• Acta Derm. Venereol. · Sep 2012

    Review

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

    • Ngoc Quan Phan, Tobias Lotts, Attila Antal, Jeffrey D Bernhard, and Sonja Ständer.
    • Competence Center for Chronic Pruritus, Department of Dermatology, University Hospital, Münster, Germany.
    • Acta Derm. Venereol. 2012 Sep 1; 92 (5): 555-60.

    AbstractChronic 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.

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