Abstract
The subjective symptoms of patients with liver cirrhosis should be carefully evaluated in clinical practice; the nature of pruritus in liver cirrhosis, especially with regard to disease progression and hepatic reserve, is still an elusive clinical question.
The identification of the putative pruritogen lysophosphatidic acid (LPA) in cholestatic liver disease sheds light on this expanding field of hepatic pruritus. Indeed, LPA likely plays a central role in the transmission of itching sensations from the peripheral tissues to the dorsal root ganglions, irrespective of the underlying disease (e.g., uremic pruritus).
Moreover, the demand for a pharmacological intervention for hepatic pruritus has been partially fulfilled with a newly available oral anti-pruritus agent, nalfurafine hydrochloride, making physicians in Japan much more aware of the clinical relevance of hepatic pruritus.
Evidence-based management of pruritus in liver cirrhosis is in its infancy. Much more attention to patients’ reported outcomes, as well as meticulously planned clinical intervention, coupled with translational research, is needed for hepatologists to address this issue.
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Komori, A., Yatsuhashi, H. (2019). Management of Pruritus in Liver Cirrhosis. In: Yoshiji, H., Kaji, K. (eds) The Evolving Landscape of Liver Cirrhosis Management. Springer, Singapore. https://doi.org/10.1007/978-981-13-7979-6_13
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