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Eid SA, Rumora AE, Beirowski B, Bennett DL, Hur J, Savelieff MG, Feldman EL. New perspectives in diabetic neuropathy. Neuron 2023; 111:2623-2641. [PMID: 37263266 PMCID: PMC10525009 DOI: 10.1016/j.neuron.2023.05.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/20/2023] [Accepted: 05/03/2023] [Indexed: 06/03/2023]
Abstract
Diabetes prevalence continues to climb with the aging population. Type 2 diabetes (T2D), which constitutes most cases, is metabolically acquired. Diabetic peripheral neuropathy (DPN), the most common microvascular complication, is length-dependent damage to peripheral nerves. DPN pathogenesis is complex, but, at its core, it can be viewed as a state of impaired metabolism and bioenergetics failure operating against the backdrop of long peripheral nerve axons supported by glia. This unique peripheral nerve anatomy and the injury consequent to T2D underpins the distal-to-proximal symptomatology of DPN. Earlier work focused on the impact of hyperglycemia on nerve damage and bioenergetics failure, but recent evidence additionally implicates contributions from obesity and dyslipidemia. This review will cover peripheral nerve anatomy, bioenergetics, and glia-axon interactions, building the framework for understanding how hyperglycemia and dyslipidemia induce bioenergetics failure in DPN. DPN and painful DPN still lack disease-modifying therapies, and research on novel mechanism-based approaches is also covered.
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Affiliation(s)
- Stephanie A Eid
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA; NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI 48109, USA
| | - Amy E Rumora
- Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Bogdan Beirowski
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; Neuroscience Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - David L Bennett
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
| | - Junguk Hur
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND 58202, USA
| | - Masha G Savelieff
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND 58202, USA
| | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA; NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI 48109, USA.
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2
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Daeschler SC, Pennekamp A, Tsilingiris D, Bursacovschi C, Aman M, Eisa A, Boecker A, Klimitz F, Stolle A, Kopf S, Schwarz D, Bendszus M, Kneser U, Kender Z, Szendroedi J, Harhaus L. Effect of Surgical Release of Entrapped Peripheral Nerves in Sensorimotor Diabetic Neuropathy on Pain and Sensory Dysfunction-Study Protocol of a Prospective, Controlled Clinical Trial. J Pers Med 2023; 13:jpm13020348. [PMID: 36836582 PMCID: PMC9962788 DOI: 10.3390/jpm13020348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Nerve entrapment has been hypothesized to contribute to the multicausal etiology of axonopathy in sensorimotor diabetic neuropathy. Targeted surgical decompression reduces external strain on the affected nerve and, therefore, may alleviate symptoms, including pain and sensory dysfunction. However, its therapeutic value in this cohort remains unclear. AIM Quantifying the treatment effect of targeted lower extremity nerve decompression in patients with preexisting painful sensorimotor diabetic neuropathy and nerve entrapment on pain intensity, sensory function, motor function, and neural signal conduction. STUDY DESIGN This prospective, controlled trial studies 40 patients suffering from bilateral therapy-refractory, painful (n = 20, visual analogue scale, VAS ≥ 5) or painless (n = 20, VAS = 0) sensorimotor diabetic neuropathy with clinical and/or radiologic signs of focal lower extremity nerve compression who underwent unilateral surgical nerve decompression of the common peroneal and the tibial nerve. Tissue biopsies will be analyzed to explore perineural tissue remodeling in correlation with intraoperatively measured nerve compression pressure. Effect size on symptoms including pain intensity, light touch threshold, static and moving two-point discrimination, target muscle force, and nerve conduction velocity will be quantified 3, 6, and 12 months postoperatively, and compared (1) to the preoperative values and (2) to the contralateral lower extremity that continues non-operative management. CLINICAL SIGNIFICANCE Targeted surgical release may alleviate mechanical strain on entrapped lower extremity nerves and thereby potentially improve pain and sensory dysfunction in a subset of patients suffering from diabetic neuropathy. This trial aims to shed light on these patients that potentially benefit from screening for lower extremity nerve entrapment, as typical symptoms of entrapment might be erroneously attributed to neuropathy only, thereby preventing adequate treatment.
