Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1071, USA.
Br J Dermatol. 2011 Jul;165(1):5-17. doi: 10.1111/j.1365-2133.2011.10217.x. Epub 2011 May 30.
Recent advances in pruritus research have elucidated mediators and neuronal pathways involved in itch transmission, and this fast emerging knowledge may possibly be translated into new therapies in the near future. In the skin and peripheral nerves, potential mediator and receptor therapeutic targets include the H4 histamine receptor, protease-activated receptor 2, serine proteases, cathepsin S, peripheral mu- and kappa-opioid receptors, interleukin-31, transient receptor potential vanilloid 1 and 3, fatty acid amide hydrolase, nerve growth factor and its receptor, acetylcholine, and the Mas-related G protein-coupled receptors. In the spinal cord, gastrin-related peptide and its receptor, as well as substance P and its receptor neurokinin receptor-1 serve as potential therapeutic targets. In the brain, reduction of itch perception and modulation of emotions may possibly be achieved through drugs acting on the anterior cingulate cortex. Clinically, management of pruritus should be instituted early and should address the skin pathology, peripheral neuropathy, central sensitization, and the cognito-affective aspects of the disease.
瘙痒研究的最新进展阐明了参与瘙痒传递的介质和神经元途径，而这一快速涌现的知识可能在不久的将来转化为新的治疗方法。在皮肤和周围神经中，潜在的介质和受体治疗靶点包括 H4 组胺受体、蛋白酶激活受体 2、丝氨酸蛋白酶、组织蛋白酶 S、外周 μ 和 κ 阿片受体、白细胞介素 31、瞬时受体电位香草素 1 和 3、脂肪酸酰胺水解酶、神经生长因子及其受体、乙酰胆碱和 Mas 相关 G 蛋白偶联受体。在脊髓中，胃泌素相关肽及其受体，以及 P 物质及其受体神经激肽受体 1 是潜在的治疗靶点。在大脑中，通过作用于前扣带皮层的药物可能可以减少瘙痒感知和调节情绪。临床上，瘙痒的治疗应尽早进行，并且应针对皮肤病理、周围神经病变、中枢敏化和疾病的认知情感方面。
