Understanding and Treating Pruritus in Primary Biliary Cholangitis

A systematic review of auxiliary liver transplantation of small-for-size grafts in patients with chronic liver disease

“…Best candidates for ALT are those with hepatocellular carcinoma developed on compensated cirrhosis with a risk of drop-out as a result of tumour progression (up to 18% at 1 year 45 ), refractory ascites (survival <50% at 1 year 46 , 47 ), debilitating encephalopathy (associated 1-year mortality rate up to 64%), 48 , 49 intractable pruritus (incidence up to 70% in primary biliary cirrhosis), 50 , 51 and repeated bleeding in patients who are ineligible for transjugular intrahepatic portosystemic shunt.…”

Cholestatic pruritus: a knowledge update

“…Additionally, the response to therapeutic interventions (bile acid-binding resins or rifampicin) is associated with decreased serum autotaxin activity, further supporting the role of autotaxin-LPA in the pathogenesis of pruritus in cholestasis. 11 …”

Skin Changes in Cirrhosis

“…5 Lysophosphatidic acid (LPA) and autotaxin (an ectoenzyme involved in LPA production) are significantly increased in patients with cholestatic pruritus, J o u r n a l P r e -p r o o f suggesting they may be potential therapeutic targets. 6 Typically, oral contraceptive pills intake in females increases autotaxin levels, and patients with bile obstruction commonly show increased pruritus during the progesterone phase of the menstrual cycle, late pregnancy, and hormone replacement therapy. 7 Thus cirrhotic patients with reduced metabolism of androgens may find elevated autotaxin levels.…”