B vitamins alleviate indices of neuropathic pain in diabetic rats

Jolivalt, Corinne G.; Mizisin, Leah M.; Nelson, Austin; Cunha, Joice Maria da; Ramos, Khara M.; Bonke, D.; Calcutt, Nigel A.

doi:10.1016/j.ejphar.2009.04.028

Cited by 78 publications

(66 citation statements)

References 47 publications

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“…14,44 Other agents effective against tactile allodynia in STZ-diabetic rat model include nitecapone, a catechol-O-methyltransferase inhibitor with potent antioxidant properties, 91 agmatine, an endogenous cationic amine resulting from the decarboxylation of L-arginine, 92 allopurinol, 28 interleukin-6, 31 melatonin, 93 benfotiamine, 94 and the cannabinoid agonist WIN 55,212-2, 95 as well as a cocktail of B 1 , B 6 , and B 12 vitamins. 96 Tactile allodynia in STZ-diabetic mice was found preventable by sulfasalazine, probably via blockage of NF-B activation, 87 as well as the cyclooxygenase-2 inhibitor meloxicam 97 and the 12/15-lipoxygenase inhibitors baicalein and cinnamyl-3,4-dihydroxy-␣-cyanocinnamate.…”

Section: Diabetes-associated Tactile Allodyniamentioning

confidence: 99%

Diabetic Painful and Insensate Neuropathy: Pathogenesis and Potential Treatments

2009

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Summary:Advanced peripheral diabetic neuropathy (PDN) is associated with elevated vibration and thermal perception thresholds that progress to sensory loss and degeneration of all fiber types in peripheral nerve. A considerable proportion of diabetic patients also describe abnormal sensations such as paresthesias, allodynia, hyperalgesia, and spontaneous pain. One or several manifestations of abnormal sensation and pain are described in all the diabetic rat and mouse models studied so far (i.e., streptozotocin-diabetic rats and mice, type 1 insulinopenic BB/Wor and type 2 hyperinsulinemic diabetic BBZDR/Wor rats, Zucker diabetic fatty rats, and nonobese diabetic, Akita, leptin-and leptin-receptor-deficient, and highfat diet-fed mice). Such manifestations are 1) thermal hyperalgesia, an equivalent of a clinical phenomenon described in early PDN; 2) thermal hypoalgesia, typically present in advanced PDN; 3) mechanical hyperalgesia, an equivalent of pain on pressure in early PDN; 4) mechanical hypoalgesia, an equivalent to the loss of sensitivity to mechanical noxious stimuli in advanced PDN; 5) tactile allodynia, a painful perception of a light touch; and 5) formalin-induced hyperalgesia. Rats with short-term diabetes develop painful neuropathy, whereas those with longer-term diabetes and diabetic mice typically display manifestations of both painful and insensate neuropathy, or insensate neuropathy only. Animal studies using pharmacological and genetic approaches revealed important roles of increased aldose reductase, protein kinase C, and poly(ADPribose) polymerase activities, advanced glycation end-products and their receptors, oxidative-nitrosative stress, growth factor imbalances, and C-peptide deficiency in both painful and insensate neuropathy. This review describes recent achievements in studying the pathogenesis of diabetic neuropathic pain and sensory disorders in diabetic animal models and developing potential pathogenetic treatments. Key Words: Animal models, diabetic insensate neuropathy, diabetic painful neuropathy, formalin-induced hyperalgesia, mechanical hyper-and hypoalgesia, pathogenetic treatments of diabetic neuropathic pain and sensory loss, symptomatic treatments of diabetic pain, tactile allodynia, thermal hyper-and hypoalgesia.

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Section: Diabetes-associated Tactile Allodyniamentioning

confidence: 99%

Diabetic Painful and Insensate Neuropathy: Pathogenesis and Potential Treatments

2009

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“…11 Studies have shown effectiveness of Vitamin B, Alpha Lipoic Acid (ALA) and Acetyl L Carnitine in the management of mild to moderate PN 9,[12][13][14][15][16] and B Vitamins can also be used as co-treatment in advanced stages. [17][18][19] Vitamin B (B 1 , B 6 , B 12 ) deficiencies, may lead to an impaired nervous system. 20 The three vitamins are complementary as they act via different modes of action.…”

