Erickson Stephen, Nahmias Zachary, Rosman Ilana S, Kim Brian S
Division of Dermatology, Department of Medicine, Washington University School of Medicine, 660 South Euclid Campus Box 8123, St Louis, MO 63110, USA.
Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, MO 63110, USA; Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA; Washington University Dermatopathology Center, Washington University School of Medicine, 660 South Euclid Campus Box 8118, St Louis, MO 63110, USA.
Dermatol Clin. 2018 Jul;36(3):325-334. doi: 10.1016/j.det.2018.02.014. Epub 2018 Apr 16.
Chronic pruritus, or itch lasting greater than 6 weeks, is an increasingly common and debilitating medical problem. Recent studies have unveiled previously unrecognized neuroimmune axes whereby inflammatory cytokines act directly on the nervous system to promote itch. Thus, the emergence of newer targeted biologic therapies has generated the possibility of novel treatment strategies for chronic itch disorders. This article reviews the pathophysiology of multiple chronic itch disorders, including atopic dermatitis, chronic idiopathic pruritus, chronic urticaria, and prurigo nodularis. Furthermore, new and emerging immunomodulatory therapies that will likely alter current treatment paradigms are discussed.
慢性瘙痒,即持续时间超过6周的瘙痒,是一个日益常见且使人衰弱的医学问题。最近的研究揭示了以前未被认识的神经免疫轴,即炎症细胞因子直接作用于神经系统以促进瘙痒。因此,更新的靶向生物疗法的出现为慢性瘙痒症带来了新的治疗策略的可能性。本文综述了多种慢性瘙痒症的病理生理学,包括特应性皮炎、慢性特发性瘙痒、慢性荨麻疹和结节性痒疹。此外,还讨论了可能改变当前治疗模式的新兴免疫调节疗法。