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Neuropathic pain (NP) is heterogeneous disorders that challenges to clinicians due to its multifaceted history, uncertain etiology and inadequate therapeutic approach. It causes many problems in day-to-day activities, reduce performance and enhances health care expenditures. Despite numerous drugs are available and the treatment is insufficient due to its various side effects and pharmacological futility. Natural products are the most favorable sources of novel chemical entities with appropriate for the therapeutic approach. Thus, the present review survey on various natural products analyzing pre-clinical studies, which shows to be a potential medicine for NP.
Systematic review was conducted using the relevant articles associated with the natural product and NP that had available in three databases namely PubMed/MEDLINE, Embase and Cochrane Central. Review searches were done in all three databases up to 23rd July 2018. A total of 2456 abstracts/citations were found, 115 articles were submitted for a full-text review and 99 articles fulfilled the inclusion and exclusion criteria. The predominant researches related to natural product and NP were conducted in China (52%), India (11%), and Brazil (11%). Natural products examined were flavonoids (27%), terpenoids (24%), alkaloids (14%), phenols (13%), glycosides (9%), carotenoids (8%) and others (5%). The most articles examined the substances were purchased commercially (67%) and the majority of animal models studied in NP were chronic constriction injury (42%), chemically induced (16%), and partial sciatic nerve ligation (9%). Based on this systematic review, the data strongly suggest that natural products are potential candidature for the treatment of NP.
Neuropathic pain (NP) is heterogeneous disorders, which neither can be described by a single etiology nor by exact anatomical lesions. NP can arise from an illness or injury to the central or the peripheral nervous system. Hence, NP is defined as pain arising as a direct consequence of a lesion or disease distressing the somatosensory system, that consider by impulsive pain with irregular sensory signs. It is normally known as one of the most challenging pain syndromes to cope, and outcomes often are poor. Epidemiological investigations showed that NP affects about 6- 8% of the general population and repeatedly can be challenging due to its multifactorial. Acute NP leads to persistent NP that causes impairing the health-related quality of life and physical and mental health of patients.
In addition, chronic pain is also another public health issue that causes the individual as well as society. Chronic pain can be categorized as inflammatory or neuropathic based on its origin (Yoon and Oh, 2018). Several pathologies outcome from overt or silent injuries affecting secondarily the CNS or, usually, in connection with an injury to the PNS such as amputation pains, complex regional syndromes, radiculopathies, herpes zoster, diabetic neuropathy, postherpetic neuralgia, spinal cord injury, and post-traumatic neuralgia. Normally, these injuries can be evoked by tumors, chemotherapy, metabolic syndromes, diseases caused by bacteria, fungi and viruses, ischemic insults, and intradural lumbar disc herniation. Due to its heterogeneous etiology and complex pathophysiology, NP is indeed difficult to treat. The existing drugs have often insufficient therapeutic potential in the controlling of the chronic pain. Currently, four main types of pharmacological therapies are used for NP: antidepressants, anticonvulsants, opioids, and topical agents. The extensive use of these therapeutic drugs causes many side effects including, sedation, dizziness, edema, and ataxia. For these motives, there is an urgent need to find new agents for relieving NP. Though the present NP animal models do not completely denote the human illness, it eases the investigations on nerve damage and labels as mediators of NP. These animal models are not perfect, however, the development of such investigational models is important, not only for the discovery of new analgesics but also for a better understanding of pain disorders that are hard to achieve clinically.
The conventional therapies were previously ineffective or created many side effects that were unbearable. Natural products or secondary metabolites are a promising therapy, which has been widely used for centuries to treat various diseases effectively without causing fewer side effects. In fact, natural products traditionally have played a vital function in the drug finding and were the root of the original medicines. Hence plant-derived natural products provide therapeutic candidates for the development of new drugs to alleviate NP. Pain relief is the furthermost cited reason that people pursue complementary and alternative medicine. Despite its significance, there is a lacking of systematic reviews on the analgesic potential of natural products for NP. Hence, the present investigation aimed to conduct a systematic review of natural products and their antinociceptive effects in NP models.
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