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Affiliation(s)
- Simeon C Daeschler
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Anna Pennekamp
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Dimitrios Tsilingiris
- Department of Internal Medicine 1 and Clinical Chemistry, University Hospital of Heidelberg, 69120 Heidelberg, Germany
| | - Catalina Bursacovschi
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Martin Aman
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Amr Eisa
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Arne Boecker
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Felix Klimitz
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Annette Stolle
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Stefan Kopf
- Department of Internal Medicine 1 and Clinical Chemistry, University Hospital of Heidelberg, 69120 Heidelberg, Germany
- German Center for Diabetes Research, 85764 Neuherberg, Germany
| | - Daniel Schwarz
- Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Ulrich Kneser
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
| | - Zoltan Kender
- Department of Internal Medicine 1 and Clinical Chemistry, University Hospital of Heidelberg, 69120 Heidelberg, Germany
- German Center for Diabetes Research, 85764 Neuherberg, Germany
| | - Julia Szendroedi
- Department of Internal Medicine 1 and Clinical Chemistry, University Hospital of Heidelberg, 69120 Heidelberg, Germany
- German Center for Diabetes Research, 85764 Neuherberg, Germany
- Joint Heidelberg-ICD Translational Diabetes Program, Helmholtz-Zentrum, 85764 Neuherberg, Germany
| | - Leila Harhaus
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG-Trauma Center Ludwigshafen/Rhine, Department of Hand and Plastic Surgery, University of Heidelberg, 67071 Ludwigshafen, Germany
- Department of Handsurgery, Peripheral Nerve Surgery and Rehabilitation, BG Trauma Hospital, 67071 Ludwigshafen, Germany
- Department of Orthopedic Surgery, Section Upper Extremity, University Hospital Heidelberg, 69120 Heidelberg, Germany
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3
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Ben-Kraiem A, Sauer RS, Norwig C, Popp M, Bettenhausen AL, Atalla MS, Brack A, Blum R, Doppler K, Rittner HL. Selective blood-nerve barrier leakiness with claudin-1 and vessel-associated macrophage loss in diabetic polyneuropathy. J Mol Med (Berl) 2021; 99:1237-1250. [PMID: 34018017 PMCID: PMC8367905 DOI: 10.1007/s00109-021-02091-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/26/2021] [Accepted: 05/10/2021] [Indexed: 12/19/2022]
Abstract
Diabetic polyneuropathy (DPN) is the most common complication in diabetes and can be painful in up to 26% of all diabetic patients. Peripheral nerves are shielded by the blood-nerve barrier (BNB) consisting of the perineurium and endoneurial vessels. So far, there are conflicting results regarding the role and function of the BNB in the pathophysiology of DPN. In this study, we analyzed the spatiotemporal tight junction protein profile, barrier permeability, and vessel-associated macrophages in Wistar rats with streptozotocin-induced DPN. In these rats, mechanical hypersensitivity developed after 2 weeks and loss of motor function after 8 weeks, while the BNB and the blood-DRG barrier were leakier for small, but not for large molecules after 8 weeks only. The blood-spinal cord barrier remained sealed throughout the observation period. No gross changes in tight junction protein or cytokine expression were observed in all barriers to blood. However, expression of Cldn1 mRNA in perineurium was specifically downregulated in conjunction with weaker vessel-associated macrophage shielding of the BNB. Our results underline the role of specific tight junction proteins and BNB breakdown in DPN maintenance and differentiate DPN from traumatic nerve injury. Targeting claudins and sealing the BNB could stabilize pain and prevent further nerve damage. KEY MESSAGES: • In diabetic painful neuropathy in rats: • Blood nerve barrier and blood DRG barrier are leaky for micromolecules. • Perineurial Cldn1 sealing the blood nerve barrier is specifically downregulated. • Endoneurial vessel-associated macrophages are also decreased. • These changes occur after onset of hyperalgesia thereby maintaining rather than inducing pain.
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Affiliation(s)
- Adel Ben-Kraiem
- Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Reine-Solange Sauer
- Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Carla Norwig
- Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Maria Popp
- Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Anna-Lena Bettenhausen
- Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Mariam Sobhy Atalla
- Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Alexander Brack
- Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Robert Blum
- Institute of Clinical Neurobiology, University Hospital of Würzburg, 97078, Würzburg, Germany
- Department of Neurology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Kathrin Doppler
- Department of Neurology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Heike Lydia Rittner
- Center for Interdisciplinary Pain Medicine, Department of Anesthesiology, University Hospital of Würzburg, 97080, Würzburg, Germany.
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Vafadar Ghasemi L, Behnam Rassouli M, Matin MM, Mahdavi-Shahri N. Benfotiamine reduced collagen IV contents of sciatic nerve in hyperglycemic rats. J Diabetes Metab Disord 2021; 20:21-30. [PMID: 34222057 PMCID: PMC8212243 DOI: 10.1007/s40200-020-00666-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 10/19/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Neuropathy as a common complication of hyperglycemia in diabetic patients is probably caused by metabolic and structural changes in extracellular matrix (ECM) of peripheral nerves. This study was designed to evaluate the effects of benfotiamine (BT) on the structural, biological and mechanical characteristics of rat sciatic nerve in hyperglycemic condition. MATERIALS AND METHODS Forty eight adult male Wistar rats were assigned to 6 groups (n = 8): control (healthy rats with no treatment; C), positive control (healthy rats received BT treatment; B), negative control groups 1&2 (hyperglycemic rats kept for 4 and/or 8 weeks; 4WD and 8WD, respectively) and experimental groups 1&2 (hyperglycemic rats treated by daily oral gavage of 100 mg kg- 1 body weight BT for 4 and/or 8 weeks; 4WD + BT and 8WD + BT, respectively). Hyperglycemia was induced by a single intraperitoneal injection of of streptozotocin (55 mg kg- 1 body weight). After a period of experimental period (4 and/or 8 weeks) rats were sacrificed and from each two segments (1 cm length) of left sciatic nerve were sampled. These samples were prepared for histological examinations (light and electron microscopy), collagen IV immunohistochemistry and strength tensile test. RESULTS In comparison to control groups, in 4WD and 8WD groups the amount of type IV collagen was increased, the structure of myelin sheath and nerve fibers were extensively altered and the tensile strength was significantly decreased (p < 0.05) while in 4WD + BT and 8WD + BT groups these abnormalities were attenuated. CONCLUSIONS It seems that BT treatment may rescue the sciatic nerve from the hyperglycemic-induced ECM structural abnormality. This beneficial advantage of BT is likely exerted through the modification of glucose metabolism pathways.
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Affiliation(s)
- Leila Vafadar Ghasemi
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Azadi Square, Mashhad, Iran
- Department of Biology, Faculty of Sciences, University of Zabol, Zabol, Iran
| | - Morteza Behnam Rassouli
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Azadi Square, Mashhad, Iran
| | - Maryam M. Matin
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Azadi Square, Mashhad, Iran
- Novel Diagnostics and Therapeutics Research Group, Institute of Biotechnology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Naser Mahdavi-Shahri
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Azadi Square, Mashhad, Iran
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Bódi N, Mezei D, Chakraborty P, Szalai Z, Barta BP, Balázs J, Rázga Z, Hermesz E, Bagyánszki M. Diabetes-related intestinal region-specific thickening of ganglionic basement membrane and regionally decreased matrix metalloproteinase 9 expression in myenteric ganglia. World J Diabetes 2021; 12:658-672. [PMID: 33995853 PMCID: PMC8107976 DOI: 10.4239/wjd.v12.i5.658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/10/2021] [Accepted: 04/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The importance of the neuronal microenvironment has been recently highlighted in gut region-specific diabetic enteric neuropathy. Regionally distinct thickening of endothelial basement membrane (BM) of intestinal capillaries supplying the myenteric ganglia coincide with neuronal damage in different intestinal segments. Accelerated synthesis of matrix molecules and reduced degradation of matrix components may also contribute to the imbalance of extracellular matrix dynamics resulting in BM thickening. Among the matrix degrading proteinases, matrix metalloproteinase 9 (MMP9) and its tissue inhibitor (TIMP1) are essential in regulating extracellular matrix remodelling.
