Do vitamins halt the COVID-19-evoked pro-inflammatory cytokines involved in the development of neuropathic pain?
Mahmoud Al-Khrasani, Nariman Essmat, Imre Boldizsár Jr, Bence Tamás Varga, Yashar Chalabiani, Sarah Kadhim Abbood, Aliz Judit Ernyey, Kornél Király, Attila Máté, Pál Riba, Julia Timár, István Gyertyán, Ildikó Miklya, Carmela Parenti, Lorella Pasquinucci, Bence Ágg, Susanna Fürst, Péter Ferdinandy, E Sylvester Vizi, Laszlo G Harsing Jr
Biomedicine & Pharmacotherapy, doi:10.1016/j.biopha.2025.118346
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.
Appendix A. Supporting information Supplementary data associated with this article can be found in the online version at doi:10.1016/j.biopha.2025.118346.
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