Current views on the mechanisms of development and pharmacotherapy of pruritus

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Pruritus is an extremely common symptom of various diseases, significantly reducing patients’ quality of life. According to a 2016 European study, the symptom was present in 54.4% of patients seen for skin pathology. Characterized by a wide range of etiopathogenetic mechanisms of development, pruritus ultimately leads to a significant reduction in the quality of life of patients. This symptom affects sensory, emotional, and cognitive aspects of life, which makes it urgent to further study the mechanisms of skin pruritus and develop modern aspects of therapy. Modern ideas about the main pathogenetic pathways of skin pruritus formation are analyzed: violation of the epidermal barrier, the role of humoral factors and neuronal sensitization. The role of dermal interleukins, opioids and a number of intracellular mediators in the formation of itching is considered separately. Data on pathogenetic pathways of pruritus are summarized and a review of pharmacotherapy on the basis of current data is given. The need for an integrated approach to the therapy of pruritus is emphasized, aimed both at eliminating the main etiopathogenetic factor and at preventing the formation of a vicious circle of allodynia, leading to chronicity of the symptom and a significant reduction in the quality of life of patients. The choice of optimal pharmacotherapy tactics for patients with pruritus is a relevant aspect of the clinical activity of physicians of various specialties.

Keywords:

pruritus

pharmacotherapy

epidermal barrier

histamine

interleukins

allodynia

Authors:

Kovalenko I.A.

Central State Medical Academy of Department for Presidential Affairs of the Russian Federation

Kruglova L.S.

Central State Medical Academy of Department of Presidential Affairs

Scopus AuthorID: 24168854300
ORCID: 0000-0002-5044-5265

Shatokhina E.A.

Central State Medical Academy of Administrative Directorate of the President of the Russian Federation

Received:

19.01.2020

Accepted:

23.11.2020

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