Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Dermatolog Treat. 2024 Dec;35(1):2355976. doi: 10.1080/09546634.2024.2355976. Epub 2024 May 26.
Based on a potential shared pathophysiology tied to mast cell activity and neurogenic inflammation that may link pruritus and chronic cough (CC), this study, leveraging the database, examines the association between the two conditions.
A nested case-control comparison was used to examine the association, identifying cases with SNOMED codes 418363000 (pruritus) and 68154008 (CC). Matching was performed on a 1:4 ratio by age, sex, and ethnicity using the MatchIt package in R, followed by maximum likelihood method to estimate odds ratios (ORs) and 95% confidence intervals from 2x2 contingency tables.
CC patients ( = 2,388) were more than twice as likely to be diagnosed with pruritus (OR: 2.65) and pruritus patients ( = 22,496) were more than twice as likely to be diagnosed with CC (OR: 2.57), than respective matched controls.
These results highlight the potential bidirectional relationship between CC and pruritus, suggesting possible shared immune and neural pathways. Treatments like difelikefalin and nalbuphine that modulate these pathways, alongside P2X3 targeting agents, are emerging as potential therapeutic approaches for itch and chronic cough given the possible interconnected pathophysiology. This study's insights into the associations between pruritus and CC may pave the way for targeted therapeutic strategies that address their shared mechanisms.
基于与肥大细胞活动和神经源性炎症相关的潜在共同病理生理学，该研究利用 数据库，检查了瘙痒和慢性咳嗽（CC）之间的关联。
采用嵌套病例对照比较来检查相关性，使用 R 中的 MatchIt 包按年龄、性别和种族以 1:4 的比例进行匹配，然后使用最大似然法从 2x2 列联表估计比值比（OR）和 95%置信区间。
CC 患者（ = 2388）被诊断为瘙痒的可能性是其匹配对照的两倍多（OR：2.65），而瘙痒患者（ = 22496）被诊断为 CC 的可能性是其匹配对照的两倍多（OR：2.57）。
这些结果突出了 CC 和瘙痒之间潜在的双向关系，表明可能存在共同的免疫和神经途径。鉴于可能存在相互关联的病理生理学，像 difelikefalin 和 nalbuphine 这样调节这些途径的药物以及 P2X3 靶向药物，作为治疗瘙痒和慢性咳嗽的潜在治疗方法正在出现。本研究对瘙痒和 CC 之间关联的见解可能为针对其共同机制的靶向治疗策略铺平道路。