AIM To evaluate the intestinal segment-specific effects of diabetes and insulin replacement on ganglionic BM thickness, MMP9 and TIMP1 expression.
METHODS Ten weeks after the onset of hyperglycaemia gut segments were taken from the duodenum and ileum of streptozotocin-induced diabetic, insulin-treated diabetic and sex- and age-matched control rats. The thickness of BM surrounding myenteric ganglia was measured by electron microscopic morphometry. Whole-mount preparations of myenteric plexus were prepared from the different gut regions for MMP9/TIMP1 double-labelling fluorescent immunohistochemistry. Post-embedding immunogold electron microscopy was applied on ultrathin sections to evaluate the MMP9 and TIMP1 expression in myenteric ganglia and their microenvironment from different gut segments and conditions. The MMP9 and TIMP1 messenger ribonucleic acid (mRNA) level was measured by quantitative polymerase chain reaction.
RESULTS Ten weeks after the onset of hyperglycaemia, the ganglionic BM was significantly thickened in the diabetic ileum, while it remained intact in the duodenum. The immediate insulin treatment prevented the diabetes-related thickening of the BM surrounding the ileal myenteric ganglia. Quantification of particle density showed an increasing tendency for MMP9 and a decreasing tendency for TIMP1 from the proximal to the distal small intestine under control conditions. In the diabetic ileum, the number of MMP9-indicating gold particles decreased in myenteric ganglia, endothelial cells of capillaries and intestinal smooth muscle cells, however, it remained unchanged in all duodenal compartments. The MMP9/TIMP1 ratio was also decreased in ileal ganglia only. However, a marked segment-specific induction was revealed in MMP9 and TIMP1 at the mRNA levels.
CONCLUSION These findings support that the regional decrease in MMP9 expression in myenteric ganglia and their microenvironment may contribute to extracellular matrix accumulation, resulting in a region-specific thickening of ganglionic BM.
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Affiliation(s)
- Nikolett Bódi
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged 6726, Hungary
| | - Diána Mezei
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged 6726, Hungary
| | - Payal Chakraborty
- Department of Biochemistry and Molecular Biology, Faculty of Science and Informatics, University of Szeged, Szeged 6726, Hungary
| | - Zita Szalai
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged 6726, Hungary
| | - Bence Pál Barta
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged 6726, Hungary
| | - János Balázs
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged 6726, Hungary
| | - Zsolt Rázga
- Department of Pathology, Faculty of Medicine, University of Szeged, Szeged 6720, Hungary
| | - Edit Hermesz
- Department of Biochemistry and Molecular Biology, Faculty of Science and Informatics, University of Szeged, Szeged 6726, Hungary
| | - Mária Bagyánszki
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged 6726, Hungary
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Roy S, Kim D. Retinal capillary basement membrane thickening: Role in the pathogenesis of diabetic retinopathy. Prog Retin Eye Res 2020; 82:100903. [PMID: 32950677 DOI: 10.1016/j.preteyeres.2020.100903] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 09/08/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023]
Abstract
Vascular basement membrane (BM) thickening has been hailed over half a century as the most prominent histological lesion in diabetic microangiopathy, and represents an early ultrastructural change in diabetic retinopathy (DR). Although vascular complications of DR have been clinically well established, specific cellular and molecular mechanisms underlying dysfunction of small vessels are not well understood. In DR, small vessels develop insidiously as BM thickening occurs. Studies examining high resolution imaging data have established BM thickening as one of the foremost structural abnormalities of retinal capillaries. This fundamental structural change develops, at least in part, from excess accumulation of BM components. Although BM thickening is closely associated with the development of DR, its contributory role in the pathogenesis of DR is coming to light recently. DR develops over several years before clinical manifestations appear, and it is during this clinically silent period that hyperglycemia induces excess synthesis of BM components, contributes to vascular BM thickening, and promotes structural and functional lesions including cell death and vascular leakage in the diabetic retina. Studies using animal models show promising results in preventing BM thickening with subsequent beneficial effects. Several gene regulatory approaches are being developed to prevent excess synthesis of vascular BM components in an effort to reduce BM thickening. This review highlights current understanding of capillary BM thickening development, role of BM thickening in retinal vascular lesions, and strategies for preventing vascular BM thickening as a potential therapeutic strategy in alleviating characteristic lesions associated with DR.
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Affiliation(s)
- Sayon Roy
- Boston University School of Medicine, Boston, MA, USA.
| | - Dongjoon Kim
- Boston University School of Medicine, Boston, MA, USA
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Jain D, Mattiassi S, Goh EL, Yim EKF. Extracellular matrix and biomimetic engineering microenvironment for neuronal differentiation. Neural Regen Res 2020; 15:573-585. [PMID: 31638079 PMCID: PMC6975142 DOI: 10.4103/1673-5374.266907] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Extracellular matrix (ECM) influences cell differentiation through its structural and biochemical properties. In nervous system, neuronal behavior is influenced by these ECMs structures which are present in a meshwork, fibrous, or tubular forms encompassing specific molecular compositions. In addition to contact guidance, ECM composition and structures also exert its effect on neuronal differentiation. This short report reviewed the native ECM structure and composition in central nervous system and peripheral nervous system, and their impact on neural regeneration and neuronal differentiation. Using topographies, stem cells have been differentiated to neurons. Further, focussing on engineered biomimicking topographies, we highlighted the role of anisotropic topographies in stem cell differentiation to neurons and its recent temporal application for efficient neuronal differentiation.
