Pharmacotherapy for Neuropathic Pain

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: 20 October 2024 | Viewed by 1258

Special Issue Editors


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Guest Editor
Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini 6, 50139 Florence, Italy
Interests: neuropathic pain; microglia; neuroinflammation

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Guest Editor
Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini 6, 50139 Florence, Italy
Interests: neurodegenerative diseases; neuroinflammation; microglia; neuropathic pain
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Special Issue Information

Dear Colleagues,

Neuropathic pain affects 7–10% of adults worldwide and tends to be more prevalent in the elderly population and in women. Despite effort exerted towards the development of new treatments, current therapy for neuropathic pain is still a clinical challenge, and the combination of two or more drugs is often needed to improve efficacy. Furthermore, the commonly used drugs are only symptomatic and do not prevent the progression of this chronic condition. Neuropathies are chronic conditions associated with pain, but they also involve the onset of long-term comorbidities such as anxiety, depression, insomnia, and loss of cognitive ability. Neuroinflammation has been reported as one of the key factors triggering chronic pain; thus, the pivotal role of glial cells in the induction, maintenance, and development of inflammatory processes and how these can drastically affect the conditions of the surrounding environment have been heavily focused on in the recent scientific literature. Indeed, the production of inflammatory factors is capable of damaging normal neuronal activity, which results in altered physiological function. Therefore, a stressful correlation between neuroinflammation, demyelination, and degeneration is observed in central and peripheral neuropathies. Restoring normal physiological conditions in the nervous environment through the modulation of specific pharmacological targets is necessary to prevent the progression of this pathology.

The aim of this Special Issue is to collect studies concerning innovative therapies for the treatment of neuropathic pain of both central and peripheral origin, thus highlighting possible new therapeutical approaches to develop more effective, safe, and personalized therapies.

Dr. Vittoria Borgonetti
Dr. Nicoletta Galeotti
Guest Editors

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Keywords

  • neuropathic pain
  • neuroinflammation
  • pharmacology
  • microglia
  • astrocytes
  • allodynia
  • hyperalgesia
  • personalized therapy
  • chronic pain
  • sex differences

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Published Papers (1 paper)

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Review

14 pages, 1578 KiB  
Review
Association of the Serotonin and Kynurenine Pathways as Possible Therapeutic Targets to Modulate Pain in Patients with Fibromyalgia
by Alfonso Alfaro-Rodríguez, Samuel Reyes-Long, Ernesto Roldan-Valadez, Maykel González-Torres, Herlinda Bonilla-Jaime, Cindy Bandala, Alberto Avila-Luna, Antonio Bueno-Nava, Elizabeth Cabrera-Ruiz, Pedro Sanchez-Aparicio, Angélica González Maciel, Ana Lilia Dotor-Llerena and José Luis Cortes-Altamirano
Pharmaceuticals 2024, 17(9), 1205; https://doi.org/10.3390/ph17091205 - 12 Sep 2024
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Abstract
Fibromyalgia (FM) is a disorder characterized by widespread chronic pain, significant depression, and various neural abnormalities. Recent research suggests a reciprocal exacerbation mechanism between chronic pain and depression. In patients with FM, dysregulation of tryptophan (Trp) metabolism has been identified. Trp, an essential [...] Read more.
Fibromyalgia (FM) is a disorder characterized by widespread chronic pain, significant depression, and various neural abnormalities. Recent research suggests a reciprocal exacerbation mechanism between chronic pain and depression. In patients with FM, dysregulation of tryptophan (Trp) metabolism has been identified. Trp, an essential amino acid, serves as a precursor to serotonin (5-HT), a neuromodulator that influences mood, appetite, sleep, and pain perception through the receptors 5-HT1, 5-HT2, and 5-HT3. Additionally, Trp is involved in the kynurenine pathway, a critical route in the immune response, inflammation, and production of neuroactive substances and nicotinamide adenine dinucleotide (NAD+). The activation of this pathway by pro-inflammatory cytokines, such as tumor necrosis factor α (TNF-α) and interferon gamma (IFN-γ), leads to the production of kynurenic acid (KYNA), which has neuroprotective properties, and quinolinic acid (QA), which is neurotoxic. These findings underscore the crucial balance between Trp metabolism, 5-HT, and kynurenine, where an imbalance can contribute to the dual burden of pain and depression in patients with FM. This review proposes a novel therapeutic approach for FM pain management, focusing on inhibiting QA synthesis while co-administering selective serotonin reuptake inhibitors to potentially increase KYNA levels, thus dampening pain perception and improving patient outcomes. Full article
(This article belongs to the Special Issue Pharmacotherapy for Neuropathic Pain)
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