Section: Introductionmentioning

confidence: 99%

“…17,29,30 These beneficial effects of combination therapy can be attributed to different modes of action of B Vitamins however the precise mode of action is not well understood some possible explanations can be found in the literature. Cobalamin has been shown to improve neuropathy symptoms by neutralizing superoxide and peroxynitrite and restoring normal glutathione levels.…”

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confidence: 99%

Management of peripheral neuropathy symptoms with a fixed dose combination of high-dose vitamin B1, B6 and B12: A 12-week prospective non-interventional study in Indonesia

et al. 2018

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Background: Peripheral neuropathy is a common condition which can have a significant impact on quality of life. It occurs as a component of several common and rare diseases or can be idiopathic and can present with various symptoms.Aims and Objectives: This study is aimed at evaluating the effectiveness and safety of the fixed dose combination of vitamin B1, B6 and B12in mild to moderate peripheral neuropathy of various etiologies in the Indonesian population.Materials and Methods: This was a prospective, open label, multi-center, single arm observational study (Indonesian Clinical Trial Registry No: INA-KPA0DYA). A total of 411 subjects with mild to moderate peripheral neuropathy of various etiologies, who met the eligibility criteria, were included in the study. A subject was considered to have “completed” the study if the study procedures, up to Visit 3 (one month of treatment) were accomplished. Procedural results and 12-week clinical outcomes are reported.Results: Treatment with combination of vitamin B1, B6 and B12 in subjects with symptoms of PN showed significant improvement in overall Total Symptom Score (TSS), within 14 days. The treatment also successfully reduced individual components of TSS from baseline to Visit 5. A significant percentage reduction was also observed for all the Visual Analogue Scale (VAS) parameters at the end of 12 weeks, while the Quality of Life (QoL) scores increased from baseline to the end of treatment.Conclusions: The fixed dose combination of vitamin B1, B6 and B12 was effective and welltolerated in subjects with mild to moderate peripheral neuropathy, of various etiologies.Asian Journal of Medical Sciences Vol.9(1) 2018 32-40

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“…The deficiency of this vitamin has been shown to create an imbalance between CSF levels of myelinotoxic and myelinotrophic cytokines and growth factors, being a key factor in the pathogenesis of vitamin B12 deficient neuropathy [8]. On the other extreme, recent studies identify vitamin B12 assisting to alleviate indices of neuropathic pain in diabetic rats [9]. It has also been shown to be superior to nortriptyline in the treatment of diabetic peripheral neuropathy even in cases of normal vitamin B12 levels [10].…”

Section: Introductionmentioning

confidence: 99%

Dual pathology as a result of spinal stenosis and vitamin B12 deficiency

Patel¹,

Rasul²,

Sell³

2011

Eur Spine J

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Vitamin B12 deficiency can confound the clinical assessment of patients presenting with features of spinal disorders. Speciality practice within spinal surgery may lead the clinician to a focus upon spinal explanations for symptoms and that belief may be reinforced by supporting imaging. In the presence of mainly sensory symptoms consideration and exclusion of non surgical causes needs to occur. This study aimed at identifying the prevalence of vitamin B12 deficiency; the presence of dual pathology on imaging performed; the implementation of replacement therapy and their subsequent clinical response as perceived by patients. This was performed through a retrospective review of patients presenting to specialist spine out-patient clinics over a 4-year period via access to pathology reports followed by a telephone survey. 457 patients were investigated of which 8.5% were vitamin B12 deficient. 70% of patients had repeat levels and 31% continued to be deficient. 26% of these patients were not placed on any supplemental therapy. 72% of patients on treatment had self perceived improved outcomes as compared with 55% not on treatment. 73% of patients underwent MRI/CT imaging. 59% of which had evidence of spinal stenosis. In older patients with sensory symptoms, the coexistence of B12 deficiency should be considered. Detection of deficiency with consequent treatment results in better global outcomes than no treatment. Unless the correct blood test is done, the pathology will remain undetected, and patients may continue with their primary symptoms despite high-risk spinal surgical procedures.

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B vitamins alleviate indices of neuropathic pain in diabetic rats

Cited by 78 publications

References 47 publications

Diabetic Painful and Insensate Neuropathy: Pathogenesis and Potential Treatments

Diabetic Painful and Insensate Neuropathy: Pathogenesis and Potential Treatments

Management of peripheral neuropathy symptoms with a fixed dose combination of high-dose vitamin B1, B6 and B12: A 12-week prospective non-interventional study in Indonesia

Dual pathology as a result of spinal stenosis and vitamin B12 deficiency

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