Ohanyan Tatevik, Schoepke Nicole, Eirefelt Stefan, Hoey Gert, Koopmann Witte, Hawro Tomasz, Maurer Marcus, Metz Martin
Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, DE-10117 Berlin, Germany.
Acta Derm Venereol. 2018 Jan 12;98(1):26-31. doi: 10.2340/00015555-2780.
Substance P (SP) and its receptor neurokinin 1 (NK1R) are thought to be involved in the pathogenesis of chronic prurigo. Here, we assessed SP serum levels, cutaneous NK1R expression, and the effects of topical aprepitant, an NK1R antagonist, in patients with chronic prurigo. SP and NK1R were increased, compared with controls, in the serum and in lesional vs. non-lesional skin of the patients, respectively. Aprepitant, in a randomized, placebo-controlled, split-sided, doubleblind trial, reduced the intensity of pruritus as assessed by visual analogue scale by >50% from baseline to day 28 (-35.2), but so did placebo vehicle (-38.1, p= 0.76). Overall clinical scores improved significantly by day 28 in both treatment groups, with no significant difference between the 2 groups (p=0.32). Our findings imply that both SP and NK1R are involved in the pathogenesis of chronic prurigo. Parallel groupdesigned trials are needed to assess the efficacy of topical aprepitant treatment in this condition.
P物质（SP）及其受体神经激肽1（NK1R）被认为参与慢性瘙痒症的发病机制。在此，我们评估了慢性瘙痒症患者的SP血清水平、皮肤NK1R表达以及NK1R拮抗剂阿瑞匹坦局部用药的效果。与对照组相比，患者血清中的SP以及病变皮肤与非病变皮肤中的NK1R均升高。在一项随机、安慰剂对照、双侧、双盲试验中，阿瑞匹坦使通过视觉模拟量表评估的瘙痒强度从基线至第28天降低了>50%（-35.2），但安慰剂载体也有同样效果（-38.1，p = 0.76）。两个治疗组的总体临床评分在第28天时均显著改善，两组之间无显著差异（p = 0.32）。我们的研究结果表明，SP和NK1R均参与慢性瘙痒症的发病机制。需要进行平行组设计试验来评估阿瑞匹坦局部治疗在此病症中的疗效。
