Palmitoylethanolamide Restores Myelinated-Fibre Function in Patients with Chemotherapy-Induced Painful Neuropathy

Abstract

We assessed the effect of palmitoylethanolamide (PEA) on pain and nerve function in patients with chemotherapy-induced painful neuropathy, in 20 patients undergoing thalidomide and bortezomib treatment for multiple myeloma. All patients were evaluated before and after a two-month treatment with PEA 300 mg BID using pain and warmth thresholds; blinded examiners measured motor and sensory nerve fibre function and laser-evoked potentials. Although no variables returned to normal values, pain and all neurophysiological measures � assessing Aα, Aβ, and Aδ fibres � significantly improved (P < 0.05). In contrast, warmth thresholds, assessing unmyelinated afferents, remained unchanged (P > 0.50). Although a placebo effect might play a role in the reported pain relief, the changes in neurophysiological measures indicate that PEA exerted a positive action on myelinated fibre groups. PEA, possibly by moderating mast cell hyperactivity, relieved conduction blocks secondary to endoneural edema. In a severe condition such as painful neuropathy associated with multiple myeloma and chemotherapy, a safe substance such as PEA provides significant restoration of nerve function.

Palmitoylethanolamide Reverses Paclitaxel-Induced Allodynia in Mice

“…Consistent with this notion, PEA administration restored nerve function in patients diagnosed with CIPN who were undergoing thalidomide and bortezomib treatment of multiple myeloma. In particular, Truini et al (2011) demonstrated that PEA exerted a positive action on myelinated fibers through the regulation of mast cell hyperactivity, providing significant restoration of nerve function. Thus, PEA may exert a similar effect to prevent paclitaxel-induced peripheral neuropathy.…”

Palmitoylethanolamide: A Useful Adjunct in Chemotherapy Providing Analgesia and Neuroprotection

“…Targeted cytoprotection such as protection against neurotoxicity and ototoxicity is much sought after. In 2011 the group of Professor Cruccu of the University of Rome, published the results of a clinical trial in 20 patients, showing that the natural compound Palmitoylethanolanide (PEA) administered concomitantly to thalidomide and bortezomib could reduce neuropathic pain after chemotherapy and restore the disturbed neurophysiology of nerves [1]. These results support the notion of targeted cytoprotection during chemotherapy.…”

Assessment and Treatment of Chemotherapy-induced Peripheral Neuropathy- a Physical Therapy Perspective

“…Acety-L-Carnitine [65], Alpha-lipoic acid [66], Amifostine [67], cholest-4-en-3-one, oxime (TRO19622) [68], Cannabinoid type-1 receptor [69], Gabapentin [70], Glutamine [71], Lamotrigine [72], recombinant human leukemia inhibitory factor (rhuLIF, AM424, emfilermin) [73], Neurosteroids [74], Palmitoylethanolamide [75] and Retinoic acid [76] were studied individually for their efficacy in randomized clinical trials.…”