Whole Body Cryostimulation: A New Adjuvant Treatment in Central Sensitization Syndromes? An Expert Opinion

Healthcare, Год журнала: 2024, Номер 12(5), С. 546 - 546

Опубликована: Фев. 25, 2024

Central sensitisation is defined as a multifactorial etiopathogenetic condition involving an increase in the reactivity of nociceptive neurons and alterations pain transmission perception central nervous system. Patients may present with widespread chronic pain, fatigue, sleep disturbance, dizziness, psychological (e.g., depression, anxiety, anger) social impairment. Pain can be spontaneous onset persistence, characterised by exaggerated response spread beyond site origin, sometimes triggered non-painful stimulus. Whole-body cryostimulation (WBC) could adjuvant therapy management this type because its global anti-inflammatory effect, changes cytokines hormone secretion, reduction nerve conduction velocity, autonomic modulation, release neurotransmitters involved pathway. In several conditions fibromyalgia, rheumatoid arthritis, musculoskeletal pain), WBC affects physical performance, perception, aspects. Given multiple targets effects at different organs levels, appears to versatile treatment for wide range rehabilitation interest. Further research needed fully understand mechanisms analgesic effect potential actions on pathways, well study long-term uses other conditions.

Язык: Английский

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Rostral ventromedial medulla astrocytes regulate chronic itch and anxiety-related behaviors

European Journal of Pharmacology, Год журнала: 2025, Номер 992, С. 177358 - 177358

Опубликована: Фев. 6, 2025

Язык: Английский

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Pruritus in Chronic Cholestatic Liver Diseases, Especially in Primary Biliary Cholangitis: A Narrative Review

International Journal of Molecular Sciences, Год журнала: 2025, Номер 26(5), С. 1883 - 1883

Опубликована: Фев. 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.

Язык: Английский

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Pruritus and Neuropsychiatric Symptoms Among Patients with Darier Disease—An Overlooked and Interconnected Challenge

Journal of Clinical Medicine, Год журнала: 2025, Номер 14(6), С. 1818 - 1818

Опубликована: Март 8, 2025

(1) Background: Darier disease (DD) is a rare autosomal dominant disorder caused by mutations in ATP2A2, gene that encodes the sarco(endo)plasmic reticulum calcium-ATPase 2 enzyme, which disrupts calcium homeostasis keratinocytes. Pruritus, frequently overlooked symptom DD, can lead to physical and emotional complications, especially patients with DD who are genetically predisposed psychiatric comorbidities. (2) Methods: This study aimed analyze pruritus other related symptoms explore their correlation neuropsychiatric conditions, psychological challenges, severity, body surface area (BSA) involvement through retrospective review of tertiary center. (3) Results: Data from 76 (equal gender distribution, mean age 44 years) revealed prevalence 90.8%, surpassing such as pain (34.3%) malodor (43.4%). Burning sensations due lesions were significantly correlated diagnosis comorbid conditions (p = 0.047) medication use 0.019). While severity %BSA involvement, findings not statistically significant. Patients reporting had higher Dermatology Life Quality Index score (2.4 ± 1.0), defined presence itch, soreness, pain, or stinging, than those did (1.5 0.6), indicating accurate reporting. (4) Conclusions: In conclusion, striking majority experience pruritus, among severe disease, greater skin involvement. Clinicians should recognize key therapeutic target adopt comprehensive treatment approaches both address comorbidities added burden DD.

Язык: Английский

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Beyond the itch: the complex interplay of immune, neurological, and psychological factors in chronic urticaria

Journal of Neuroinflammation, Год журнала: 2025, Номер 22(1)

Опубликована: Март 11, 2025

Chronic urticaria (CU) arises from a multifaceted interplay of immunological, neurological, and psychological components. Immune dysregulation, mediated through both immunoglobulin E (IgE)-dependent IgE-independent pathways, plays pivotal role in CU pathogenesis, involving key effector cells such as mast (MCs), basophils, eosinophils. This dysregulation culminates the release histamine, prostaglandins, other mediators, which precipitate pruritus. The chronicity disease leads to sustained pruritic symptoms, contributing central peripheral sensitization. excitation itch circuit is augmented, leading neurotransmitters neuropeptides, subsequently interact with immune cells. Psychological factors depression, anxiety, stress exacerbate symptoms diminish quality life. These disrupt hypothalamic-pituitary-adrenal (HPA) axis autonomic nervous system (ANS). Furthermore, act scratching activates reward circuit, resulting manifestation itch-scratching cycle. Current treatments, antihistamines, omalizumab, cyclosporine, demonstrate variable efficacy are often associated adverse effects. A holistic approach addressing physiological aspects advocated. review highlights critical importance understanding neuroimmune interactions influence psychosomatic CU. It aims enhance diagnostic therapeutic strategies by integrating psychological, immunological perspectives.

