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Pruritus characteristic of cirrhosis predominantly manifests as a central phenomenon, purportedly stemming from augmented release of -endorphin, Met-enkephalin, and endomorphin-1,2, which stimulate -receptors within nerve tissues
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This hypothesis is supported by preclinical studies showing that early life traumatic stress is associated with chronic anxiety, spatial memory deficits and reduced expression of GABA A R subunits in the adult rat brains (351)
Researchers should evaluate their results around the four to six week mark to determine whether to continue, adjust, or discontinue their protocol
