Skin Changes in Cirrhosis

Bhandari, Adhyatm; Mahajan, Rohit

doi:10.1016/j.jceh.2021.12.013

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…Itch accompanies some systemic disorders, for example, some chronic kidney and liver diseases [ 54 ]. Diabetic neuropathy and shingles are among neurological disorders with itching as one of their debilitating symptoms [ 55 , 56 , 57 ]. Although probably not fully accurate, the first report of the antipruritic effect of Botulinum Toxin Type A (BoNTA) appeared in 2002, which presented the beneficial effects of BoNTA for lichen simplex in an open-label pilot study [ 58 ].…”

Section: Clinical Evidence For the Use Of Bont In Clinical Conditions...mentioning

confidence: 99%

How Does Botulinum Toxin Inhibit Itch?

Gazerani

2022

Toxins

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Two decades after reports of the anti-pruritic effects of botulinum neurotoxins (BoNTs), there is still no approved product for the anti-itch indication of BoNTs, and most clinical case reports still focus on the off-label use of BoNTs for various itchy conditions. Few randomized clinical trials have been conducted with controversial results, and the beneficial effects of BoNTs against itch are mainly based on case studies and case series. These studies are valuable in presenting the potential application of BoNTs in chronic pruritic conditions, but due to the nature of these studies, they are categorized as providing lower levels of evidence or lower grades of recommendation. To obtain approval for the anti-pruritic indication of BoNTs, higher levels of evidence are required, which can be achieved through conducting large-scale and well-designed studies with proper control groups and established careful and reliable primary and secondary outcomes. In addition to clinical evidence, presenting the mechanism-based antipruritic action of BoNTs can potentially strengthen, accelerate, and facilitate the current efforts towards further investments in accelerating the field towards the potential approval of BoNTs for itchy conditions. This review, therefore, aimed to provide the state-of-the-art mechanisms underlying the anti-itch effect of BoNTs from basic studies that resemble various clinical conditions with itch as a hallmark. Evidence of the neuronal, glial, and immune modulatory actions of BoNTs in reducing the transmission of itch are presented, and future potential directions are outlined.

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Section: Clinical Evidence For the Use Of Bont In Clinical Conditions...mentioning

confidence: 99%

How Does Botulinum Toxin Inhibit Itch?

Gazerani

2022

Toxins

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Integration of high‐resolution mass spectrometry technology with molecular network analysis and systems biology techniques to elucidate the active ingredients and mechanisms of Shiduqing capsules

Liu,

Li,

Wang

et al. 2024

Rapid Comm Mass Spectrometry

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RationaleShiduqing Capsules, a well‐known Chinese patent medicine, are widely used clinically for the treatment of pruritus. However, to date, there is a lack of research on its pharmacological substances and mechanisms of action.MethodsIn the current study, the chemical components of Shiduqing Capsules were identified using UHPLC‐QE‐Orbitrap‐MS technology. Molecular network analysis was employed to identify structurally similar compounds to the known chemical components. The potential molecular targets of the active ingredients were predicted using the SwissTargetPrediction website. The identified targets were further analyzed using gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis through the DAVID database. Molecular docking was used to validate the network pharmacology results.ResultsUltimately, A total of 51 chemical components of Shiduqing Capsules were identified. Molecular network analysis identified 21 flavonoids and 13 terpenoids. The core targets of these ingredients include TP53, AKT1, and STAT3. GO and KEGG enrichment analysis revealed 1,371 different biological functions and 177 signaling pathways. Molecular docking confirmed the high affinity between multiple core active ingredients of Shiduqing Capsules and pruritus targets.ConclusionIn conclusion, the effective ingredients of Shiduqing Capsules exert a multifaceted therapeutic effect on pruritus through multiple targets and pathways.

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