Advances in natural products driven drug discovery from medicinal plants for neuropathic pain

Abstract

Neuropathic pain, which affects 7–10% of the general population, is induced by the lesions or diseases of the somatosensory system including the central neurons and peripheral fibers. Numerous causes of neuropathic pain have been identified, and globally, its prevalence is rising continuously among the ever-increasing aging population, especially among those with diabetes and cancer. Most drugs approved for normal inflammatory pain (NSAIDs, etc.) are ineffective against CNS-related pain due to underlying mechanisms and pathways involved in initiating the neuropathy pain cascade. Hence, considering the multifactorial etiology of neuropathic pain, small molecule natural products (morphine onwards) and their synthetic variants have been explored against neuropathic pain, with remarkable success. However, the pharmacological liabilities (habit-forming, psychoactive, etc.) are still a major challenge with an ever-greater unmet need. The article presents a critical review of the types, manifestations, diagnosis, and different signaling pathways linked to the pharmacology of neuropathic pain and nociception. It summarizes diverse categories of natural products from medicinal plants like alkaloids, terpenoids, steroids, coumarins, glycosides, lignans and flavonoids revealing their pain attenuation abilities. © 2023 Elsevier Inc.