What lies beneath the surface of the itch in adults?

Weldon, David

doi:10.2500/aap.2007.28.2942

Cited by 4 publications

(2 citation statements)

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“…SP is a short neuropeptide that preferentially binds to the NK1 receptor expressed in the CNS and on immune cells, cutaneous keratinocytes, and mast cells [ 27 ]. An increase in NK1 receptor expression has been reported on keratinocytes in pruritic skin conditions [ 28 , 29 ]. Upon binding to its receptor on keratinocytes, fibroblasts, and mast cells in the skin, SP stimulates the secretion of a variety of inflammatory factors, including interferon- γ , IL-1 β , IL-8, histamine, leukotriene B4, prostaglandin D2, and vascular endothelial growth factor (VEGF) [ 27 ].…”

Section: Mechanism Of the Antipruritic Effectmentioning

confidence: 99%

Aprepitant for the Treatment of Chronic Refractory Pruritus

Alhariri

Sweren

et al. 2017

BioMed Research International

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Chronic pruritus is a difficult condition to treat and is associated with several comorbidities, including insomnia, depression, and decreased quality of life. Treatment for chronic itch includes corticosteroids, antihistamines, and systemic therapies such as naltrexone, gabapentin, UV light therapy, and immunomodulatory treatments, including azathioprine, methotrexate, and cellcept. However, some patients still remain refractory to conventional therapy. Aprepitant is a neurokinin-1 receptor antagonist approved for the prevention of chemotherapy-induced and postoperative nausea and vomiting (CINV, PONV). Recently, aprepitant has demonstrated effectiveness in several case series and open label trials in relieving pruritus for patients refractory to other treatments. Patients with pruritus associated with Sézary syndrome, mycosis fungoides, lung adenocarcinoma, breast carcinoma, sarcomas, metastatic solid tumors, chronic kidney disease, hyperuricemia, iron deficiency, brachioradial pruritus, and Hodgkin's lymphoma have experienced considerable symptom relief with short-term use of aprepitant (up to two weeks). Due to differences in reporting and evaluation of drug effects, the mechanism of aprepitant's role is difficult to understand based on the current literature. Herein, we evaluate aprepitant's antipruritic effects and discuss its mechanism of action and adverse effects. We propose that aprepitant is an alternative for patients suffering from pruritus who do not obtain enough symptom relief from conventional therapy.

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