Pruritus in Chronic Cholestatic Liver Diseases, Especially in Primary Biliary Cholangitis: A Narrative Review
International Journal of Molecular Sciences,
Journal Year:
2025,
Volume and Issue:
26(5), P. 1883 - 1883
Published: Feb. 22, 2025
Patients
with
chronic
cholestatic
liver
diseases
often
experience
itch
and
struggle
this
symptom.
We
discuss
the
mechanism
of
in
patients
diseases,
such
as
primary
biliary
cholangitis
(PBC)
others,
their
therapies,
including
ileal
bile
acid
transporter
(IBAT)
inhibitors.
In
PBC,
there
are
high
serum/plasma
concentrations
multiple
factors,
salts,
bilirubin,
endogenous
opioids,
lysophosphatidic
(LPA),
autotaxin,
histamine.
Bile
LPA,
autotaxin
affect
mediators
skin
sensory
nerves,
while
opioid
balance
affects
spinal
cord.
Itch
is
sensitized
by
both
peripheral
central
nervous
systems.
Both
mechanisms
involved
disease.
Although
IBAT
inhibitors
have
been
approved
for
use
pediatric
conditions,
progressive
familial
intrahepatic
cholestasis
Alagille
syndrome,
inhibition
seems
to
be
a
promising
treatment
refractory
PBC.
A
traditional
non-systematic
review
results
narrative
review.
Multidisciplinary
cooperation,
involving
hepatologists,
dermatologists,
pharmacists,
could
provide
better
PBC
suffering
from
itch.
conclusion,
we
summarized
existing
knowledge
on
caused
especially
focus
therapies.
This
provides
therapeutic
options
diseases.
Language: Английский
Practical guide for the diagnosis and treatment of localized and generalized cutaneous pruritus (chronic itch with no underlying pruritic dermatosis)
The Journal of Dermatology,
Journal Year:
2024,
Volume and Issue:
52(2), P. 204 - 220
Published: Dec. 12, 2024
Abstract
Itch,
also
known
as
pruritus,
is
one
of
the
most
prevalent
symptoms
observed
in
dermatological
practices.
Itch
frequently
arises
from
primary
pruritic
dermatoses,
although
it
may
manifest
absence
a
skin
rash.
The
latter
itchy
condition
referred
to
“cutaneous
pruritus”
Japanese
guidelines
published
2020.
Cutaneous
pruritus
can
be
classified
into
two
categories
based
on
its
distribution:
localized
cutaneous
and
generalized
pruritus.
Localized
indicative
neuropathic
cause,
whereas
suggests
underlying
systemic
disease(s),
drug‐induced
itch,
psychogenic
itch
(also
functional
disorder),
or
chronic
unknown
origin
(CPUO).
Systemic
diseases
associated
with
include
disorders
iron
metabolism,
kidney
disease,
liver
disease
(especially
cholestasis),
endocrine/metabolic
diseases,
hematological
disorders,
malignant
solid
tumors.
CPUO
term
used
describe
that
often
for
which
no
cause
identified
despite
comprehensive
careful
diagnostic
workup.
A
variety
treatment
approaches
are
available
including
device‐based
physical
therapies
(such
phototherapy)
medications
act
itch‐perception
processing
pathway
skin,
peripheral
sensory
nerves,
spinal
cord,
brain.
This
review
presents
an
overview
current
knowledge
regarding
pathophysiologic
mechanisms
procedures
currently
available.
Language: Английский