Tannins in the Treatment of Diabetic Neuropathic Pain: Research Progress and Future Challenges

Abstract

Diabetes mellitus and its consequences continue to put a significant demand on medical resources across the world. Diabetic neuropathic pain (DNP) is a frequent diabetes mellitus chronic microvascular outcome. Allodynia, hyperalgesia, and aberrant or lack of nerve fibre sensation are all symptoms of DNP. These clinical characteristics will lead to worse quality of life, sleep disruption, depression, and increased mortality. Although the availability of numerous medications that alleviate the symptoms of DNP, the lack of long-term efficacy and unfavourable side effects highlight the urgent need for novel treatment strategies. This review paper systematically analysed the preclinical research on the treatment of DNP using plant phytochemicals that contain only tannins. A total of 10 original articles involved in in-vivo and in-vitro experiments addressing the promising benefits of phytochemical tannins on DNP were examined between 2008 and 2021. The information given implies that these phytochemicals may have relevant pharmacological effects on DNP symptoms through their antihyperalgesic, anti-inflammatory, and antioxidant properties; however, because of the limited sample size and limitations of the studies conducted so far, we were unable to make definitive conclusions. Before tannins may be employed as therapeutic agents for DNP, more study is needed to establish the specific molecular mechanism for all of these activities along the pain pathway and examine the side effects of tannins in the treatment of DNP.

Cajanus cajan Leaves and Ginger Increase Antioxidant Defence in Pancreatic Diabetic Rats: An Immunohistochemical Study

“…Tannins reduce glucose absorption in the digestive system by inhibiting the action of alpha-glucosidase and alphaamylase enzymes so that the time needed for carbohydrate metabolism is extended and preventing hyperglycemia (Türkan et al, 2019). It was also reported that tannins lowered blood glucose levels and exhibited free radicals scavengers (Sieniawska 2015;Omar et al, 2022), as reported by Esmaiel et al, (2019), tannins can minimize the pathological oxidative state of a diabetic situation, as well as lowered blood glucose levels by enhancing the glucose uptake through activation and GLUT-4 translocation, and insulin-signalling pathways, such as PI3K (Phosphoinositide 3-Kinase) and p38 MAPK (Mitogen-Activated Protein Kinase) (Syafril et al, 2019).…”

Anti-Glucotoxicity Effect of Phytoconstituents via Inhibiting MGO-AGEs Formation and Breaking MGO-AGEs

“…Due to the health benefits associated with their antioxidant and hypoglycemic properties, tannins can be potential compounds in the prevention and management of diabetes and the associated complications [179]. Due to their antihyperalgesic, anti-inflammatory, and antioxidant properties, tannins may be useful in the treatment of DN [180].…”

Evaluation of the Antidiabetic Effect of Aqueous Crude Extract of Seed, Leaf and Stem of Linum usitatissimum on Streptozotocin-Induced Diabetic Rats

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