norepinephrine reuptake inhibitors) may help to modulate itch. Stress can also be combatted using nonpharmacologic treatments such as cognitiveebehavioral therapies and stress-relieving holistic approaches (eg, yoga, acupuncture).

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Complementary integrative approach for treating pruritus

Cited by 11 publications

References 75 publications

Handbook of Integrative Dermatology

Handbook of Integrative Dermatology

Inhibitory Activity of Yokukansankachimpihange against Nerve Growth Factor-Induced Neurite Growth in Cultured Rat Dorsal Root Ganglion Neurons

Effects of Stress on Itch

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