The use of nucleotides in diseases of the peripheral nervous system


  • N.I. Fister Uzhhorod National University, Uzhhorod, Ukraine
  • M.M. Oros Uzhhorod National University, Uzhhorod, Ukraine



peripheral nervous system, nucleotides, uridine monophosphate, cyanocobalamin, folic acid, peripheral neuropathic pain


Peripheral neuropathy (PN) is a common condition with a preva-lence of approximately 8 % in the elderly. Neuropathic pain is significant in the general population and affects more than half of all patients with PN. The pathophysiology of PN is characterized by lesions of myelin-producing Schwann cells in peripheral nerves. Regeneration/protection of the myelin sheath after nerve damage is the main element of recovery in PN. The problem of neuropathic pain is becoming increasingly important for clinicians of various profiles due to the significant spread of pathology and difficulties in achieving a persistent therapeutic effect. Despite the large number of pharmacological drugs recommended for the management of patients with neuropathic pain, the choice of the optimal treatment regimen often causes difficulties for clinicians. Over the last decade, a group of so-called nucleotides has been used quite actively in medical practice. Additional information about the effects of this group of drugs is accumulated, and there is a gradual transformation, including their composition. Thus, recently the attention of researchers has been devoted to studying the effectiveness of the combination “uridine monophosphate + vitamin B12 (cyanocobalamin) + folic acid”, which is characterized by a fairly high safety profile and good regenerative potential. The objective of this article is to highlight the mechanisms of action and results of clinical use of this combination.


Аattal N., Cruccu G., Baron R. et al. European Federation of Neurological Societies: EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur. J. Neurol. 2010. 17. e1113-e1188.

Scholz J., Finnerup N.B., Attal N. et al. The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain. 2019. Vol. 160. № 1. P. 53-59.

Szok D., Tajti J., Nyári A., Vécsei L. Therapeutic Approaches for Peripheral and Central Neuropathic Pain. Behav. Neurol. 2019. Vol. 2019. Article ID 8685954.

Negrão L., Almeida P., Alcino S. et al. Effect of the combination of uridine nucleotides, folic acid and vitamin B12 on the clinical expression of peripheral neuropathies. Pain Manag. 2014. Vol. 4. № 3. P. 191-196.

Finnerup N.B., Attal N. Pharmacotherapy of neuropathic pain: time to rewrite the rulebook. Pain Manag. 2016. 6(1). 1–3.

Finnerup N.B., Otto M., McQuay H.J. et al. Algorithm for neuropathic pain treatment — an evidence based proposal. Pain. 2005. 118(3). 289-305.

Lauretti G.C., Оmals M., Pereira A.C. et al. Clinical evaluation of the analgesic effect of the cytidine-uridine-hydroxocobalamin complex as a coadjuvant in the treatment of chronic neuropathic low back pain. Column. 2004. 3(2). 73-76.

Мartinez V., Аttal N., Bouhassira D. et al. Chronic neuropathic pain: diagnosis, evaluation and treatment in outpatient services. Guidelines for clinical practice of the French Society for the Study and Treatment of Pain. Douleur analg. 2010. 23. 51-66.

Мüller D. Treatment of neuropathic pain syndromes. Results of an open study of the efficacy of a preparation based on pyrimidine nucleotides. Munich: Medien und Medizin Verlagsgesellschaft mbH&Co, 2002.

Okada M., Nakagawa T., Minami M., Satoh M. Analgesic effects of intrathecal administration of P2Y nucleotide receptor agonists UTP and UDP in normal and neuropathic pain model rats. J. Pharmacol. Exp. Ther. 2002. Vol. 303. № 1. P. 66-73.

Negrão L., Аlmeida P., Alcino S. et al. Effect of the combination of uridine nucleotides, folic acid and vitamin B12 on the clinical expression of peripheral neuropathies. Pain Manag. 2014. 4(3). 191-196. doi: 10.2217/pmt.14.10.

Suezawa Y., Jacob H.A. Percutaneous nucleotomy. An alternative to spinal surgery. Arch. Orthop. Trauma Surg. 1986. Vol. 105. № 5. P. 287-295.

Sheki A.A., Hamdan F.B. The role of different neurophysiological tests in the differential diagnosis of diabetic axonal neuropathy and lumbosacral radiculopathy. Neurosciences (Riyadh). 2009. Vol. 14. № 1. P. 25-30.

Manole E., Bastian A., Neagu M. et al. Schwann Cell Plasticity in Peripheral Nerve Regeneration after Injury. 2020.

Yonezawa T., Onomura T., Kosaka R. et al. The system and procedures of percutaneous intradiscal laser nucleotomy. Spine (Phila. Pa 1976). 1990. Vol. 15. № 11. P. 1175-1185.





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