New and emerging treatments for inflammatory itch |
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| Authors: | Stephen Erickson Aaron Ver Heul Brian S. Kim |
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| Affiliation: | 1. Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;2. Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;3. Center for the Study of Itch and Sensory Disorders, Washington University School of Medicine, St. Louis, Missouri;4. Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri;1. Laboratory of Experimental and Molecular Immunology and Neurogenetics(INEM), UMR 7355 CNRS-University of Orleans, Orleans, France;2. Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil;1. Center for the Study of Itch, Washington University School of Medicine in St Louis, St Louis, Missouri;2. Division of Dermatology, Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri;3. Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, Missouri;4. Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, Missouri;5. Department of Dermatology, University of California, San Francisco, California;6. Miami Itch Center, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida;1. Center for the Study of Itch, Washington University School of Medicine, St. Louis, MO 63110, USA;2. Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA;3. Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA;4. Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA;5. Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA;6. Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA;7. Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA;8. International Centre for Genetic Engineering and Biotechnology and Institute of Infectious Disease and Molecular Medicine, Division of Immunology, University of Cape Town, Cape Town 7700, South Africa;1. International Center for Neurotherapeutics, Dublin City University, Dublin, Ireland;2. Department of Dermatology and UCD Charles Institute for Translational Dermatology, Dublin, Ireland;3. Department of Dermatology, University of California, San Francisco, Calif;4. Department of Dermatology, University Hospital Düsseldorf, Dusseldorf, Germany;5. Department of Dermatology and Venereology, Hamad Medical Corporation, Qatar University, Doha, Qatar;6. School of Medicine, Weill Cornell University–Qatar and Qatar University, Doha, Qatar;7. Department of Dermatology, University Medical Center Göttingen, Gottingen, Germany;8. AnaBios, San Diego, Calif;9. Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria;10. Institut für Physiologie & Pathophysiologie, Universität Erlangen-Nürnberg, Erlangen, Germany |
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| Abstract: | ObjectiveTo summarize recent therapeutic developments for chronic pruritus with a focus on allergic and type 2 inflammatory pathways.Data SourcesLiterature search of PubMed, industry websites, and review of the ClinicalTrials.gov database.Study SelectionsPeer-reviewed publications and public disclosures by industry relating to chronic pruritus pathophysiology and therapeutics.ResultsHistamine and immunoglobulin E remain primary targets for the treatment of itch in the setting of chronic urticaria. More recently, blockade of type 2 immune cell–associated cytokines, including interleukin (IL) 4, IL-13, and IL-31, and the epithelial cell–derived cytokines, specifically IL-33 and thymic stromal lymphopoietin, has and is revolutionizing the treatment of chronic pruritic dermatoses, such as atopic dermatitis and prurigo nodularis. Other novel targets include histamine receptor 4, Janus kinases, κ-opioid receptor, neurokinin 1 receptor, and phosphodiesterase 4.ConclusionAdvances in our understanding of the neuroimmunology of chronic pruritus have led to the identification of new therapeutic targets and the rapid development of cutting-edge clinical trials. Although incredible advances have already been made, chronic itch continues to be an area of great unmet need. |
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