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Affiliation(s)
- Deepak Jain
- Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Sabrina Mattiassi
- Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Eyleen L Goh
- Neuroscience Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Evelyn K F Yim
- Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario, Canada
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Ennerfelt H, Voithofer G, Tibbo M, Miller D, Warfield R, Allen S, Kennett Clark J. Disruption of peripheral nerve development in a zebrafish model of hyperglycemia. J Neurophysiol 2019; 122:862-871. [DOI: 10.1152/jn.00318.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Diabetes mellitus-induced hyperglycemia is associated with a number of pathologies such as retinopathy, nephropathy, delayed wound healing, and diabetic peripheral neuropathy (DPN). Approximately 50% of patients with diabetes mellitus will develop DPN, which is characterized by disrupted sensory and/or motor functioning, with treatment limited to pain management. Zebrafish ( Danio rerio) are an emerging animal model used to study a number of metabolic disorders, including diabetes. Diabetic retinopathy, nephropathy, and delayed wound healing have all been demonstrated in zebrafish. Recently, our laboratory has demonstrated that following the ablation of the insulin-producing β-cells of the pancreas (and subsequent hyperglycemia), the peripheral nerves begin to show signs of dysregulation. In this study, we take a different approach, taking advantage of the transdermal absorption abilities of zebrafish larvae to extend the period of hyperglycemia. Following 5 days of 60 mM d-glucose treatment, we observed motor axon defasciculation, disturbances in perineurial glia sheath formation, decreased myelination of motor axons, and sensory neuron mislocalization. This study extends our understanding of the structural changes of the peripheral nerve following induction of hyperglycemia and does so in an animal model capable of potential DPN drug discovery in the future. NEW & NOTEWORTHY Zebrafish are emerging as a robust model system for the study of diabetic complications such as retinopathy, nephropathy, and impaired wound healing. We present a novel model of diabetic peripheral neuropathy in zebrafish in which the integrity of the peripheral nerve is dysregulated following the induction of hyperglycemia. By using this model, future studies can focus on elucidating the underlying molecular mechanisms currently unknown.
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Affiliation(s)
- Hannah Ennerfelt
- Department of Biological Sciences, Salisbury University, Salisbury, Maryland
- Department of Psychology, Salisbury University, Salisbury, Maryland
| | - Gabrielle Voithofer
- Department of Biological Sciences, Salisbury University, Salisbury, Maryland
- Department of Psychology, Salisbury University, Salisbury, Maryland
| | - Morgan Tibbo
- Department of Biological Sciences, Salisbury University, Salisbury, Maryland
- Department of Psychology, Salisbury University, Salisbury, Maryland
| | - Derrick Miller
- Department of Chemistry, Salisbury University, Salisbury, Maryland
| | - Rebecca Warfield
- Department of Biological Sciences, Salisbury University, Salisbury, Maryland
- Department of Psychology, Salisbury University, Salisbury, Maryland
| | - Samantha Allen
- Department of Biological Sciences, Salisbury University, Salisbury, Maryland
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Quantitative assessment of diabetic amyotrophy using magnetic resonance neurography-a case-control analysis. Eur Radiol 2019; 29:5910-5919. [PMID: 30980123 DOI: 10.1007/s00330-019-06162-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/19/2019] [Accepted: 03/14/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To quantitatively characterize diabetic amyotrophy (DA), or diabetic lumbosacral radiculoplexopathy, and compare with controls using magnetic resonance neurography (MRN). METHODS Forty controls and 23 DA cases were analyzed qualitatively and quantitatively. Cross-sectional areas (CSAs) of bilateral L3 through S2 lumbosacral nerve roots, femoral nerves, and sciatic nerves (proximal and distal measurements) were measured. A linear model was used to assess the nerve location and case/control effect on angle-corrected CSAs. Intra- and inter-reader analysis was performed using intraclass correlation (ICC). RESULTS In DA cases, abnormalities of the lumbosacral nerve roots, sciatic, femoral, and obturator nerves were seen in 21/23, 16/23, 21/23, and 9/23, respectively. Denervation abnormalities of multiple abdominopelvic muscles were seen. Quantitatively, the CSA of all measured LS plexus nerve roots and bilateral femoral nerves were significantly larger in DA cases vs. controls by 45% (95% CI, (30%, 49%); p < 0.001). The ICC was moderate for inter-rater analysis = 0.547 (95% CI, 0.456-0.626) and excellent for intra-rater analysis = 0.90 (95% CI, 0.89-92). CONCLUSIONS Multifocal neuromuscular lesions related to diabetic amyotrophy were qualitatively and quantitatively detected on MRN. Qualitative abnormalities distinguished cases from controls, and nerve CSAs of cases were significantly larger than those of controls. Therefore, MRN may be employed as a non-invasive diagnostic tool for the evaluation of diabetic amyotrophy. KEY POINTS • Qualitative abnormalities of lumbosacral nerve roots, their peripheral branches, and muscles are seen in DA. • The lumbosacral nerve roots and their peripheral branches in diabetic amyotrophy cases are significantly larger in cross-sectional area than non-diabetic subjects by 45% (95 CI, 30%, 49%; p < 0.001). • The ICC was moderate for inter-rater analysis = 0.547 (95% CI, 0.456-0.626) and excellent for intra-rater analysis = 0.90 (95% CI, 0.89-92).
