Hepatitis C virus-associated pruritus: Etiopathogenesis and therapeutic strategies

作     者：Youssef Alhmada Denis Selimovic Fadi Murad Sarah-Lilly Hassan Youssef Haikel Mossaad Megahed Matthias Hannig Mohamed Hassan 

作者机构：Department of PathologyUniversity of Mississippi Medical Center Graduate School of Dental MedicineDepart-ment of Restorative DentistryDivision of Oral Health ScienceHokkaido University Clinic of Operative DentistryPeriodontology and Preventive DentistrySaarland University Department of SurgeryTulane University School of Medicine Clinic of DermatologyUniversity Hospital of Aachen Institut National de la Santéet de la RecherchéMédicale Department of Operative Dentistry and EndodonticsDental FacultyUniversity of Strasbourg 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第5期

页      面：743-750页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Hepatitis C virus Pruritus Cholestasis Autotoxin Lysophosphatidic acid PI3 kinase 

摘      要：In addition to its contributing role in the development of chronic liver diseases, chronic hepatitis C virus (HCV) infection is associated with extrahepatic manifestations, particularly, cutaneous-based disorders including those with pruritus as a symptom. Pruritus is frequently associated with the development of chronic liver diseases such as cholestasis and chronic viral infection, and the accumulation of bile acids in patients’ sera and tissues as a consequence of liver damage is considered the main cause of pruritus. In addition to their role in dietary lipid absorption, bile acids can trigger the activation of specific receptors, such as the G protein-coupled bile acid receptor (GPBA/ TGR5). These types of receptors are known to play a crucial role in the modulation of the systemic actions of bile acids. TGR5 expression in primary sensory neurons triggers the activation of the transient receptor potential vanilloid 1 (TRPV1) leading to the induction of pruritus by an unknown mechanism. Although the pathologic phenomenon of pruritus is common, there is no uniformly effective therapy available. Understanding the mechanisms regulating the occurrence of pruritus together with the conduction of large-scale clinical and evidence-based studies, may help to create a standard treatment protocol. This review focuses on the etiopathogenesis and treatment strategies of pruritus associated with chronic HCV infection.