Peripheral Neuropathies: Different Strategies for Promoting Regeneration and Relief of Neuropathic Pain

Peripheral neuropathies are common problems in nowadays societies, with an incidence similar to stroke or Alzheimer's disease. They can be a consequence of vehicle or sports accidents or of neurodegenerative processes. However, their implications are not correctly understood by patients, health systems, and neuroscientists.

After a peripheral nerve injury (acquired or inherited) of different origins (mechanical, chemical, ischemic), a Wallerian degeneration takes place, with myelin and axon degeneration occurring, Schwann cell dedifferentiation to a repair phenotype, recruitment of macrophages and other immune cells occurs; all these events are accompanied by an inflammation process with several metabolic pathways involved. In addition to the modification in the synthesis and expression of various proteins, the development of neuropathic pain with modifications in the levels of sensitivity to thermal and mechanical stimuli occurs.

In this context, the most common treatments for peripheral neuropathies used to include microsurgery and different types of anti-inflammatory treatments for the management of neuropathic pain; however, the recovery achieved is not total.

Some treatments, such as transplantation of bone marrow-derived stem cells, promote regeneration of myelin and nerve tissue and reduce neuropathic pain associated with mechanical stimulus, but a delay in conduction velocity was observed. Some studies demonstrated the key role of cells such as macrophages and other immune cells in the degeneration-regeneration process; others indicated the use of a natural element such as curcumin or blueberry as a potential treatment for the protection of nerve fibers after injury. Other practices that may promote recovery after peripheral nerve injury include acupuncture, electrical stimulation, exercises, physiotherapy, etc.

This Research Topic seeks to bring together original articles that contribute to the knowledge of nerve degeneration-regeneration processes and the signaling pathways involved in neuropathic pain in order to propose different therapeutic approaches that promote not only the regeneration of injured tissue but also its functional recovery and the management of neuropathic pain.

Both animal models and preclinical studies in humans are welcome, with a focus on all aspects that could bright light on a complex theme such as the degeneration-regeneration process, cells that participate, molecular pathways involved, and original treatments. The study of various stem cell types, nanotechnology, and extracellular vesicles, among others, opens the possibility of new therapeutic tools to achieve regeneration of damaged tissue, along with the treatment of pain associated with the injury.