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SP and NK1R: new targets in the treatment of chronic pruritus
Author(s) -
Ständer S.,
Yosipovitch G.
Publication year - 2019
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.18496
Subject(s) - aprepitant , medicine , substance p , itching , drug , vomiting , nausea , placebo , prurigo , clinical trial , disease , tachykinin receptor 1 , dermatology , pharmacology , receptor , pathology , neuropeptide , alternative medicine , antiemetic
Summary Chronic itch (pruritus) can severely affect quality of life; it can be associated with several different skin diseases or systemic disease (affecting the whole body rather than just the skin). Current treatments are not always successful, and a fuller understanding of the mechanisms of itch should lead to better treatment. Substance P, which is secreted by nerve fibres, plays an important role in itch; this binds to a receptor, neurokinin 1, on several cell types in the central and peripheral nervous system. The authors, based in Germany, reviewed what is known about the role of these substances in chronic itch. They found that substance P and neurokinin 1 receptor are over‐expressed (too much is produced) in several conditions associated with itching. They also reviewed clinical studies on drugs which antagonise neurokinin 1 receptor binding. These include aprepitant, an oral drug (taken by mouth) which is already in use to treat nausea and vomiting caused by chemotherapy. However, serlopitant and tradipant, which have been developed specifically to reduce itch, show more promise in placebo‐controlled trials (meaning trials where some people take the drug and others take a dummy drug, or placebo, and the results are compared) in conditions such as nodular prurigo and atopic eczema. The authors state that further trials are needed to assess the safety and efficacy of these drugs in chronic itch.