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10
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Rocker A, Howell J, Voithofer G, Clark JK. Acute effects of hyperglycemia on the peripheral nervous system in zebrafish (Danio rerio) following nitroreductase-mediated β-cell ablation. Am J Physiol Regul Integr Comp Physiol 2019; 316:R395-R405. [DOI: 10.1152/ajpregu.00258.2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Diabetic peripheral neuropathy (DPN) is estimated to affect 50% of diabetic patients. Although DPN is highly prevalent, molecular mechanisms remain unknown and treatment is limited to pain relief and glycemic control. We provide a novel model of acute DPN in zebrafish ( Danio rerio) larvae. Beginning 5 days postfertilization (dpf), zebrafish expressing nitroreductase in their pancreatic β-cells were treated with metronidazole (MTZ) for 48 h and checked for β-cell ablation 7 dpf. In experimental design, this was meant to serve as proof of concept that β-cell ablation and hyperglycemia are possible at this time point, but we were surprised to find changes in both sensory and motor nerve components. Compared with controls, neurod+ sensory neurons were often observed outside the dorsal root ganglia in MTZ-treated fish. Fewer motor nerves were properly ensheathed by nkx2.2a+ perineurial cells, and tight junctions were disrupted along the motor nerve in MTZ-treated fish compared with controls. Not surprisingly, the motor axons of the MTZ-treated group were defasciculated compared with the control group, myelination was attenuated, and there was a subtle difference in Schwann cell number between the MTZ-treated and control group. All structural changes occurred in the absence of behavioral changes in the larvae at this time point, suggesting that peripheral nerves are influenced by acute hyperglycemia before becoming symptomatic. Moving forward, this novel animal model of DPN will allow us to access the molecular mechanisms associated with the acute changes in the hyperglycemic peripheral nervous system, which may help direct therapeutic approaches.
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Affiliation(s)
- Amanda Rocker
- Department of Biological Sciences, Salisbury University, Salisbury, Maryland
| | - Julia Howell
- Department of Biological Sciences, Salisbury University, Salisbury, Maryland
| | - Gabrielle Voithofer
- Department of Biological Sciences, Salisbury University, Salisbury, Maryland
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YOO DY, YIM HS, JUNG HY, NAM SM, KIM JW, CHOI JH, SEONG JK, YOON YS, KIM DW, HWANG IK. Chronic type 2 diabetes reduces the integrity of the blood-brain barrier by reducing tight junction proteins in the hippocampus. J Vet Med Sci 2016; 78:957-62. [PMID: 26876499 PMCID: PMC4937155 DOI: 10.1292/jvms.15-0589] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 02/04/2016] [Indexed: 12/11/2022] Open
Abstract
In the present study, we investigated the effects of type 2 diabetes-induced hyperglycemia on the integrity of the blood-brain barrier and tight junction markers in the rat hippocampus. Forty-week-old diabetic (Zucker diabetic fatty, ZDF) rats and littermate control (Zucker lean control, ZLC) rats were used in this study. We evaluated the integrity of the blood-brain barrier by measuring sodium fluorescein extravasation and blood vessel ultrastructure. In addition, tight junction markers, such as zona occludens-1, occludin and claudin-5, were quantified by western blot analysis. ZDF rats showed significantly increased sodium fluorescein leakage in the hippocampus. Tight junction markers, such as occludin and claudin-5, were significantly decreased in the hippocampi of ZDF rats compared to those of ZLC rats. In addition, ZDF rats showed ultrastructural changes with phagocytic findings in the blood vessels. These results suggest that chronic untreated diabetes impairs the permeability of the hippocampal blood-brain barrier by down-regulating occludin and claudin-5, indicating that chronic untreated diabetes may cause hippocampus-dependent dysfunction.
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Affiliation(s)
- Dae Young YOO
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and
Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
| | - Hee Sun YIM
- Department of Biochemistry and Molecular Biology, Research Institute of Oral
Sciences, College of Dentistry, Kangneung-Wonju National University, Gangneung 25457; South Korea
| | - Hyo Young JUNG
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and
Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
| | - Sung Min NAM
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and
Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
| | - Jong Whi KIM
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and
Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
| | - Jung Hoon CHOI
- Department of Anatomy, College of Veterinary Medicine, Kangwon National
University, Chuncheon 24341, South Korea
| | - Je Kyung SEONG
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and
Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
- KMPC (Korea Mouse Phenotyping Center), Seoul National University, Seoul 08826,
South Korea
| | - Yeo Sung YOON
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and
Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
- KMPC (Korea Mouse Phenotyping Center), Seoul National University, Seoul 08826,
South Korea
| | - Dae Won KIM
- Department of Biochemistry and Molecular Biology, Research Institute of Oral
Sciences, College of Dentistry, Kangneung-Wonju National University, Gangneung 25457; South Korea
| | - In Koo HWANG
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and
Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
- KMPC (Korea Mouse Phenotyping Center), Seoul National University, Seoul 08826,
South Korea
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12
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Lee YF, Lin CC, Cheng JS, Chen GS. Nerve conduction block in diabetic rats using high-intensity focused ultrasound for analgesic applications. Br J Anaesth 2015; 114:840-6. [PMID: 25904608 DOI: 10.1093/bja/aeu443] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2014] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Nerve conduction block using high-intensity focused ultrasound (HIFU) has been conducted with nerves of mixed fibres in normal animal models. This study tested the feasibility and safety of HIFU for sensory nerve conduction block in diabetic neuropathic nerves to determine its potential for pain relief. METHODS Diabetes was induced in Sprague-Dawley rats using streptozotocin, and HIFU at 2.68 MHz was used for the block. This study consisted of two sections, in vitro and in vivo. For the in vitro experiments, the entire contiguous sciatic-sural nerves were obtained. Compound action potentials and sensory action potentials were recorded in the sciatic and sural nerves, respectively. For the in vivo experiments, compound muscle action potentials (CMAPs) were recorded from the gastrocnemius muscles. All data were expressed as median (range). RESULTS The in vitro results showed that HIFU temporarily inhibited sensory action potentials of the control and diabetic rat nerves to 33.9 (8.2) and 14.0 (10.7)% of the baseline values, respectively, whereas the compound action potentials were suppressed to 53.6 (8.4) and 76.2 (7.5)% of baseline, respectively. The in vivo results showed that HIFU acutely blocked CMAPs to 32.9 (12.6) and 19.9 (10.9)% of baseline in control and diabetic rat nerves, respectively. Measurements of CMAPs and histological exanmination were used for indirect assessment of the safety of the HIFU technique. CONCLUSIONS High-intensity focused ultrasound safely and reversibly suppressed nerve conduction in diabetic rat nerves when the stimulation parameters were appropriate. The results suggest that HIFU may have potential to block sensory nerves reversibly and provide peripheral pain relief.
