Purines and neuroregeneration in neuropathies
Keywords:
pain, neuropathies, purines, uridine monophosphateAbstract
The damage of the peripheral nervous system is caused by axonopathy or demyelination. There are no known drugs that may cause remyelination or activate the axonal regeneration. After peripheral nerve injury a neuropathic pain occurs that does not disappear after the healing of the tissue lesion.
The purinergic signalling system has an important role in the development, plastic remodelling and regeneration of the nervous system. The system uses purines and pyrimidines as extracellular transmitters. The main neurotransmitters are adenosine triphosphate and uridine triphosphate. The purinergic receptors in the central and peripheral nervous system in the neurones and glia, control the balance between neuroprotection and neurotoxicity. Additional consumption of uridine monophosphate accelerates the physiological regeneration of the peripheral nerves. It is a starting substance for the synthesis of pyrimidine nucleotides and uridine. These substances are source of energy and co-enzymes in reactions for generation of fundamental components of the neurone membrane, like sphingomyelin, phospholipids and glycoproteins. Uridine monophosphate accelerates and activates the recovery after experimental lesions of n. ischiadicus and inhibits the transmission of pain signals at spinal level. The activation of P2Y1 receptors inhibits the release of pain transmitters in the spinal neurones. These experimental results were confirmed in clinical trials with patients suffering from radiculopathy due to compression of the spinal nerves, compression neuropathies, alcoholic and diabetic neuropathies. Despite of improvement of neuropathic pain an improved peripheral nerve conduction velocity was found.
In conclusion the agonist of the nucleotide purinergic receptors uridine may be used per orally in the form of uridine monophosphate for patients with peripheral nerve lesions in order to accelerate the recovery of the peripheral nerve and as additional therapy for neuropathic pain.
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