Dr Phillip Frost Department of Dermatology and Miami Itch Center, University of Miami, Miami, FL, USA.
Dr Phillip Frost Department of Dermatology and Miami Itch Center, University of Miami, Miami, FL, USA.
Pharmacol Ther. 2023 Mar;243:108355. doi: 10.1016/j.pharmthera.2023.108355. Epub 2023 Feb 3.
Itch is an unpleasant sensation arising from a variety of dermatologic, neuropathic, systemic, and psychogenic etiologies. Various itch pathways are implicated according to the underlying etiology. A variety of pruritogens, or itch mediators, as well as receptors have been identified and provide potential therapeutic targets. Recent research has primarily focused on targeting inflammatory cytokines and Janus kinase signaling, protease-activated receptors, substance P and neurokinin, transient receptor potential-vanilloid ion channels, Mas-related G-protein-coupled receptors (MRGPRX2 and MRGPRX4), the endogenous opioid and cannabinoid balance, and phosphodiesterase 4. Periostin, a newly identified pruritogen, should be further explored with clinical trials. Drugs targeting neural sensitization including the gabergic system and P2X3 are other potential drugs for chronic itch. There is a need for more targeted therapies to improve clinical outcomes and reduce side effects.
瘙痒是一种不愉快的感觉，源于多种皮肤、神经、系统和精神病因。根据潜在病因，涉及各种瘙痒途径。已经确定了多种瘙痒原或瘙痒介质以及受体，为潜在的治疗靶点提供了依据。最近的研究主要集中在靶向炎症细胞因子和 Janus 激酶信号、蛋白酶激活受体、P 物质和神经激肽、瞬时受体电位香草素离子通道、Mas 相关 G 蛋白偶联受体（MRGPRX2 和 MRGPRX4）、内源性阿片类和大麻素平衡以及磷酸二酯酶 4。新近发现的瘙痒原——前胶原，应进一步通过临床试验进行探索。靶向神经敏化的药物，包括 GABA 能系统和 P2X3，是治疗慢性瘙痒的另一种潜在药物。需要更有针对性的治疗方法来改善临床结果并减少副作用。
