Neuropathic pain (NP) is a chronic pain disorder arising from somatosensory nervous system impairment. Extensive evidence supports the notion that the gut microbiota (GM) is crucial in maintaining human health by performing vital tasks. At the same time, its disruption has been linked to the emergence and advancement of an expanding range of disorders, including NP, in which GM could play a role in its pathophysiology. The crosstalk between the nervous system and GM happens through immune mediators, metabolites, and nervous structures and involves both central and peripheral nervous systems. This literature review aims to thoroughly investigate the function of modulating GM in the treatment of NP. It will achieve this by integrating existing knowledge, identifying underlying mechanisms, and evaluating the possible clinical consequences of exploiting the gut–brain axis. We will cover the main therapeutic applications of the described GM-modulators, such as probiotics, faecal microbiota transplantation, dietary supplements and emotional support, to the main kinds of NP in which any evidence, even if only pre-clinical, has been unravelled in recent years. The explored NP areas include chemotherapy-induced peripheral neuropathy, diabetic neuropathy, trauma-induced neuropathic pain, trigeminal neuralgia, postherpetic neuralgia and low back pain.

神经性疼痛 （NP） 是一种由体感神经系统损伤引起的慢性疼痛疾病。大量证据支持肠道微生物群 （GM） 通过执行重要任务来维持人类健康的关键观点。与此同时，它的破坏与包括 NP 在内的一系列疾病的出现和发展有关，其中 GM 可能在其病理生理学中发挥作用。神经系统和 GM 之间的串扰通过免疫介质、代谢物和神经结构发生，涉及中枢和周围神经系统。本文献综述旨在彻底研究调节 GM 在 NP 治疗中的作用。它将通过整合现有知识、确定潜在机制和评估利用肠脑轴可能产生的临床后果来实现这一目标。我们将涵盖所描述的转基因调节剂的主要治疗应用，例如益生菌、粪便微生物群移植、膳食补充剂和情感支持，以及近年来已经发现任何证据（即使只是临床前）的主要 NP 类型。探索的 NP 领域包括化疗引起的周围神经病变、糖尿病性神经病变、创伤引起的神经性疼痛、三叉神经痛、带状疱疹后神经痛和腰痛。