Targeting JNK to prevent antiretroviral neuropathy

With an estimated 33 million people living with HIV and more gaining access to antiretroviral therapy every day, the management of antiretroviral associated neuropathic pain is a problem of major global significance. Despite the decreased use in developed countries due to neurotoxicity, NRTIs remain in the first-line HIV treatment in many resource-limited countries as a result of its high effectiveness and inexpensiveness. Nevertheless, NRTI-induced neuropathy may precipitate abbreviation or discontinuation of antiretroviral therapy thus limiting viral suppression strategies. Authors [6] indicate JNK as a target to be exploited as a therapeutic approach to intervene and better manage the antiretroviral-induced neuropathic pain. The efficacy of JNK inhibitors to prevent the development of neuropathic pain might represent a unique preventive therapy that might enlarge and prolong the clinical use of these highly effective antiviral drugs, otherwise destined to be phased it out. JNK blockers are currently tested for clinical use for the treatment of several pathologies with a good tolerability pro le and may represent a concrete therapeutic opportunity in humans.