Do vitamins halt the COVID-19-evoked pro-inflammatory cytokines involved in the development of neuropathic pain?

Al-Khrasani, Mahmoud and Gomaa, Nariman Essmat Mohamed Abdeltawab and Boldizsár Jr, Imre and Varga, Bence Tamás and Chalabiani, Yashar and Abbood, Sarah Kadhim and Ernyey, Alíz Judit and Király, Kornél P and Máté, Attila and Riba, Pál and Timár, Júlia and Gyertyán, István and Miklya, Ildikó and Parenti, Carmela and Pasquinucci, Lorella and Ágg, Bence and Fürst, Zsuzsanna and Ferdinandy, Péter and Vizi, E. Szilveszter and Hársing, László Gábor (2025) Do vitamins halt the COVID-19-evoked pro-inflammatory cytokines involved in the development of neuropathic pain? BIOMEDICINE & PHARMACOTHERAPY, 189. No. 118346. ISSN 0753-3322

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Abstract

Neuropathic pain (NP), a disease affecting the somatosensory nervous system, causes a high socioeconomic burden on healthcare systems and society; yet, its management has not been fully solved. Post COVID-19, with sequelae of the somatosensory system, further increases the number of individuals with chronic pain, thus further exacerbating the social burden related to NP. The pro-inflammatory mediators, such as TNF-α, IL-1β, and IL-6, are massively released in patients with COVID-19 and are known to be involved in the pathomechanisms of NP, particularly in relation to neuronal sensitization. Specifically, the release of large amounts of these proinflammatory cytokines from immune and non-immune effector cells during the acute and post COVID-19 phases prone to have substantial involvement in the development of post COVID-19 NP. Several preclinical and clinical studies have shown that vitamins’ supplementation, namely vitamins A, B1, B2, B3, B5, B6, B7, B9, B12, C, D, E, and K can attenuate the enhanced release of TNF-α, IL-1β, and IL-6. The early supplementation of these vitamins may mitigate the neuronal sensitization evoked by cytokine storm due to COVID-19 or other viruses. This strategy may provide a novel approach to prevent the development of post COVID-19 NP. This review highlights the mechanisms by which COVID-19 can induce NP and how vitamins may help to alleviate these post COVID-19 sequelae.

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