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Affiliation(s)
- Y-F Lee
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Taiwan
| | - C-C Lin
- Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - J-S Cheng
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Taiwan
| | - G-S Chen
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Taiwan
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13
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Morrison BM, Tsingalia A, Vidensky S, Lee Y, Jin L, Farah MH, Lengacher S, Magistretti PJ, Pellerin L, Rothstein JD. Deficiency in monocarboxylate transporter 1 (MCT1) in mice delays regeneration of peripheral nerves following sciatic nerve crush. Exp Neurol 2014; 263:325-38. [PMID: 25447940 DOI: 10.1016/j.expneurol.2014.10.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 10/16/2014] [Accepted: 10/22/2014] [Indexed: 12/20/2022]
Abstract
Peripheral nerve regeneration following injury occurs spontaneously, but many of the processes require metabolic energy. The mechanism of energy supply to axons has not previously been determined. In the central nervous system, monocarboxylate transporter 1 (MCT1), expressed in oligodendroglia, is critical for supplying lactate or other energy metabolites to axons. In the current study, MCT1 is shown to localize within the peripheral nervous system to perineurial cells, dorsal root ganglion neurons, and Schwann cells by MCT1 immunofluorescence in wild-type mice and tdTomato fluorescence in MCT1 BAC reporter mice. To investigate whether MCT1 is necessary for peripheral nerve regeneration, sciatic nerves of MCT1 heterozygous null mice are crushed and peripheral nerve regeneration was quantified electrophysiologically and anatomically. Compound muscle action potential (CMAP) recovery is delayed from a median of 21 days in wild-type mice to greater than 38 days in MCT1 heterozygote null mice. In fact, half of the MCT1 heterozygote null mice have no recovery of CMAP at 42 days, while all of the wild-type mice recovered. In addition, muscle fibers remain 40% more atrophic and neuromuscular junctions 40% more denervated at 42 days post-crush in the MCT1 heterozygote null mice than wild-type mice. The delay in nerve regeneration is not only in motor axons, as the number of regenerated axons in the sural sensory nerve of MCT1 heterozygote null mice at 4 weeks and tibial mixed sensory and motor nerve at 3 weeks is also significantly reduced compared to wild-type mice. This delay in regeneration may be partly due to failed Schwann cell function, as there is reduced early phagocytosis of myelin debris and remyelination of axon segments. These data for the first time demonstrate that MCT1 is critical for regeneration of both sensory and motor axons in mice following sciatic nerve crush.
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Affiliation(s)
- Brett M Morrison
- Department of Neurology, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Akivaga Tsingalia
- Department of Neurology, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Svetlana Vidensky
- Department of Neurology, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA; Brain Science Institute, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Youngjin Lee
- Department of Neurology, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA; Brain Science Institute, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Lin Jin
- Department of Neurology, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA; Brain Science Institute, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Mohamed H Farah
- Department of Neurology, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA.
| | - Sylvain Lengacher
- Laboratory of Neuroenergetics and Cellular Dynamics, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland.
| | - Pierre J Magistretti
- Division of Biological and Environmental Sciences and Engineering, KAUST, Thuwal, Saudi Arabia; Brain Mind Institute, Ecole Polytechnique Federale de Lausanne, SV2511, Station 19, CH-1015 Lausanne, Switzerland.
| | - Luc Pellerin
- Department of Fundamental Neurosciences, University of Lausanne, 7 Rue du Bugnon, 1005 Lausanne, Switzerland.
| | - Jeffrey D Rothstein
- Department of Neurology, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA; Brain Science Institute, School of Medicine, The Johns Hopkins University, 855 North Wolfe Street, Baltimore, MD 21205, USA.
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14
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Scheede-Bergdahl C, Bergdahl A, Schjerling P, Qvortrup K, Koskinen SO, Dela F. Exercise-induced regulation of matrix metalloproteinases in the skeletal muscle of subjects with type 2 diabetes. Diab Vasc Dis Res 2014; 11:324-34. [PMID: 24903024 DOI: 10.1177/1479164114535943] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMP) play a critical role during vascular remodelling, in both health and disease. Impaired MMP regulation is associated with many diabetes-related complications. This study examined whether exercise-induced regulation of MMPs is maintained in the skeletal muscle of patients with uncomplicated type 2 diabetes (T2DM). Subjects [12 T2DM, 9 healthy control subjects (CON)] underwent 8 weeks of physical training. Messenger RNA (mRNA) was measured at baseline, during and after 8 weeks of training. Protein was measured pre- and post-training. At baseline, there were no effects of diabetes on MMP or TIMP mRNA or protein. mRNA and protein response to training was similar in both groups, except active MMP-2 protein was elevated post training in T2DM only. Our results indicate that exercise-induced stimulation of MMPs is preserved in skeletal muscle of patients with T2DM. This early stage of diabetes may provide an opportunity for intervention and prevention of complications.
