Neuroinflammation Involved in Diabetes-Related Pain and Itch

Abstract

Diabetes mellitus (DM) is a global epidemic with increasing incidence, which results in diverse complications, seriously affects the patient quality of life, and brings huge economic burdens to society. Diabetic neuropathy is the most common chronic complication of DM, resulting in neuropathic pain and chronic itch. The precise mechanisms of diabetic neuropathy have not been fully clarified, hindering the exploration of novel therapies for diabetic neuropathy and its terrible symptoms such as diabetic pain and itch. Accumulating evidence suggests that neuroinflammation plays a critical role in the pathophysiologic process of neuropathic pain and chronic itch. Indeed, researchers have currently made significant progress in knowing the role of glial cells and the pro-inflammatory mediators produced from glial cells in the modulation of chronic pain and itch signal processing. Here, we provide an overview of the current understanding of neuroinflammation in contributing to the sensitization of the peripheral nervous system (PNS) and central nervous system (CNS). In addition, we also summarize the inflammation mechanisms that contribute to the pathogenesis of diabetic itch, including activation of glial cells, oxidative stress, and pro-inflammatory factors. Targeting excessive neuroinflammation may provide potential and effective therapies for the treatment of chronic neuropathic pain and itch in DM.

Survey of factors related to diabetic foot pruritus in the elderly in Shanghai

“…In addition, diabetes mellitus (DM)‐induced increases in advanced glycosylation products in dermal collagen and skin ageing in the elderly may both lead to reduced hydration of the stratum corneum and cause dry skin followed by pruritus. Complications of peripheral neuropathy in elderly diabetic patients may also lead to the impaired barrier function of the skin, resulting in sensory dysfunction of cutaneous nerve endings of C fibres, leading to abnormal discharge of sensory C nerve fibres and causing pruritus 20 . Peripheral nerve injury can result in sensory abnormalities accompanied with inflammation.…”

Alpha-Lipoic Acid as an Antioxidant Strategy for Managing Neuropathic Pain

“…Both ALA and vitamin E modulate upstream enzymes responsible for the disinhibition of NF-κB, thereby preventing its activation [ 89 ]. Avoiding NF-kB activation is possibly the mechanism by which ALA has been shown to reduce neuroinflammation markers in vitro [ 90 ], considering that NF-kB is an important transcription factor associated with glial activation and transcription of pro-inflammatory cytokines such as TNF-α and IL-1β, which lead to spinal neuroinflammation and increased ROS production [ 91 ].…”

Mechanism underlying linezolid-induced peripheral neuropathy in multidrug-resistant tuberculosis

“…Besides, 66.6% of patients reported that linezolid-induced pain was mainly in the feet (Figure 1D). This led us to consider that linezolid caused clinical symptoms similar to diabetic peripheral neuropathy (DPN) (Liu J. et al, 2022;Fang, Wang, Song, Wang, & Zhang, 2022).…”