Traditional Chinese medicine use in neuropathic pain: Targeting glial cell-mediated neuroinflammation

Abstract

Introduction: Neuropathic pain (NP) is a common form of chronic pain that severely affects patients' physical and mental health. The pathogenesis of NP is complex, with peripheral and central sensitization as the main mechanisms. Neuroinflammation mediated by peripheral glial cells (Schwann cells and satellite glial cells) and central glial cells (microglia and astrocytes) is the main factor driving peripheral sensitization and central sensitization. Traditional Chinese medicine (TCM) can prevent and treat NP and is becoming a popular area of research for novel analgesics. However, the mechanism of TCM in treating NP by regulating glial cell-mediated neuroinflammation is unclear. Methods: Online databases, including Scopus, PubMed, and Web of Science, were searched using different keywords: “glial cells and neuropathic pain”, “traditional Chinese medicine and neuropathic pain”. The purpose of this review is to summarize the mechanism of TCM's anti-NP effect from the perspective of glial cell-mediated neuroinflammation. Results: Neuroinflammation mediated by glial cells promotes the occurrence and development of NP. TCM can inhibit inflammatory responses mediated by glial cells mainly through inhibition of purinergic signaling, the MAPK pathway, the TLR pathway, the NF-κB pathway, and chemokine signaling, thereby alleviating NP. Discussion: TCM is a valuable candidate for the treatment of NP. This review will provide a reference for further scientific development and application of anti-NP therapeutic drugs.

Keywords

• Neuropathic pain
• Glial cells
• Neuroinflammation
• Traditional Chinese medicine
• Mechanisms