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Affiliation(s)
- Celena Scheede-Bergdahl
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Andreas Bergdahl
- Department of Exercise Science, Concordia University, Montreal, QC, Canada
| | - Peter Schjerling
- Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Qvortrup
- Department of Biomedical Sciences/CFIM, University of Copenhagen, Copenhagen, Denmark
| | - Satu O Koskinen
- Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Dela
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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15
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Ali S, Driscoll HE, Newton VL, Gardiner NJ. Matrix metalloproteinase-2 is downregulated in sciatic nerve by streptozotocin induced diabetes and/or treatment with minocycline: Implications for nerve regeneration. Exp Neurol 2014; 261:654-65. [PMID: 25158309 PMCID: PMC4199570 DOI: 10.1016/j.expneurol.2014.08.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 08/07/2014] [Accepted: 08/11/2014] [Indexed: 12/13/2022]
Abstract
Minocycline is an inhibitor of matrix metalloproteinases (MMPs) and has been shown to have analgesic effects. Whilst increased expression of MMPs is associated with neuropathic pain, MMPs also play crucial roles in Wallerian degeneration and nerve regeneration. In this study we examined the expression of MMP-2, MMP-9 and tissue inhibitor of metalloproteinase (TIMP)-1/-2 in the sciatic nerve of control and streptozotocin-induced diabetic rats treated with either vehicle or minocycline by quantitative PCR and gelatin zymography. We assessed the effects of minocycline on nerve conduction velocity and intraepidermal nerve fibre (IENF) deficits in diabetic neuropathy and investigated the effects of minocycline or MMP-2 on neurite outgrowth from primary cultures of dissociated adult rat sensory neurons. We show that MMP-2 is expressed constitutively in the sciatic nerve in vivo and treatment with minocycline or diabetes leads to downregulation of MMP-2 expression and activity. The functional consequence of this is IENF deficits in minocycline-treated nondiabetic rats and an unsupportive microenvironment for regeneration in diabetes. Minocycline reduces levels of MMP-2 mRNA and nerve growth factor-induced neurite outgrowth. Furthermore, in vivo minocycline treatment reduces preconditioning-induced in vitro neurite outgrowth following a sciatic nerve crush. In contrast, the addition of active MMP-2 facilitates neurite outgrowth in the absence of neurotrophic support and pre-treatment of diabetic sciatic nerve substrata with active MMP-2 promotes a permissive environment for neurite outgrowth. In conclusion we suggest that MMP-2 downregulation may contribute to the regenerative deficits in diabetes. Minocycline treatment also downregulates MMP-2 activity and is associated with inhibitory effects on sensory neurons. Thus, caution should be exhibited with its use as the balance between beneficial and detrimental outcomes may be critical in assessing the benefits of using minocycline to treat diabetic neuropathy. MMP-2, but not MMP-9, is constitutively expressed in the adult rat sciatic nerve. Levels of cleaved active MMP-2 are reduced in sciatic nerve of diabetic rats. Active MMP-2 potentiates neurite outgrowth from sensory neurons. Minocycline reduces levels of MMP-2 mRNA and impairs NGF-induced neurite growth. Minocycline did not prevent nerve dysfunction in experimental diabetic neuropathy.
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Affiliation(s)
- Sumia Ali
- Faculty of Life Sciences, University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | - Heather E Driscoll
- Faculty of Life Sciences, University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | - Victoria L Newton
- Faculty of Life Sciences, University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | - Natalie J Gardiner
- Faculty of Life Sciences, University of Manchester, Oxford Road, Manchester M13 9PT, UK.
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Morphometric analysis of connective tissue sheaths of sural nerve in diabetic and nondiabetic patients. BIOMED RESEARCH INTERNATIONAL 2014; 2014:870930. [PMID: 25147820 PMCID: PMC4132315 DOI: 10.1155/2014/870930] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 06/13/2014] [Accepted: 06/27/2014] [Indexed: 02/06/2023]
Abstract
One of the most common complications of diabetes mellitus is diabetic neuropathy. It may be provoked by metabolic and/or vascular factors, and depending on duration of disease, various layers of nerve may be affected. Our aim was to investigate influence of diabetes on the epineurial, perineurial, and endoneurial connective tissue sheaths. The study included 15 samples of sural nerve divided into three groups: diabetic group, peripheral vascular disease group, and control group. After morphological analysis, morphometric parameters were determined for each case using ImageJ software. Compared to the control group, the diabetic cases had significantly higher perineurial index (P < 0.05) and endoneurial connective tissue percentage (P < 0.01). The diabetic group showed significantly higher epineurial area (P < 0.01), as well as percentage of endoneurial connective tissue (P < 0.01), in relation to the peripheral vascular disease group. It is obvious that hyperglycemia and ischemia present in diabetes lead to substantial changes in connective tissue sheaths of nerve, particularly in peri- and endoneurium. Perineurial thickening and significant endoneurial fibrosis may impair the balance of endoneurial homeostasis and regenerative ability of the nerve fibers. Future investigations should focus on studying the components of extracellular matrix of connective tissue sheaths in diabetic nerves.
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17
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Temporal course of streptozotocin-induced diabetic polyneuropathy in rats. Neurol Sci 2014; 35:1813-20. [DOI: 10.1007/s10072-014-1848-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 05/27/2014] [Indexed: 10/25/2022]
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18
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Boyd BS, Dilley A. Altered tibial nerve biomechanics in patients with diabetes mellitus. Muscle Nerve 2014; 50:216-23. [PMID: 24375463 DOI: 10.1002/mus.24155] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 12/17/2013] [Accepted: 12/23/2013] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Hyperglycemia associated with diabetes mellitus (DM) has adverse impacts on peripheral nerve connective tissue structure, and there is preliminary evidence that nerve biomechanics may be altered. METHODS Ultrasound imaging was utilized to quantify the magnitude and timing of tibial nerve excursion during ankle dorsiflexion in patients with DM and matched healthy controls. RESULTS Tibial nerve longitudinal excursion at the ankle and knee was reduced, and timing was delayed at the ankle in the DM group. Severity of neuropathy was correlated with larger reductions in longitudinal excursion. Nerve cross-sectional area was increased at the ankle in the DM group. CONCLUSIONS Larger tibial nerve size within the tarsal tunnel in patients with DM may restrict longitudinal excursion, which was most evident with more severe neuropathy. It is hypothesized that these alterations may be related to painful symptoms during functional activities that utilize similar physiological motions through various biomechanical and physiological mechanisms.
