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Review Article Alcoholic Neuropathy and Remedies Journal of Innovations in Pharmaceuticals and Biological Sciences JIPBS www.jipbs.com ISSN: 2349-2759 Review article Alcoholic neuropathy and remedies Shashidhar Mehta*1, Puneet Sudan2, Shaveta Bhardwaj3, Sonika Redhu Sihag4, Rajesh Kumar Pandey5 1Department of Biochemistry, Mewar University, Rajasthan. 2Chandigarh College of Pharmacy, Landran, Punjab. 3Department of Pharmacy, LLR College of Pharmacy, Moga, Punjab. 4Shekhwati College of Pharmacy, Dunload, Jhunjhunu, Rajasthan. 5All Excel Inc., 135 Wood Street Suite 201 West Haven, CT 06516. Abstract Neuropathy is caused by a wide variety of factors, however majority of them are under reported till date. Medicinal plants have been used in research long before the centuries to extract out the therapeutic effect in order to relieve the morbidities. The administration of alcohol for long time causes the advent of alcoholic neuropathic like state. Herbal drugs offer a novel approach in the treatment of the disorder. Thus, further exploration is needed in order to explore the further mechanism that will provide substantial support for claiming the therapeutic effect. Key words: neuropathy; chronic; alcoholism; remedies; immunity *Corresponding Author: Shashidhar Mehta, Department of Biochemistry, Mewar University, Rajasthan. 1. Introduction Neuropathy is caused by a number of the condition of the neuropathy worsens to factors including heredity causes, induction the utmost level when a person is suffering of diabetes like morbidity, advent of from fever or any other disorder that leads arthritis problem, HIV and cancer disorders to loss of immunity occurs because that and induction of heavy metals like arsenic, condition destroys the myelin sheath that lead and mercury. The ingestion of alcohol provides protective covering of the nerves causes the problem of neuropathy to a and neurons. In certain cases, the capacity wider extent, which cannot be ignored. The of regeneration occurs that leads to the role of nutritional deficiencies is also origination of new cells that improvise the playing a mandate role in the progression of conditions. However, the regeneration neuropathic like state, indeed worsens the capacity is further limited by many other disorder and may lead to mortality issues factors including the morbidity and also. The administration of medications like mortality issues. Herbal supplements ddl and d4T also causes the progression of alleviate and attenuate the issue of the disease. Apart these causative factors, ©JIPBS, All rights reserved Shashidhar Mehta et al., JIPBS, Vol 3 (2), 66-70, 2016 neuropathy pain to a major extent and has of various complications that leads to the provided a therapeutic effect for the same. progression of neuropathy [7]. Emergence of vitamin D as a regulator of the immune system and to prevent the 3. Pathogenesis destruction of myelin sheath cannot be ignored. This has become possible due to The underlying mechanism beneath this the antioxidant capacity of vitamin D. The concept is also not well understood. The supplementation of brain by vitamin D is effect of chronic alcohol consumption on mandate for the smooth functioning of the nervous system cannot be ignored as brain and to maintain the normal metabolic parasympathetic system is also halted to a activities. Studies form literature reveals large extent. that vitamin B 12 is essential for Large debate occurs on understanding the maintaining and repairing the destroyed pathophysiology of alcoholic neuropathy. myelin sheath and thus helps in maintaining The quantity of the alcohol that leads to the the nervous system healthy. Vitamin C symptoms of alcoholic neuropathy is also complex is also good supplement regimen not well-established [8-11]. The most since it is water soluble, and therefore is studies done in the past have revealed being stored as a reserve in the body. association of the chronic alcohol consumption with the effect on the nervous 2. Alcoholic Neuropathy system. The reports from the previous studies The consumption of alcohol for a long associate largely thiamine deficiency period produces a complex cascade of responsible for the precipitation of many disorders that attributes to complications symptoms that are well seen in the alcoholic which disrupts the homeostatic neuropathy. The alcoholic neuropathy mechanisms occurring in the human body symptoms are a result of the consumption [1]. These changes cause the various of ethanol and its metabolites as well the alterations affecting the life quality of the deficiencies that also go hand in hand with person to a great extent. The numerous the disorder. complications arise because of the poor The deficiency of vitamins leads to the onset understanding of the mechanisms that of various severe symptoms that contribute contribute widely to these disorders [2-3]. largely to the affect the increased level of Chronic consumption of alcohol leads to glucose and impaired utilization of B12 also advent of peripheral neuropathy. This leads occurs with the symptoms of alcoholic to low threshold of pain that contributes to neuropathy.This phenomenon may be resp lower deformities. Axonal degeneration is onsible for the induction of the neuropathic also quite common with the consumption of pain like behaviour following chronic alcohol for longer periods [4-6]. This leads ethanol consumption. also to degeneration of myelinated and unmyelinated fibres. 