New effective and safe treatments for complications of diabetes are clearly needed, and we will discuss in this paper a special group of compounds which stimulate the innate repair and protective mechanisms of our body, via co-inducing Heat Shock Proteins (HSPs). These are the hydroxylamine compounds bimoclomol and arimoclomol which have been consistently found to increase the expression of the molecular chaperones, the HSPs, in cells exposed to a physiological stress. The hydroxylamines are characterized as coinducers of HSPs, because they up-regulate HSP production only in situations of cellular stress responses, for instance induced by diabetes or ischemia, first described in a patent filed in 1996.
In this review, we will discuss some findings supporting the use of such compounds to treat complications of diabetes, such as neuropathy and neuropathic pain, with an emphasis on arimoclomol, as this compound is still in clinical development, while the development of its parent compound seems have come to stand still by the end of last century. However, as both compounds have a similar mechanism of action, we will also review data related to bimoclomol.