Maintaining efficacy in the treatment of diabetic peripheral neuropathic pain: role of duloxetine

Neuropathic pain results from lesions or diseases of the somatosensory nervous system and it remains largely difficult to treat. Peripheral neuropathic pain originates from injury to the peripheral nervous system (PNS) and manifests as a series of symptoms and complications, including allodynia and hyperalgesia. The aim of this review is to discuss a novel approach on neuropathic pain management, which is based on the knowledge of processes that underlie the development of peripheral neuropathic pain; in particular highlights the role of glia and mast cells in pain and neuroinflammation. ALIAmides (autacoid local injury antagonist amides) represent a group of endogenous bioactive lipids, including palmitoylethanolamide (PEA), which play a central role in numerous biological processes, including pain, inflammation, and lipid metabolism. These compounds are emerging thanks to their anti-inflammatory and anti-hyperalgesic effects, due to the down-regulation of activation of mast cells. Collectively, preclinical and clinical studies support the idea that ALIAmides merit further consideration as therapeutic approach for controlling inflammatory responses, pain, and related peripheral neuropathic pain.

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Role of Duloxetine as Adjuvant in Chemotherapy Induced Peripheral Neuropathic Pain-An Update

Journal of Addiction Medicine and Therapeutic Science ◽

10.17352/2455-3484.000014 ◽

2016 ◽

pp. 010-012 ◽

Cited By ~ 1

Author(s):

R Garg

Keyword(s):

Neuropathic Pain ◽

Peripheral Neuropathic Pain

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Peripheral Mechanisms of Neuropathic Pain—The Role of Neuronal and Non-Neuronal Interactions and Their Implications for Topical Treatment of Neuropathic Pain

Pharmaceuticals ◽

10.3390/ph14020077 ◽

2021 ◽

Vol 14 (2) ◽

pp. 77

Author(s):

Magdalena Kocot-Kępska ◽

Renata Zajączkowska ◽

Joanna Mika ◽

Jerzy Wordliczek ◽

Jan Dobrogowski ◽

...

Keyword(s):

Neuropathic Pain ◽

Nerve Injury ◽

Structural Changes ◽

Neuronal Cells ◽

Special Focus ◽

Peripheral Sensitization ◽

Peripheral Neuropathic Pain ◽

Topical Analgesics ◽

Underlying Mechanisms

Neuropathic pain in humans arises as a consequence of injury or disease of somatosensory nervous system at peripheral or central level. Peripheral neuropathic pain is more common than central neuropathic pain, and is supposed to result from peripheral mechanisms, following nerve injury. The animal models of neuropathic pain show extensive functional and structural changes occurring in neuronal and non-neuronal cells in response to peripheral nerve injury. These pathological changes following damage lead to peripheral sensitization development, and subsequently to central sensitization initiation with spinal and supraspinal mechanism involved. The aim of this narrative review paper is to discuss the mechanisms engaged in peripheral neuropathic pain generation and maintenance, with special focus on the role of glial, immune, and epithelial cells in peripheral nociception. Based on the preclinical and clinical studies, interactions between neuronal and non-neuronal cells have been described, pointing out at the molecular/cellular underlying mechanisms of neuropathic pain, which might be potentially targeted by topical treatments in clinical practice. The modulation of the complex neuro-immuno-cutaneous interactions in the periphery represents a strategy for the development of new topical analgesics and their utilization in clinical settings.

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The role of the skin in peripheral neuropathic pain

European Journal of Pain Supplements ◽

10.1016/s1754-3207(10)70526-5 ◽

2010 ◽

Vol 4 (S2) ◽

pp. 157-160 ◽

Cited By ~ 3

Author(s):

Gordon Irving

Keyword(s):

Neuropathic Pain ◽

Peripheral Neuropathic Pain

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Foreign Body Induced Neuralgia: A Diagnostic Challenge

Case Reports in Dentistry ◽

10.1155/2013/352671 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

S. Padmashree ◽

Chaitra H. Ramprakash ◽

Rema Jayalekshmy

Keyword(s):

Neuropathic Pain ◽

Foreign Body ◽

Surgical Intervention ◽

Mental Foramen ◽

Radiographic Evaluation ◽

Diagnostic Challenge ◽

Peripheral Neuropathic Pain ◽

Iatrogenic Trauma ◽

Proper Diagnosis

Neuropathic pain is caused by neural injury or painful states associated with either peripheral or central nerve injury. One of the aetiologies of this type of pain is iatrogenic trauma. This case highlights the features of peripheral neuropathic pain caused by foreign body left in the mental foramen following a previous surgical procedure. The foreign body was detected on routine radiographic evaluation. Once the foreign body was removed by surgical intervention, the pain resolved. This stresses the importance of routine radiographic evaluation in proper diagnosis and treatment planning in the management of neuropathic pain. This paper also sheds light on the role of iatrogenic mechanical cause of peripheral neuropathic pain and warrants a tough degree of caution on the part of oral clinicians.

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