Diabetic neuropathic pain is mainly seen in Type II diabetes in the clinical situation. However, the model widely used is the streptozotocin (STZ)-induced diabetic neuropathy model in rats. Is there a disconnect between the clinical and preclinical situation where type II models are just evolving now?
1. What are good preclinical models for diabetic neuropathic pain?
2. Are there any biomarkers in diabetic neuropathic pain? Is nerve conduction a primary marker for diabetic neuropathy? The advanced glycation end-products are mainly the marker for diabetes.
3. Most of the drugs used for diabetic neuropathy have been derived from other indications like antidepressants; anti-seizure compounds like amitriptyline, pregabalin, and gabapentin; and some aldose reductase inhibitors. Are any preclinical studies or clinical trials working to develop agents that directly target neuropathic pain, or are most of the compounds being studied derived from other indications?
4. Are there any markers to observe the progression of the disease, in terms of the transition from diabetes to a diabetic neuropathic condition?