4. Symptoms The alcoholic neuropathy has caused significant alterations in the neuronal and Alcoholic polyneuropathy has similar axonal level. Thus, the homeostatic symptoms as that of other kinds of mechanisms get disturbed by the causation neuropathies, e.g., tingling and numbness in the extremities, loss of heat 67 Shashidhar Mehta et al., JIPBS, Vol 3 (2), 66-70, 2016 and cold sensation, loss of fine motor benfotiamine has significant control etc [12-14]. Symptoms usually improvement on paralysis and motor develop slowly and worsen with time coordination parameters: however the Numbness in the arms and legs reason for the same is not well Abnormal painful sensations in limbs understood. However further studies are Muscle weakness, needed to explore the hidden Cramps mechanisms. Heat intolerance. Impotency in men 2. Alpha lipoic acid Urinating problems including: Alpha lipoic acid till date is the most well Incontinence (leaking urine), Feeling explored nutrient used in the treatment of incomplete bladder emptying, of not only neuropathy and associated Difficulty beginning to urinate complications. The same has been used Sub-perineurialedema in western countries from long decades. Other symptoms The administration of streptozotocin in Weight loss (occurring mostly due to rats caused the problem of neuropathy nutritional deficiency), Constipation, and alpha lipoic has proven out to be Diarrhoea, Nausea/vomiting [15], beneficial in this condition. It cause the Swallowing difficulty, Movement significant increase in the levels of disorders. glucose, glutathione and also normalises In severe cases, both upper and lower NAD:NADH ratio. Thus it has also a good limbs are affected which may entirely be therapeutic effect in the treatment of absent in the extremities [16,17]. In such neuropathic pain. cases, the skin becomes dehydrated, rough and atrophic. 3. Acetyl•L•carnitine Acetyl-L-carnitine is used in the 5. Treatments treatment of peripheral neuropathy and has been used widely in large number of 1. Benfotiamine clinical and animal studies. Attenuation Benfotiamine (S•benzoylthiamine O•mono in the levels of nerve conduction velocity phoshate) is a synthetic S•acyl derivative was reduced to a great extent in the of thiamine (vitamin B1). A deficiency of animals supplanted with Acetyl- L- vitamin B1 is attributed due to inadequate carnitine. However much research need intake of dietary supplements, reduced to be done in this domain in order to hepatic storage and various other factors rule out the exact mechanism for the like reduced transportation and treatment of disorders. absorption [18-21]. Benfotiamine has caused significant improvement in 4. Vitamin E patients suffering from alcoholic One of the most important fat soluble polyneuropathy. compounds include vitamin E that has The administration of alcohol for a long been widely used in the treatment of period causes the significant destruction many neuropathic complications of the thiamine due to inhibition of the including alcohol induced neuropathic enzyme thiamine diphosphate. The pain, streptozotocin induced studies from the literature revealed that neuropathic pain and other peripheral 68 Shashidhar Mehta et al., JIPBS, Vol 3 (2), 66-70, 2016 neuropathies. Data elucidated from the Capsaicin is an important constituent of previous studies indicates the significant Capsicum officinalis and has been used in improvement in rats fed with vitamin E the treatment of neuropathic complications as evidence by absence of hyperalgesia [24]. The parameters like motor in and allodynia in the rats [22]. The coordination and paralysis has attracted the hyperalgesia and allodynia are well attention of various researchers to known markers for the neuropathic investigate the therapeutic effect in pain. However vital screening of the alleviation of many symptoms of components is necessary in order to neuropathic pain. ensure the therapeutic effect. ALOCOHOL 5. Myo-inositol The cell membranes are made up of phospholipids of which myo-inositol is ABSORPTION OF THIAMINE an important constituent. The patients suffering from one or other
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