Use of coumarin osthole in peripheral neuropathy

Osthole, a natural origin, has shown promising effects in preclinical studies involving pain. P2X and P2Y receptor family members play a pathological role in neuropathic pain. Activation of P2X4 receptors elicits an inflammatory response through the stimulation of microglia, leading to the aggravation of pain sensation. Reports have also documented that an increased expression of the P2Y receptor due to nerve injury can lead to neuropathic pain. Inhibition of P2X3, P2X4, and P2Y1 receptors is the major modulations produced by osthole to confer protection against neuropathic pain. An increased expression of c-Fos has been pathologically implicated in neuropathic pain and also used as an identifying marker. Osthole has been documented to modulate c-Fos, calcium current, MAP kinases, cyclooxygenase-2, inflammatory cytokines to confer protection against neuropathy. The current review gives insights into the literature evidences and future prospective for using osthole in neuropathy.