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Novel mechanisms of pain in painful diabetic neuropathy

A recent study has generated compelling experimental data on the role of GPR177 and WNT5a in the pathogenesis and treatment of painful diabetic neuropathy (PDN). The clinical value of these translational findings should be interpreted with caution. However, the limited efficacy of current treatments for PDN warrants further clinical studies on these novel pathways.

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References

  1. Pop-Busui, R. et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care 40, 136–154 (2017).

    Article  CAS  Google Scholar 

  2. Kalteniece, A. et al. Corneal nerve loss is related to the severity of painful diabetic neuropathy. Eur. J. Neurol. 29, 286–294 (2022).

    Article  Google Scholar 

  3. Worthington, A. et al. Spinal inhibitory dysfunction in patients with painful or painless diabetic neuropathy. Diabetes Care 44, 1835–1841 (2021).

    Article  Google Scholar 

  4. Wilkinson, I. D. et al. Determinants of treatment response in painful diabetic peripheral neuropathy: a combined deep sensory phenotyping and multimodal brain MRI study. Diabetes 69, 1804–1814 (2020).

    Article  Google Scholar 

  5. Xie, Y. K. et al. GPR177 in A-fiber sensory neurons drives diabetic neuropathic pain via WNT-mediated TRPV1 activation. Sci. Transl. Med. 14, eabh2557 (2022).

    Article  CAS  Google Scholar 

  6. Melzack, R. & Wall, P. D. Pain mechanisms: a new theory. Science 150, 971–979 (1965).

    Article  CAS  Google Scholar 

  7. Jin, H. Y., Moon, S. S. & Calcutt, N. A. Lost in translation? measuring diabetic neuropathy in humans and animals. Diabetes Metab. J. 45, 27–42 (2021).

    Article  Google Scholar 

  8. Themistocleous, A. C. et al. The pain in neuropathy study (PiNS): a cross-sectional observational study determining the somatosensory phenotype of painful and painless diabetic neuropathy. Pain 157, 1132–1145 (2016).

    Article  CAS  Google Scholar 

  9. Polydefkis, M. et al. The time course of epidermal nerve fibre regeneration: studies in normal controls and in people with diabetes, with and without neuropathy. Brain 127, 1606–1615 (2004).

    Article  Google Scholar 

  10. Malik, R. A. Wherefore art thou, o treatment for diabetic neuropathy? Int. Rev. Neurobiol. 127, 287–317 (2016).

    Article  CAS  Google Scholar 

Download references

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Correspondence to Rayaz A. Malik.

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Competing interests

R.M. has received honoraria for talks on painful neuropathy from Pfizer and Proctor and Gamble.

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Malik, R.A. Novel mechanisms of pain in painful diabetic neuropathy. Nat Rev Endocrinol 18, 459–460 (2022). https://doi.org/10.1038/s41574-022-00710-6

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