Язык: Английский

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Odevixibat: A Novel Bile Salt Inhibitor Treatment for Pruritus in Progressive Familial Intrahepatic Cholestasis

Cureus, Год журнала: 2024, Номер unknown

Опубликована: Март 25, 2024

Chronic pruritus is defined as an itch lasting greater than six weeks. It can manifest from a wide variety of etiologies, many different substances act pruritogens, such steroids, histamine, progesterone, endogenous opioids, and serotonin. In the setting cholestatic liver disease, increased bile acids play major role in chronic pruritus. The itching disease worsened intensity at night localized frequently to palms, soles, knees, other pressure sites. be hard manage, affecting quality sleep causing irritability, poor attention, and, some cases, depression. One that results progressive familial intrahepatic cholestasis (PFIC), group uncommon hereditary disorders affects formation its outflow liver. Previously, drug ursodeoxycholic acid was used help manage or surgical procedures, e.g., partial external biliary diversion internal diversion, control complications disease. This literature review will discuss three clinical studies covering effectiveness odevixibat treating patients with PFIC. Odevixibat (Bylvay) oral has been FDA-approved treat months age older prevents reabsorption salts intestines, resulting decreased levels via their excretion stool. Several have determined well tolerated provides nonsurgical, pharmacological treatment alternative for those

Язык: Английский

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Current and emerging drugs for the treatment of pruritus: an update of the literature

Expert Opinion on Pharmacotherapy, Год журнала: 2024, Номер 25(6), С. 655 - 672

Опубликована: Апрель 12, 2024

Pruritus, particularly in its chronic form, often imposes significant suffering and reductions patients' quality of life. The pathophysiology itch is varied depending on disease context, creating opportunities for unique drug development multimodal therapy.

Язык: Английский

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Annexin 1 Reduces Dermatitis-Induced Itch and Cholestatic Itch through Inhibiting Neuroinflammation and Iron Overload in the Spinal Dorsal Horn of Mice

Brain Sciences, Год журнала: 2024, Номер 14(5), С. 440 - 440

Опубликована: Апрель 28, 2024

The unclear pathogenesis of chronic itch originating from several systemic disorders poses challenges to clinical intervention. Recent studies recapitulate the spinal neurocircuits associated with neuroinflammation and synaptic plasticity responsible for pruriceptive sensations. resolution nociception inflammation by Annexin 1 (ANXA1) has been identified. Given that pain share many neural mechanisms, we employed two mice models study underlying targets therapeutic potential ANXA1, comprising allergic contact dermatitis-induced cholestatic itch. Herein, report expression ANXA1 is down-regulated in Repetitive injections ANXA1-derived peptide Ac2-26 (intrathecal, 10 μg) reduce itch-like scratching behaviors following dermatitis cholestasis. Single exposure alleviates established phenotypes. Moreover, delivery (intravenous, 100 effective against Strikingly, therapy inhibits transferrin receptor over-expression, iron accumulation, cytokine IL-17 release production its IL-17R, as well astrocyte activation dorsal horn cord mouse Pharmacological intervention chelator deferoxamine impairs accumulation after Also, IL-17/IL-17R neutralization attenuates Taken together, this current research indicates protects beginning maintenance long-term itch, which may occur via suppression IL-17-mediated neuroinflammation, overload.

Язык: Английский

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From Compression to Itch: Exploring the Link Between Nerve Compression and Neuropathic Pruritus

American Journal of Clinical Dermatology, Год журнала: 2024, Номер unknown

Опубликована: Окт. 17, 2024

Neuropathic itch is a type of chronic pruritus resulting from neural dysfunction along the afferent pathway. It often accompanied by abnormal sensations such as paresthesia, hyperesthesia, or hypoesthesia. This condition, which may involve motor autonomic damage, significantly impacts patients' quality life, causing severe and associated comorbidities depression, disrupted sleep, social strain. accounts for 8% cases, though this be underestimated. comprehensive review focuses on nerve impingement primary pathophysiological mechanism various forms neuropathic including brachioradial (BRP), notalgia paresthetica (NP), anogenital itch. BRP, seen in middle-aged white women, manifests dorsolateral forearms typically exacerbated ultraviolet (UV) exposure related to cervical spine pathology. NP, prevalent presents upper back due thoracic compression. Anogenital pruritus, affecting 1-5% adults, linked lumbosacral issues after ruling out dermatologic conditions lichen sclerosus simplex chronicus. The pathophysiology involves both peripheral central mechanisms, with damage being key factor. Diagnosis requires thorough history, physical examination, potentially imaging studies. Topical agents menthol, capsaicin, lidocaine are used mild while systemic medications gabapentin, pregabalin, antidepressants prescribed moderate cases; however, no US Food Drug Administration (FDA)-approved therapies currently exist specifically Understanding underlying appropriate therapeutic strategies crucial managing effectively.

Язык: Английский

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Practical guide for the diagnosis and treatment of localized and generalized cutaneous pruritus (chronic itch with no underlying pruritic dermatosis)

The Journal of Dermatology, Год журнала: 2024, Номер 52(2), С. 204 - 220

Опубликована: Дек. 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.

Язык: Английский

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