Main Article Content
Although the predominant clinical manifestation of COVID-19 is a respiratory disease, various neurological symptoms are increasingly being diagnosed, in particular, diabetic polyneuropathy is diagnosed in most patients with diabetes, affecting large and small nerve fibers. Drugs that are traditionally used for neuropathic pain (tricyclic antidepressants, gabapentinoids, etc.), despite their positive effect in eliminating the symptoms of polyneuropathy, often cause side effects and do not impact nerve regeneration. Over the last decade, a group of nucleotides has been used quite actively. Additional information on the effects of this group of drugs was accumulated and there is a gradual transformation, including their compositions. Thus, recently the attention of researchers has been devoted to the study of the effectiveness of the combination of uridine, choline, vitamins B1, B6, B12, and folic acid, which is characterized by a fairly high safety profile and regenerative potential. The review highlights the mechanisms of action and results of clinical use of this combination. Uridine monophosphate, B vitamins, folic acid are involved in metabolic processes, enhancing nerve regeneration. This contributes to the development of indirect (secondary) analgesic effect. In addition, the data of new studies indicate the ability of uridine monophosphate derivatives to impact purinergic P2Y receptors, which causes a direct analgesic and direct regenerative effect. Studies have demonstrated the clinical efficacy of this combination in the main types of peripheral neuropathic pain. The combination did not cause side effects and was well tolerated. There was a reduction or complete withdrawal of concomitant analgesics against the background of improving the quality of life of patients. The combination of uridine, choline, vitamin B1, vitamin B6, vitamin B12, and folic acid is a very effective addition to the standard therapy of peripheral neuropathic pain of various genesis and rehabilitation after COVID-19.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
Cariou B, Hadjadj S, Wargny M, et al; CORONADO investigators. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia. 2020 Aug;63(8):1500-1515. doi:10.1007/s00125-020-05180-x.
Mullol J, Alobid I, Mariño-Sánchez F, et al. The Loss of Smell and Taste in the COVID-19 Outbreak: a Tale of Many Countries. Curr Allergy Asthma Rep. 2020 Aug 3;20(10):61. doi:10.1007/s11882-020-00961-1.
Maury A, Lyoubi A, Peiffer-Smadja N, de Broucker T, Meppiel E. Neurological manifestations associated with SARS-CoV-2 and other coronaviruses: A narrative review for clinicians. Rev Neurol (Paris). 2021 Jan-Feb;177(1-2):51-64. doi:10.1016/j.neurol.2020.10.001.
Abenza-Abildúa MJ, Ramírez-Prieto MT, Moreno-Zabaleta R, et al. Neurological complications in critical patients with COVID-19. Neurologia (Engl Ed). 2020 Nov-Dec;35(9):621-627. English, Spanish. doi:10.1016/j.nrl.2020.07.014.
Román GC, Spencer PS, Reis J, et al; WFN Environmental Neurology Specialty Group. The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries. J Neurol Sci. 2020 Jul 15;414:116884. doi:10.1016/j.jns.2020.116884.
Dubbioso R, Nobile-Orazio E, Manganelli F, et al; SIN, SINC and ASNP. Dealing with immune-mediated neuropathies during COVID-19 outbreak: practical recommendations from the task force of the Italian Society of Neurology (SIN), the Italian Society of Clinical Neurophysiology (SINC) and the Italian Peripheral Nervous System Association (ASNP). Neurol Sci. 2020 Jun;41(6):1345-1348. doi:10.1007/s10072-020-04448-9.
Alschuler L, Chiasson AM, Horwitz R, et al. Integrative medicine considerations for convalescence from mild-to-moderate COVID-19 disease. Explore (NY). 2020 Dec 23:S1550-8307(20)30417-1. doi:10.1016/j.explore.2020.12.005.
Ersöz A, Yılmaz TE. The association between micronutrient and hemogram values and prognostic factors in COVID-19 patients: A single-center experience from Turkey. Int J Clin Pract. 2021 Jun;75(6):e14078. doi:10.1111/ijcp.14078.
Gorji A, Khaleghi Ghadiri M. Potential roles of micronutrient deficiency and immune system dysfunction in the coronavirus disease 2019 (COVID-19) pandemic. Nutrition. 2021 Feb;82:111047. doi:10.1016/j.nut.2020.111047.
Acklin S, Xia F. The Role of Nucleotide Excision Repair in Cisplatin-Induced Peripheral Neuropathy: Mechanism, Prevention, and Treatment. Int J Mol Sci. 2021 Feb 17;22(4):1975. doi:10.3390/ijms22041975.
Srivastava R, Cao Z, Nedeva C, et al. BCL-2 family protein BOK is a positive regulator of uridine metabolism in mammals. Proc Natl Acad Sci U S A. 2019 Jul 30;116(31):15469-15474. doi:10.1073/pnas.1904523116.
Goldberg H, Mibielli MA, Nunes CP, et al. A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate trisodium, cytidine monophosphate disodium, and hydroxocobalamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias. J Pain Res. 2017 Feb 15;10:397-404. doi:10.2147/JPR.S123045.
Baumel BS, Doraiswamy PM, Sabbagh M, Wurtman R. Potential Neuroregenerative and Neuroprotective Effects of Uridine/Choline-Enriched Multinutrient Dietary Intervention for Mild Cognitive Impairment: A Narrative Review. Neurol Ther. 2021 Jun;10(1):43-60. doi:10.1007/s40120-020-00227-y.
Negrão L, Nunes P; Portuguese Group for the Study of Peripheral Neuropathy. Uridine monophosphate, folic acid and vitamin B12 in patients with symptomatic peripheral entrapment neuropathies. Pain Manag. 2016;6(1):25-9. doi:10.2217/pmt.15.60.
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 May;4(3):191-6. doi:10.2217/pmt.14.10.
Romanenko VI. Use of the natural compound of uridine in the therapy of chronic pain with manifestations of neuropathy. International Neurological Journal. 2020;16(2):70-75. doi:10.22141/2224-07188.8.131.520.200966. (in Ukrainian).