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dc.contributor.authorMollanazar, Nicholas K
dc.contributor.authorSmith, Peter K
dc.contributor.authorYosipovitch, Gil
dc.date.accessioned2019-03-01T06:15:31Z
dc.date.available2019-03-01T06:15:31Z
dc.date.issued2016
dc.identifier.issn1080-0549
dc.identifier.doi10.1007/s12016-015-8488-5
dc.identifier.urihttp://hdl.handle.net/10072/141220
dc.description.abstractFor centuries, itch was categorized as a submodality of pain. Recent research over the last decade has led to the realization that itch is in fact a separate and distinct, albeit closely related, sensation. Chronic itch is a common complaint and has numerous etiologies. Various receptors (TRPA1, TRPV1, PAR2, gastrin-releasing peptide receptor (GRPR), Mas-related G proteins), secreted molecules (histamine, nerve growth factor (NGF), substance P (SP), proteases), and cytokines/chemokines (thymic stromal lymphopoietin (TSLP), IL-2, IL-4, IL-13, and IL-31) are implicated as mediators of chronic pruritus. While much remains unknown regarding the mechanisms of chronic itch, this much is certain: there is no singular cause of itch. Rather, itch is caused by a complex interface between skin, keratinocytes, cutaneous nerve fibers, pruritogenic molecules, and the peripheral and central nervous systems. Atopic dermatitis is one of the most itchy skin dermatoses and affects millions worldwide. The sensation of atopic itch is mediated by the interplay between epidermal barrier dysfunction, upregulated immune cascades, and the activation of structures in the central nervous system. Clinicians are in possession of an arsenal of different treatment options ranging from moisturizers, topical immunomodulators, topical anesthetic ion channel inhibitors, systemic immunomodulators, as well as oral drugs capable of reducing neural hypersensitization. Emerging targeted therapies on the horizon, such as dupilumab, promise to usher in a new era of highly specific and efficacious treatments. Alternative medicine, stress reduction techniques, and patient education are also important treatment modalities. This review will focus on the mediators of chronic pruritus mainly associated with atopic dermatitis (atopic itch), as well as numerous different therapeutic options.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherHumana Press, Inc.
dc.relation.ispartofpagefrom263
dc.relation.ispartofpageto292
dc.relation.ispartofissue3
dc.relation.ispartofjournalClinical Reviews in Allergy and Immunology
dc.relation.ispartofvolume51
dc.subject.fieldofresearchImmunology
dc.subject.fieldofresearchcode3204
dc.subject.keywordsAtopic dermatitis
dc.subject.keywordsChronic pruritus
dc.subject.keywordsBarrier disruption
dc.subject.keywordsNonhistaminergic itch
dc.subject.keywordsNeural hypersensitization
dc.subject.keywordsNeuropeptides
dc.subject.keywordsPruritus receptor unit
dc.subject.keywordsAlternative itch therapies
dc.subject.keywordsImmunomodulators
dc.subject.keywordsPatient education
dc.titleMediators of Chronic Pruritus in Atopic Dermatitis: Getting the Itch Out?
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorSmith, Peter K.


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