title: Advances in therapeutic strategies for the treatment of pruritus.
abstract: BACKGROUND
  Chronic pruritus is a common symptom that arises from both dermatologic and non-dermatologic conditions including chronic kidney disease, cholestasis, lymphoma and neuropathy. Over the past decade, research has elucidated many of the receptors, neuropeptides and cytokines involved in itch sensation and transmission. In addition, the first biomarker for cholestatic itch has been discovered. These findings have led to the development of a host of novel antipruritic medications, both on the market and in the pipeline.
  
  
  METHODS
  A summary of new and emerging treatments for pruritus, as well as possible targets for future therapeutic development is provided.
  
  
  CONCLUSIONS
  At present, there is no universally effective treatment available for all types of chronic pruritus. A combination of topical and systemic therapies addressing peripheral mediators, and a top-down approach targeting the brain and spinal cord, seems preferable to a single agent approach. Neural hypersensitization plays a significant role in many forms of chronic pruritus and may be downregulated by new treatments. In addition, specific neuropeptides are now targeted by novel antipruritic therapies. Furthermore, targeted biologic agents are anticipated to play a significant role in treating pruritus of inflammatory origin.
authors.affiliation: a Department of Dermatology & Temple Itch Center , Temple University School of Medicine , Philadelphia , PA , USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Stull
authors.affiliation: a Department of Dermatology & Temple Itch Center , Temple University School of Medicine , Philadelphia , PA , USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lavery
authors.affiliation: a Department of Dermatology & Temple Itch Center , Temple University School of Medicine , Philadelphia , PA , USA.
authors.forename: Gil
authors.initials: G
authors.lastname: Yosipovitch
mesh_terms: D000982:Antipruritics / Q000627:therapeutic use*; D002908:Chronic Disease; D006801:Humans; D011537:Pruritus / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000982:Antipruritics
keywords: Atopic dermatitis; IL-31; antipruritics; autotaxin; biologics; chronic pruritus; nerve growth factor; neural hypersensitization; neuropeptides; nonhistaminergic itch; psoriasis