J Korean Med Assoc.  2018 Nov;61(11):670-677. 10.5124/jkma.2018.61.11.670.

Pathophysiology and new treatment of itch

• Jung MJ
• Choi YW
• Chung BY
• Park CW
• Kim HO

• KMID: 2426477
• DOI: http://doi.org/10.5124/jkma.2018.61.11.670

Abstract

Many of the patients visit the doctors because of itching sensation. Itching is an unpleasant sensation. In the epidermal keratinocytes, various neurotransmitters and receptors are related itching. The itch signal is mainly transmitted through the lateral spinal ganglion-derived nerve fibers extending to the lower epidermis. Many mediators such as histamine are involved in the itching pathway. It can be helpful in the treatment of patients having itching sensation with a lot of new therapies from the basic medication such as antihistamines. Also, many drugs are currently under study.

Keyword

Pruritus; Etiology; Therapy

MeSH Terms

Epidermis
Histamine
Histamine Antagonists
Humans
Keratinocytes
Nerve Fibers
Neurotransmitter Agents
Pruritus
Sensation
Histamine
Histamine Antagonists
Neurotransmitter Agents

Figure

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  Figure 1 Pathway of itch. Reproduced from Kamo A et al. J Clin Cosmet Dermatol 2017 Apr 24 [Epub], according to the Creative Commons license [5].

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  Figure 2 Neuropathway of pain and itch. GRP, gastrin releasing peptide; SP, substance P; GABA, gamma aminobutyric acid. Reproduced from Akiyama T et al. PLoS One 2011;6:e22665, according to the Creative Commons license [18].

• 

  Figure 3 Mediators that may be targets of treatment for pruritus. TRPV1, transient receptor potential vanilloid 1; KC, keratinocyte; TSLP, thymic stromal lymphopoietin; TSLPR, thymic stromal lymphopoietin receptor; TrkA, tropomyosin receptor kinase A; MrgprA3, Mas-related G-protein coupled receptor member A3; TLP, toll-like receptor; DRG, dorsal root ganglion; IL, interleukin; OSM, oncostatin M; H4R, histamine H4 receptor; NK1R, neurokinin 1 receptor; IgE, immunoglobulin E.

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