The pruritus of cholestasis

Why do patients with cholestasis itch? The answer to this fundamental question is unknown. It is inferred that substances that accumulate in plasma and other tissues, as a result of cholestasis, cause pruritus; however, the specific nature of the substances and the mechanism by which they cause pruritus has not been discerned. The absence of a clear rationale in studies of pruritus and the lack of techniques to study pruritus in human beings, and specifically, in patients with cholestasis have contributed to the vacuum of information on the pathophysiology and pathogenesis of the pruritus of cholestasis. Over the past 15 years, however, progress has been made in the study of pruritus by advancing the philosophy that research in pruritus, like in any other type of scientific area, requires valid methodology that provides objective data to be analyzed. In this context, the development of a system that allows for the conduct of behavioral studies of scratching activity, the behavioral manifestation of the sensation of itch, has satisfied the requirement of methodology. With the use of this technique, the role of the endogenous opioid system in the pathogenesis of the pruritus of cholestasis has been demonstrated.

[1]  E. Carstens,et al.  Superficial dorsal horn neurons identified by intracutaneous histamine: chemonociceptive responses and modulation by morphine. , 2000, Journal of neurophysiology.

[2]  E. Jones,et al.  Florid opioid withdrawal-like reaction precipitated by naltrexone in a patient with chronic cholestasis. , 2000, Gastroenterology.

[3]  J. Bernhard,et al.  Gabapentin treatment for brachioradial pruritus , 1999, Journal of the European Academy of Dermatology and Venereology : JEADV.

[4]  David C. Jones,et al.  C ASE R EPORT: Oral antioxidant therapy for the treatment of primary biliary cirrhosis: A pilot study , 1999, Journal of gastroenterology and hepatology.

[5]  D. Alling,et al.  Oral nalmefene therapy reduces scratching activity due to the pruritus of cholestasis: a controlled study. , 1999, Journal of the American Academy of Dermatology.

[6]  C. Ghent.  The pruritus of cholestasis , 1999, Hepatology.

[7]  B. Balkau,et al.  Clinical and biochemical expression of the histopathological lesions of primary biliary cirrhosis , 1999 .

[8]  K. Okuda,et al.  Propensity of ectopic liver to hepatocarcinogenesis: Case reports and a review of the literature , 1999, Hepatology.

[9]  R Ohlsson,et al.  Identification of a human nuclear receptor defines a new signaling pathway for CYP3A induction. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[10]  M. Schemper,et al.  Treatment of pruritus in chronic liver disease with the 5‐hydroxytryptamine receptor type 3 antagonist ondansetron: a randomized, placebo‐controlled, double‐blind cross‐over trial , 1998, European journal of gastroenterology & hepatology.

[11]  V. Ng,et al.  Long-term outcome after partial external biliary diversion for intractable pruritus in patients with intrahepatic cholestasis. , 1998, Journal of pediatric gastroenterology and nutrition.

[12]  D. Alling,et al.  Open‐label trial of oral nalmefene therapy for the pruritus of cholestasis , 1998, Hepatology.

[13]  Hermann O. Handwerker,et al.  Specific C-Receptors for Itch in Human Skin , 1997, The Journal of Neuroscience.

[14]  W. Hop,et al.  Oral naltrexone treatment for cholestatic pruritus: a double-blind, placebo-controlled study. , 1997, Gastroenterology.

[15]  D. Keppler,et al.  Transport of glutathione conjugates and glucuronides by the multidrug resistance proteins MRP1 and MRP2. , 1997, Biological chemistry.

[16]  Morris A. Fisher,et al.  Butorphanol (Stadol) , 1997, Neurology.

[17]  M. Greaves,et al.  Pathophysiology of itching , 1996, The Lancet.

[18]  M. Goldberg,et al.  Treatment of Opioid‐Induced Pruritus with Ondansetron: Report of Four Patients , 1996, Pharmacotherapy.

[19]  G. Schnetz,et al.  Pruritometer 1: Portables Meßsystem zur Quantifizierung des Kratzens als objektives Maß für den cholestatischen Pruritus - Pruritometer 1: A Portable Measuring System for the Quantification of Scratching as an Objective Criterion of Cholestatic Pruritus , 1996 .

[20]  C. Hunt,et al.  Pilot study of the use of naltrexone to treat the severe pruritus of cholestatic liver disease. , 1996, The American journal of gastroenterology.

[21]  G. Hobbs,et al.  Ondansetron for the treatment of pruritis after spinal opioids , 1996, Anaesthesia.

[22]  D. Hammond,et al.  Microinjection of morphine into the rat medullary dorsal horn produces a dose-dependent increase in facial scratching , 1995, Brain Research.

[23]  D. Alling,et al.  Effects of Naloxone Infusions in Patients with the Pruritus of Cholestasis: A Double-Blind, Randomized, Controlled Trial , 1995, Annals of Internal Medicine.

[24]  N. Bergasa,et al.  The pruritus of cholestasis: potential pathogenic and therapeutic implications of opioids. , 1995, Gastroenterology.

[25]  G. Ramadori,et al.  Relief of cholestatic pruritus by a novel class of drugs: 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists: effectiveness of ondansetron , 1995, Pain.

