Peripheral targets for neuropathic pain

Neuropathic pain represents a significant clinical challenge, with still limited pharmacological approaches to symptomatic relief. This review focuses on molecular targets implicated in neuropathic pain, particularly those involved in peripheral mechanisms. Using the IUPHAR/BPS database of biological targets, their occurrence together with 'neuropathic pain' in PubMed overall and in the past 6 years was analysed. Results were classified as 'large targets', 'rising targets' and 'novel targets'. Ion channels were more prominent in the established targets compared with more recently addressed targets. The 15 top hits in the literature for each of the three categories are discussed. For targets with approved drugs, the scope encompasses authorisation for other clinical indications, with subsequent emphasis on their mechanistic relevance to neuropathic pain. For targets without approved drugs but for which substances were or are currently tested in clinical trials, there is a focus on their progress. For the novel targets, the preclinical evidence for pain and in particular neuropathic pain is presented. The ongoing clinical trials are encouraging, with an expectation of not only new drugs for established targets but also new mechanistic options.