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The Complexity of Pruritus Requires a Variety of Treatment Strategies

  • Urticaria and Atopic Dermatitis (M Furue and T Nakahara, Section Editors)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Abstract

Purpose of the review

There are numerous causes of chronic pruritus (itch) which is associated with a variety of inflammatory skin diseases, including many primarily extracutaneous disorders. This review provides an overview of typical skin and systemic diseases involving pruritus. We focus on relevant molecular mechanisms of pruritus and the current therapeutic strategies.

Recent findings

IL-31, released by eosinophil granulocytes, may play an important role in the neuromodulation of pruritus. Consequently, the anti-IL-31 antibody nemolizumab shows promising results in clinical trials. The novel IL-4 receptor antagonist dupilumab is already approved for the treatment of atopic dermatitis and significantly inhibits inflammation and pruritus. Further, novel treatment approaches include the H4-receptor pathway which has been successfully investigated in a recent clinical trial in patients with atopic dermatitis.

Summary

The emergence, transmission, and perception of pruritus are complex processes that greatly depend on the underlying condition. As more and more specific molecular pathways of these processes are understood, the development of effective treatment strategies for pruritus is becoming increasingly available. Future research should thus focus on the less well-understood forms of pruritus and their underlying mechanisms.

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Funding Sources

Ulrike Raap is supported by a research grant of the DFG RA 1026/3-1 for the Research Group Translational Pruritus Research. Nika Kotnik is supported by a PhD studentship funded by the University of Oldenburg (Oldenburg-Groningen Joint PhD Programme)

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  1. Department of Medicine, Division of Experimental Allergology and Immunodermatology, University of Oldenburg, Carl-von-Ossietzky-Str. 9-11, 26129, Oldenburg, Germany

    N. Helge Meyer PhD, Nika Kotnik MD, Bernhard F. Gibbs PhD & Ulrike Raap MD

  2. University Hospital for Dermatology and Allergology, Rahel-Straus Straße 10, 26133, Oldenburg, Germany

    Volker Meyer PhD & Ulrike Raap MD

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N. Helge Meyer declares that he has no conflict of interest. Nika Kotnik declares that she has no conflict of interest. Volker Meyer declares that he has no conflict of interest. Bernhard F. Gibbs declares that he has no conflict of interest. Ulrike Raap declares that she has no conflict of interest.

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Meyer, N.H., Kotnik, N., Meyer, V. et al. The Complexity of Pruritus Requires a Variety of Treatment Strategies. Curr Treat Options Allergy 6, 189–199 (2019). https://doi.org/10.1007/s40521-019-00217-y

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