Objective

To summarize recent therapeutic developments for chronic pruritus with a focus on allergic and type 2 inflammatory pathways.

Data Sources

Literature search of PubMed, industry websites, and review of the ClinicalTrials.gov database.

Study Selections

Peer-reviewed publications and public disclosures by industry relating to chronic pruritus pathophysiology and therapeutics.

Results

Histamine and immunoglobulin E remain primary targets for the treatment of itch in the setting of chronic urticaria. More recently, blockade of type 2 immune cell–associated cytokines, including interleukin (IL) 4, IL-13, and IL-31, and the epithelial cell–derived cytokines, specifically IL-33 and thymic stromal lymphopoietin, has and is revolutionizing the treatment of chronic pruritic dermatoses, such as atopic dermatitis and prurigo nodularis. Other novel targets include histamine receptor 4, Janus kinases, κ-opioid receptor, neurokinin 1 receptor, and phosphodiesterase 4.

Conclusion

Advances in our understanding of the neuroimmunology of chronic pruritus have led to the identification of new therapeutic targets and the rapid development of cutting-edge clinical trials. Although incredible advances have already been made, chronic itch continues to be an area of great unmet need.

中文翻译：

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炎性瘙痒的新疗法和新兴疗​​法。

目的

总结慢性瘙痒症的最新治疗进展，重点是过敏和2型炎症途径。

数据源

在PubMed，行业网站上进行文献搜索，并查看ClinicalTrials.gov数据库。

研究选择

与慢性瘙痒症的病理生理学和治疗有关的经过同行评审的出版物和行业公开披露。

结果

组胺和免疫球蛋白E仍然是治疗慢性荨麻疹瘙痒的主要靶标。最近，对2型免疫细胞相关细胞因子（包括白介素（IL）4，IL-13和IL-31）以及上皮细胞衍生的细胞因子（特别是IL-33和胸腺基质淋巴细胞生成素）的阻断已经并且正在发生革命性变化。慢性瘙痒性皮肤病，如特应性皮炎和结节性瘙痒的治疗。其他新的靶标包括组胺受体4，Janus激酶，κ阿片受体，神经激肽1受体和磷酸二酯酶4。

结论

我们对慢性瘙痒症的神经免疫学的了解的进步导致了新的治疗靶标的确定和前沿临床试验的迅速发展。尽管已经取得了令人难以置信的进步，但是长期瘙痒仍然是亟待解决的领域。