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Systemic Kappa Opioid Receptor Agonists in the Treatment of Chronic Pruritus: A Literature Review

期刊

ACTA DERMATO-VENEREOLOGICA
卷 92, 期 5, 页码 555-560

出版社

ACTA DERMATO-VENEREOLOGICA
DOI: 10.2340/00015555-1353

关键词

itch; therapy; kappa opioid receptor antagonist; mu-opioid receptor

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  1. Dr. August Wolff GmbH&Co.KG Arzneimittel

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Chronic pruritus is frequently refractory to currently available treatments. Studies suggest that pruritus may arise from an imbalance of the mu- and kappa-opioid receptor system activity in either the skin or the central nervous system. Stimulation of kappa-opioid receptors by their agonists inhibits pruritus in both animals and humans. The antipruritic effect of kappa-opioid receptors agonists can currently be assumed to be related to their binding to kappa-opioid receptors on keratinocytes and cutaneous and/or central itch neurones. To date, several case reports and 2 controlled trials have demonstrated a beneficial effect of systemic kappa-opioid receptor agonists in the treatment of uraemic pruritus, prurigo nodularis, paraneoplastic and cholestatic pruritus. Nalfurafine hydrochloride (Remitch (R)), a selective kappa-opioid receptor agonist, is approved for the treatment of chronic pruritus in Japan. The aim of this review is to provide an overview of the promising role of kappa-opioid receptors and their agonist in the pathophysiology and treatment of pruritus.

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