Diabetic Peripheral Neuropathy: Emerging Treatments of Neuropathic Pain and Novel Diagnostic Methods.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM
Johan Røikjer, Mette Krabsmark Borbjerg, Trine Andresen, Rocco Giordano, Claus Vinter Bødker Hviid, Carsten Dahl Mørch, Pall Karlsson, David C Klonoff, Lars Arendt-Nielsen, Niels Ejskjaer
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引用次数: 0

Abstract

Background: Diabetic peripheral neuropathy (DPN) is a prevalent and debilitating complication of diabetes, often leading to severe neuropathic pain. Although other diabetes-related complications have witnessed a surge of emerging treatments in recent years, DPN has seen minimal progression. This stagnation stems from various factors, including insensitive diagnostic methods and inadequate treatment options for neuropathic pain.

Methods: In this comprehensive review, we highlight promising novel diagnostic techniques for assessing DPN, elucidating their development, strengths, and limitations, and assessing their potential as future reliable clinical biomarkers and endpoints. In addition, we delve into the most promising emerging pharmacological and mechanistic treatments for managing neuropathic pain, an area currently characterized by inadequate pain relief and a notable burden of side effects.

Results: Skin biopsies, corneal confocal microscopy, transcutaneous electrical stimulation, blood-derived biomarkers, and multi-omics emerge as some of the most promising new techniques, while low-dose naltrexone, selective sodium-channel blockers, calcitonin gene-related peptide antibodies, and angiotensin type 2 receptor antagonists emerge as some of the most promising new drug candidates.

Conclusion: Our review concludes that although several promising diagnostic modalities and emerging treatments exist, an ongoing need persists for the further development of sensitive diagnostic tools and mechanism-based, personalized treatment approaches.

糖尿病周围神经病变:新出现的神经病理性疼痛治疗方法和新型诊断方法。
背景:糖尿病周围神经病变(DPN)是一种普遍存在且使人衰弱的糖尿病并发症,通常会导致严重的神经性疼痛。尽管近年来其他糖尿病相关并发症的治疗方法层出不穷,但 DPN 的治疗进展却微乎其微。这种停滞不前源于多种因素,包括诊断方法不敏感和神经病理性疼痛的治疗方案不足:在这篇综合综述中,我们重点介绍了用于评估 DPN 的前景看好的新型诊断技术,阐明了这些技术的发展、优势和局限性,并评估了它们作为未来可靠的临床生物标记物和终点的潜力。此外,我们还深入研究了治疗神经病理性疼痛最有前景的新兴药理学和机理疗法,该领域目前的特点是疼痛缓解不充分和副作用显著:结果:皮肤活检、角膜共聚焦显微镜、经皮电刺激、血源性生物标记物和多组学成为最有前景的新技术,而小剂量纳曲酮、选择性钠通道阻滞剂、降钙素基因相关肽抗体和血管紧张素 2 型受体拮抗剂成为最有前景的候选新药:我们的综述得出的结论是,尽管存在几种有前景的诊断方式和新兴治疗方法,但仍需要进一步开发敏感的诊断工具和基于机制的个性化治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Diabetes Science and Technology
Journal of Diabetes Science and Technology Medicine-Internal Medicine
CiteScore
7.50
自引率
12.00%
发文量
148
期刊介绍: The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.
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