[26]  M. Roncalli,et al.  Liver cell dysplasia is a major risk factor for hepatocellular carcinoma in cirrhosis: a prospective study. , 1995, Gastroenterology.

[27]  W. Young,et al.  Cholestasis is associated with preproenkephalin mRNA expression in the adult rat liver. , 1995, The American journal of physiology.

[28]  M. Rawlins,et al.  Flumecinol for the treatment of pruritus associated with primary biliarg cirrhosis , 1994, Alimentary pharmacology & therapeutics.

[29]  W. Scheithauer,et al.  Ondansetron for pruritus due to cholestasis. , 1994, The New England journal of medicine.

[30]  T. Wright,et al.  Pruritus as a symptom of hepatitis C. , 1994, Journal of the American Academy of Dermatology.

[31]  G. Ramadori,et al.  Improvement of cholestatic pruritus by ondansetron , 1993, The Lancet.

[32]  A. Borgeat,et al.  Subhypnotic doses of propofol relieve pruritus induced by epidural and intrathecal morphine. , 1993, Anesthesiology.

[33]  R. Bodnar,et al.  Serotonin receptor subtype antagonists in the medial ventral medulla inhibit mesencephalic opiate analgesia , 1992, Brain Research.

[34]  W. Banks,et al.  Permeability of the blood-brain barrier to peptides: An approach to the development of therapeutically useful analogs , 1992, Peptides.

[35]  N. Bergasa,et al.  Endogenous opioids accumulate in plasma in a rat model of acute cholestasis. , 1992, Gastroenterology.

[36]  D. A. Thomas,et al.  Effects of central administration of opioids on facial scratching in monkeys , 1992, Brain Research.

[37]  R. LaMotte.  Subpopulations of “nocifensor neurons” contributing to pain and allodynia, itch and alloknesis , 1992 .

[38]  A. Parés,et al.  Effects of long-term rifampicin administration in primary biliary cirrhosis , 1992 .

[39]  S. Maier,et al.  Cholecystokinin antianalgesia: safety cues abolish morphine analgesia. , 1992, Science.

[40]  N. Bergasa,et al.  Central mu-opioid receptors are down-regulated in a rat model of cholestasis. , 1992, Journal of hepatology.

[41]  G. Mentha,et al.  Propofol and cholestatic pruritus. , 1992, The American journal of gastroenterology.

[42]  E. C. Walker,et al.  A controlled trial of naloxone infusions for the pruritus of chronic cholestasis. , 1992, Gastroenterology.

[43]  N. Bergasa,et al.  Management of the pruritus of cholestasis: potential role of opiate antagonists. , 1991, The American journal of gastroenterology.

[44]  E A Jones,et al.  Application of piezo film technology for the quantitative assessment of pruritus. , 1991, Biomedical instrumentation & technology.

[45]  G. Centini,et al.  S-adenosylmethionine for the treatment of intrahepatic cholestasis of pregnancy. Results of a controlled clinical trial. , 1990, Hepato-gastroenterology.

[46]  B. Richardson.  Serotonin and Nociception , 1990, Annals of the New York Academy of Sciences.

[47]  F. Fiaccadori,et al.  Oral S-adenosylmethionine in the symptomatic treatment of intrahepatic cholestasis. A double-blind, placebo-controlled study. , 1990, Gastroenterology.

[48]  W. Banks,et al.  Peptide transport systems for opiates across the blood-brain barrier. , 1990, The American journal of physiology.

[49]  N. Bergasa,et al.  Hypothesis the pruritus of cholestasis: From bile acids to opiate agonists , 1990 .

[50]  H. Cynamon,et al.  Rifampin relieves pruritus in children with cholestatic liver disease. , 1990, Gastroenterology.

[51]  T. Reynolds,et al.  Failure of rifampin to relieve pruritus in chronic liver disease. , 1990, Journal of clinical gastroenterology.

[52]  A. Parés,et al.  COMPARISON OF RIFAMPICIN WITH PHENOBARBITONE FOR TREATMENT OF PRURITUS IN BILIARY CIRRHOSIS , 1989, The Lancet.

[53]  M. Losowsky,et al.  Opioid peptides and primary biliary cirrhosis. , 1988, BMJ.

[54]  D. Thangathurai,et al.  The incidence of pruritus after epidural morphine , 1988, Anaesthesia.

[55]  M. Losowsky,et al.  Plasma methionine enkephalin concentration and prognosis in primary biliary cirrhosis. , 1988, BMJ.

[56]  S. Sheather,et al.  Clinical applications of visual analogue scales: a critical review , 1988, Psychological Medicine.

[57]  A. Fellgiebel,et al.  Effect of cholestyramine on plasma cholecystokinin and pancreatic polypeptide levels, and exocrine pancreatic secretion , 1988, European journal of clinical investigation.

[58]  P. Toghill,et al.  Effect of stanozolol on itching in primary biliary cirrhosis , 1988 .

[59]  S. Carruthers,et al.  Treatment of pruritus in primary biliary cirrhosis with rifampin. Results of a double-blind, crossover, randomized trial. , 1988, Gastroenterology.

