Systemic kappa opioid receptor agonists in the treatment of chronic pruritus: a literature review.

Abstract

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(®)), 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.

• Authors: Ngoc Quan Phan, Tobias Lotts, Attila Antal, Jeffrey D Bernhard, Sonja Ständer
• Journal: Acta dermato-venereologica (Acta Derm Venereol) Vol. 92 Issue 5 Pg. 555-60 (Sep 2012) ISSN: 1651-2057 [Electronic] Sweden
• PMID: 22504709 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antipruritics
• Morphinans
• Receptors, Opioid, kappa
• Spiro Compounds
• TRK 820
• Butorphanol

Topics

• Animals
• Antipruritics (therapeutic use)
• Butorphanol (therapeutic use)
• Chronic Disease
• Humans
• Morphinans (therapeutic use)
• Pruritus (diagnosis, drug therapy, metabolism)
• Receptors, Opioid, kappa (agonists, metabolism)
• Spiro Compounds (therapeutic use)
• Treatment Outcome