A call to action for peripheral neuropathy research funding—Time to consolidate funding under one NIH initiative?

Funding

The economic and societal impacts of PN are difficult to overstate. However, in the United States, NIH allocates funding through specialized institutes, each dedicated to a specific area of health research. As a result, PN research as a whole is fragmented, with different types of PN receiving support from separate NIH institutes: DPN is primarily funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), CIPN by the National Cancer Institute (NCI), aging\u2010related neuropathy at the National Institute on Aging (NIA), and HN and inflammatory neuropathies by the National Institute of Neurological Disorders and Stroke (NINDS; Table 1 ). While the current siloed approach has led to important scientific discoveries regarding disease pathogenesis and therapeutic intervention, as described above, it also hinders effective collaboration and information\u2010sharing among researchers and under\u2010values investigations that target peripheral nerve degeneration versus degeneration overall, making it difficult to consider PN as a distinct highly morbid disorder worthy of its own mechanistic and therapeutic investigations even beyond (or not restricted) to individual disease etiologies. The limitations of the current funding structure likely perpetuate the lack of mechanistic understanding of disease pathogenesis and the slow identification of effective disease\u2010modifying therapies. By comparison, Europe's funding structure, led by the European Union through Horizon Europe (2021\u20132027), adopts a more comprehensive, cross\u2010disciplinary strategy. Horizon Europe emphasizes extensive, collaborative projects that engage various stakeholders and prioritize critical pathological areas based on parameters like public health impact, disease burden, and potential innovation, including PN. This structure offers numerous advantages for information sharing and treatment development across PN subtypes. Funding support was provided by the National Institutes of Health (P30DK020572 and K01DK135799 to S.A.E.; R01DK130913 and R24DK082841 to E.L.F.); the Novo Nordisk Foundation (NNF14OC0011633 to E.L.F.), the Nathan and Rose Milstein Research Fund (to S.A.E.), the Sinai Medical Staff Foundation (to E.L.F.), the Robert and Katherine Jacobs Environmental Health Initiative (to E.L.F.), the Andrea and Lawrence Wolfe Brain Health Initiative (to E.J.K. and E.L.F.), the Dr. John H. Doran Neuropathy Research Fund (to S.A.E. and E.L.F), and the NeuroNetwork for Emerging Therapies at the University of Michigan (to S.A.E. and E.L.F.).