title: Advances in pathogenesis and treatment of pruritus.
abstract: The pathogenesis of itch during cholestasis is largely unknown and treatment options are limited. Lysophosphatidate, female steroid hormones, and endogenous opioids are among the agents discussed as potential pruritogens in cholestasis. The itch-alleviating action of guideline-based therapeutic interventions with anion exchanger resins, rifampicin, opioid antagonists, and serotonin reuptake inhibitors are studied to unravel the molecular pathogenesis of itch. Still, a considerable part of the patients is in need of alternative experimental therapeutic approaches (eg, UV-B phototherapy, extracorporeal albumin dialysis, nasobiliary drainage), providing additional information about the enigmatic pathophysiology of cholestatic pruritus.
authors.affiliation: Tytgat Institute for Liver and Intestinal Research, Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, G4-216, PO Box 22600, Amsterdam NL-1100 DD, The Netherlands.
authors.forename: Ruth
authors.initials: R
authors.lastname: Bolier
authors.forename: Ronald P J
authors.initials: RP
authors.lastname: Oude Elferink
authors.forename: Ulrich
authors.initials: U
authors.lastname: Beuers
mesh_terms: D000818:Animals; D000837:Anion Exchange Resins / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D001647:Bile Acids and Salts / Q000378:metabolism; D002779:Cholestasis / Q000150:complications*; D002792:Cholestyramine Resin / Q000627:therapeutic use; D006801:Humans; D008246:Lysophospholipids / Q000378:metabolism; D009292:Narcotic Antagonists / Q000627:therapeutic use; D000077297:Pregnane X Receptor; D011537:Pruritus / Q000188:drug therapy* / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D011987:Receptors, Steroid / Q000819:agonists / Q000378:metabolism; D012293:Rifampin / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D020280:Sertraline / Q000627:therapeutic use; D015398:Signal Transduction
chemical_list: D000837:Anion Exchange Resins; D000904:Antibiotics, Antitubercular; D001647:Bile Acids and Salts; D002792:Cholestyramine Resin; D008246:Lysophospholipids; D009292:Narcotic Antagonists; D000077297:Pregnane X Receptor; D011987:Receptors, Steroid; D012293:Rifampin; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline; C032881:lysophosphatidic acid