[60]  P. E. Shapiro,et al.  Unilateral pruritus after a stroke. , 1987, Archives of dermatology.

[61]  M. Kaplan,et al.  Primary Biliary Cirrhosis , 1987, The New England journal of medicine.

[62]  Ghent Cn.  Pruritus of cholestasis is related to effects of bile salts on the liver, not the skin. , 1987 .

[63]  Bernhard Jd.  Itching as a manifestation of noncutaneous disease. , 1987 .

[64]  M. Bushnell,et al.  The medullary dorsal horn: a target for the expression of opiate effects on the perceived intensity of noxious heat , 1986 .

[65]  James V. Mitchell.  NALTREXONE AND HEPATOTOXICITY , 1986, The Lancet.

[66]  K. E. Newhouse.  Goodman and Gilman's The Pharmacological Basis of Therapeutics , 1986, The Yale Journal of Biology and Medicine.

[67]  T. Abboud,et al.  The Effects of Naloxone Associated with the Intrathecal Use of Morphine in Labor , 1985, Anesthesia and analgesia.

[68]  F. Schaffner,et al.  Role of plasmapheresis in primary biliary cirrhosis. , 1985, Gut.

[69]  Massey Ew.  Unilateral neurogenic pruritus following stroke. , 1984 .

[70]  J. Summerfield,et al.  Bile acid profiles of human serum and skin interstitial fluid and their relationship to pruritus studied by gas chromatography-mass spectrometry. , 1982, Clinical science.

[71]  E. Dickson,et al.  TREATMENT OF PRURITUS OF CHOLESTASIS BY PLASMA PERFUSION THROUGH USP-CHARCOAL-COATED GLASS BEADS , 1980, The Lancet.

[72]  R. Swift,et al.  Relief of intractable pruritus with naloxone. , 1979, Archives of dermatology.

[73]  L. Stehling,et al.  Double-Blind Comparison of Butorphanol Tartrate and Meperidine Hydrochloride in Balanced Anaesthesia , 1978, The Journal of international medical research.

[74]  J. Bloomer,et al.  Efficacy and safety of long-term phenobarbital therapy of familial cholestasis. , 1978, The Journal of pediatrics.

[75]  E. Dickson,et al.  Plasmaperfusion for the treatment of intractable pruritus of cholestasis. , 1978, Mayo Clinic proceedings.

[76]  P. O. Osterman,et al.  Paroxysmal itching in multiple sclerosis , 1976, The British journal of dermatology.

[77]  M. Kreek,et al.  Rifampin-induced methadone withdrawal. , 1976, The New England journal of medicine.

[78]  I. Oswald,et al.  Further studies of scratching during sleep , 1975, The British journal of dermatology.

[79]  J. M. Anderson,et al.  " NULL CELLS " IN SYSTEMIC LUPUS ERYTHEMATOSUS , 1975, The Lancet.

[80]  J. Boyer,et al.  Phenobarbital Effects in Cholestatic Liver Disease , 1975 .

[81]  J. Burton,et al.  Pruritic Effect of Bile Salts , 1974, British medical journal.

[82]  D. Varadi.  Pruritus induced by crude bile and purified bile acids. Experimental production of pruritus in human skin. , 1974, Archives of dermatology.

[83]  I Oswald,et al.  Scratching during sleep. , 1973, Lancet.

[84]  W. Watson.  Intravenous lignocaine for relief of intractable itch. , 1973, Lancet.

[85]  D. V. Datta,et al.  Cholestyramine for long term relief of the pruritus complicating intrahepatic cholestasis. , 1966, Gastroenterology.

[86]  S. Sherlock,et al.  Testosterone Therapy for the Pruritus of Obstructive Jaundice , 1952, British medical journal.

[87]  H. Koenigstein.  Experimental study of itch stimuli in animals. , 1948, Archives of dermatology and syphilology.

[88]  T. Reisine.  Opioid analgesics and antagonists , 1996 .

[89]  R. Moore,et al.  Organization of the mammalian circadian system. , 1995, Ciba Foundation symposium.

[90]  D. Alling,et al.  Cholestasis in the male rat is associated with naloxone-reversible antinociception. , 1994, Journal of hepatology.

[91]  G. Mentha,et al.  Subhypnotic doses of propofol relieve pruritus associated with liver disease. , 1993, Gastroenterology.

[92]  M. Turner,et al.  Plasma from patients with the pruritus of cholestasis induces opioid receptor-mediated scratching in monkeys. , 1993, Life sciences.

[93]  E. Jones,et al.  The pruritus of cholestasis: from bile acids to opiate agonists. , 1990, Hepatology.

[94]  C. Ghent.  Pruritus of cholestasis is related to effects of bile salts on the liver, not the skin. , 1987, The American journal of gastroenterology.

[95]  H. Popper.  Cholestasis. , 1968, Annual review of medicine.

[96]  S. Sherlock,et al.  Diseases of the Liver and Biliary System , 1955 .

[97]  A. Querido.  On the permeability of the blood-brain barrier. , 1948, Archives neerlandaises de physiologie de l'homme et des animaux.