Chronic pruritus of unknown origin (CPUO) is a debilitating condition that affects millions of patients worldwide, causing severe itching with no identifiable cause or targeted therapies approved for treatment. A recent study from the University of Maryland School of Medicine, led by Dr. Shawn Kwatra, may offer hope for future treatments for these patients. The study found that patients with CPUO had lower levels of metabolite biomarkers in their blood plasma, including amino acids and other metabolites involved in immune system regulation, compared to a healthy control group. This discovery could provide insights into the underlying cause of the condition and potential therapeutic targets for future treatment.
CPUO is most commonly seen in older adults and can cause severe itching lasting more than six weeks, leading to significantly impaired quality of life for patients. Current therapies used to manage symptoms are off-label and often ineffective. In the study, Dr. Kwatra and his colleagues compared blood plasma samples from patients with CPUO and healthy controls, finding lower levels of nine amino acids in the CPUO patients that correlated with itch severity. Previous animal studies have shown a correlation between low levels of these amino acids and itch symptoms in mice, suggesting a potential role in the body’s itch response and other allergic skin reactions.
Dr. Kwatra’s research has also shown promising results with existing medications for related itching disorders. A drug targeting inflammation, abrocitinib, was found to significantly improve itching symptoms in patients with CPUO and another itching disorder called prurigo nodularis in a study published in JAMA Dermatology. Additionally, a monoclonal antibody, nemolizumab, was shown to be effective in treating prurigo nodularis in a study published in the New England Journal of Medicine. This drug was recently approved by the US Food and Drug Administration and is one of the first FDA-approved treatments for the condition, particularly impacting African-American patients.
Dr. Kwatra’s work has led to the establishment of the Maryland Itch Center at the University of Maryland Medical Center, where he currently serves as the Chair of Dermatology. Collaborating with researchers from Johns Hopkins University School of Medicine and Duke University Medical Center, Dr. Kwatra’s studies have provided valuable insights into the underlying mechanisms of CPUO and potential therapeutic approaches for this challenging condition. Further research is needed to explore the role of depleted metabolite biomarkers in CPUO and to validate potential treatments targeting neurotransmitters involved in the body’s itch response.
Overall, Dr. Kwatra’s research offers new hope for patients suffering from chronic pruritus of unknown origin by identifying potential therapeutic targets based on low levels of metabolite biomarkers. With promising results from existing medications for related itching disorders, there is optimism for developing targeted therapies to alleviate symptoms and improve the quality of life for patients with this debilitating condition. The establishment of the Maryland Itch Center underscores the commitment to advancing research and providing comprehensive care for patients with chronic itching disorders.
