Neuropathic pain (NeP) can result from sources as varied as nerve compression, channelopathies, autoimmune disease, and incision. By identifying the neurobiological changes that underlie the pain state, it will be clinically possible to exploit mechanism-based therapeutics for maximum analgesic effect as diagnostic accuracy is optimized. Obtaining sufficient knowledge regarding the neuroadaptive alterations that occur in a particular NeP state will result in improved patient analgesia and a mechanism-based, as opposed to a disease-based, therapeutic approach to facilitate target identification. This will rely on comprehensive disease pathology insight; our knowledge is vastly improving due to continued forward and back translational preclinical and clinical research efforts. Here we discuss the clinical aspects of neuropathy and currently used drugs whose mechanisms of action are outlined alongside their clinical use. Finally, we consider sensory phenotypes, patient clusters, and predicting the efficacy of an analgesic for neuropathy.

中文翻译：

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神经性疼痛：基于机制的疗法。

神经性疼痛（NeP）可以由神经压迫，通道病变，自身免疫性疾病和切口等多种来源引起。通过确定疼痛状态背后的神经生物学变化，临床将有可能利用基于机制的疗法来获得最大的止痛效果，从而优化诊断准确性。获得有关在特定NeP状态下发生的神经适应性改变的足够知识，将导致患者的镇痛效果得到改善，并且与基于疾病的治疗方法（旨在促进目标识别）相反，该方法基于机制。这将取决于对疾病病理的全面了解；由于不断地进行前移和后移的临床前和临床研究工作，我们的知识正在大大提高。在这里，我们讨论了神经病变和目前使用的药物的临床方面，这些药物的作用机理与临床用途一起概述。最后，我们考虑感觉表型，患者群，并预测镇痛药对神经病的疗效。