Effects of alkaloids on peripheral neuropathic pain: a review
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Chinese Medicine Open Access
REVIEW
Effects of alkaloids on peripheral neuropathic pain: a review Chunhao Zhu1†, Ning Liu1,2†, Miaomiao Tian1, Lin Ma4, Jiamei Yang1,2, Xiaobing Lan1,2, Hanxiang Ma3*, Jianguo Niu4* and Jianqiang Yu1,2,4*
Abstract Neuropathic pain is a debilitating pathological pain condition with a great therapeutic challenge in clinical practice. Currently used analgesics produce deleterious side effects. Therefore, it is necessary to investigate alternative medicines for neuropathic pain. Chinese herbal medicines have been widely used in treating intractable pain. Compelling evidence revealed that the bioactive alkaloids of Chinese herbal medicines stand out in developing novel drugs for neuropathic pain due to multiple targets and satisfactory efficacy. In this review, we summarize the recent progress in the research of analgesic effects of 20 alkaloids components for peripheral neuropathic pain and highlight the potential underlying molecular mechanisms. We also point out the opportunities and challenges of the current studies and shed light on further in-depth pharmacological and toxicological studies of these bioactive alkaloids. In conclusion, the alkaloids hold broad prospects and have the potentials to be novel drugs for treating neuropathic pain. This review provides a theoretical basis for further applying some alkaloids in clinical trials and developing new drugs of neuropathic pain. Keywords: Chinese herbal medicines, Alkaloids, Peripheral neuropathic pain, Analgesia Background Neuropathic pain is a type of chronic pain directly caused by the injuries or dysfunction of the somatosensory nervous system [1], which further triggers anxiety and depression symptoms via worsening sleep, essential daily functioning, and quality of life of the patients. Chronic neuropathic pain has aroused a severe public health concern due to its heavy burden on families and society. The population prevalence of chronic neuropathic pain has been estimated to range from 6.9 to 10% [2–4]. *Correspondence: [email protected]; [email protected]; [email protected] † Chunhao Zhu and Ning Liu contributed equally to this work 3 Department of Anesthesiology, General Hospital of Ningxia Medical University, No. 804 Shengli Street, Yinchuan, Ningxia Hui Autonomous Region 750004, Ningxia, China 4 Ningxia Key Laboratory of Craniocerebral Diseases of Ningxia Hui Autonomous Region, Ningxia Medical University, No. 1160 Shengli Street, Yinchuan 750004, Ningxia, China Full list of author information is available at the end of the article
It is noteworthy that the incidence of neuropathic pain is likely to escalate due to the improved survival rate of cancer patients, the aging population, and the aggressively growing incidence of diabetes mellitus. Generally, neuropathic pain is further subdivided into central and peripheral neuropathic pain. Central neuropathic pain includes central lesions [5] and diseases (e.g., stroke [6], multiple sclerosis [7]), whereas peripheral nerve injuries or pathological changes induce peripher
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