The role of cytokines in diabetic neuropathic pain

Aim: To investigate the role of cytokines in painful diabetic neuropathy (PDN) (PDN) and compare findings with recent evidence. Methods: Sixty patients with PDN and thirty healthy controls were studied. Serum TNF-α, TGF-β, IL-10, and IL-17 levels were measured by ELISA. Parametric and non-parametric tests were applied. Results: TNF-α (6.35±1.64 vs 7.41±2.26 pg/mL; p<0.001) and TGF-β (513.6±358.6 vs 783.8±406.9 pg/mL; p=0.02) were significantly reduced in patients, while IL-10 and IL-17 showed no difference. Recent studies have consistently reported elevated TNF-α, IL-6, and IL-1β levels in painful phenotypes. Conclusion: Our findings highlight an imbalance in cytokine regulation in PDN, with a central role for the TNF-α/TGF-β axis. Beyond pathogenesis, these cytokines may serve as potential biomarkers and therapeutic targets guiding future treatment strategies.