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Affiliation(s)
- Benjamin S Boyd
- Department of Physical Therapy, Samuel Merritt University, 450 30th Street, Oakland, California, 94609, USA
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19
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Mason S, Phillips JB. An ultrastructural and biochemical analysis of collagen in rat peripheral nerves: the relationship between fibril diameter and mechanical properties. J Peripher Nerv Syst 2011; 16:261-9. [DOI: 10.1111/j.1529-8027.2011.00352.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Ugrenović S, Jovanović I, Vasović L. Morphometric analysis of human sciatic nerve perineurial collagen type IV content. Microsc Res Tech 2011; 74:1127-33. [PMID: 21538698 DOI: 10.1002/jemt.21004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2010] [Accepted: 02/03/2011] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Aging is the process which unavoidably alters structure and function of the basal membranes in humans. Though, collagen type IV presents the most prominent component of the basal membranes, we estimated its presence in the perineurium of the human sciatic nerve samples during the aging process. MATERIALS AND METHODS Material was 12 sciatic nerve samples, obtained from cadavers whose age ranged from 36 to 84 years. Cadavers were classified into three age groups: first which age ranged from 35 to 54 years, second which age ranged from 55 to 74 years and third which included cases older than 75 years. Tissue slices were further stained by labeled streptavidin-biotin method with collagen type IV monoclonal antibody and analyzed with light microscope under 100× lens magnification with oil immersion. Digital images of sciatic nerve perineurium were further processed and analyzed with ImageJ software. RESULTS Our results showed that there is statistically significant increase of perineurial area, perimeter, collagen type IV area, and collagen type IV area per perineurial perimeter unit in the third age group. These parameters also increased in the second age group, but this increase was not significant. Multiple regression analysis showed that beside fascicular size, age more significantly predict perineurial collagen type IV content. CONCLUSIONS Results of morphometric and statistical analysis pointed to the conclusion that there is significant increase of sciatic nerve perineurial thickness during the aging process. This increase might represent the consequence of perineurial collagen type IV deposition with aging.
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Serafín A, Molín J, Márquez M, Blasco E, Vidal E, Foradada L, Añor S, Rabanal RM, Fondevila D, Bosch F, Pumarola M. Diabetic neuropathy: electrophysiological and morphological study of peripheral nerve degeneration and regeneration in transgenic mice that express IFNbeta in beta cells. Muscle Nerve 2010; 41:630-41. [PMID: 19918773 DOI: 10.1002/mus.21564] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Diabetic neuropathy is one of the most frequent complications in diabetes but there are no treatments beyond glucose control, due in part to the lack of an appropriate animal model to assess an effective therapy. This study was undertaken to characterize the degenerative and regenerative responses of peripheral nerves after induced sciatic nerve damage in transgenic rat insulin I promoter / human interferon beta (RIP/IFNbeta) mice made diabetic with a low dose of streptozotocin (STZ) as an animal model of diabetic complications. In vivo, histological and immunohistological studies of cutaneous and sciatic nerves were performed after left sciatic crush. Functional tests, cutaneous innervation, and sciatic nerve evaluation showed pronounced neurological reduction in all groups 2 weeks after crush. All animals showed a gradual recovery but this was markedly slower in diabetic animals in comparison with normoglycemic animals. The delay in regeneration in diabetic RIP/IFNbeta mice resulted in an increase in active Schwann cells and regenerating neurites 8 weeks after surgery. These findings indicate that diabetic-RIP/IFNbeta animals mimic human diabetic neuropathy. Moreover, when these animals are submitted to nerve crush they have substantial deficits in nerve regrowth, similar to that observed in diabetic patients. When wildtype animals were treated with the same dose of STZ, no differences were observed with respect to nontreated animals, indicating that low doses of STZ and the transgene are not implicated in development of the degenerative and regenerative events observed in our study. All these findings indicate that RIP/IFNbeta transgenic mice are a good model for diabetic neuropathy.
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Affiliation(s)
- Anna Serafín
- Centre de Biotecnologia Animal i Terapia Gènica (CBATEG), Universitat Autònoma de Barcelona, Edifici H, Campus UAB, 08193 Bellaterra (Cerdanyola del Vallès), Spain.
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Chen RJ, Lin CCK, Ju MS. In situ transverse elasticity and blood perfusion change of sciatic nerves in normal and diabetic rats. Clin Biomech (Bristol, Avon) 2010; 25:409-14. [PMID: 20172636 DOI: 10.1016/j.clinbiomech.2010.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 01/20/2010] [Accepted: 01/21/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diabetic neuropathy is the most pervasive complication of diabetes mellitus and its etiopathology is not completely elucidated. The existing literature focuses on the histological and structural changes as well as the longitudinal mechanical properties of nerves. The main objective of this study is to investigate the in situ transverse biomechanical properties and changes of microcirculation of sciatic nerves in diabetic and normal control rats. METHODS Quasi-static circular compression experiments were conducted on sciatic nerves of six normal and six diabetic Wistar rats. Local blood perfusion during the compression was also measured by laser Doppler flowmetry. The compressive stress and strain were estimated, in order to calculate the apparent Young's modulus. The impact of diabetes on peripheral nerves was examined by analyzing the transverse elasticity and microcirculation changes. FINDINGS The mean transverse apparent Young's modulus of the sciatic nerves in diabetic rats was 210.7 kPa, which was nearly two times greater than that of normal controls (116.3 kPa). The pressure threshold that blood perfusion started to decrease in diabetic rats (24.1 mm Hg) was smaller than in the normal controls (47.1 mm Hg). INTERPRETATION These results suggest that the sciatic nerve was stiffer in the diabetic rats. The structural changes in microvessels might lead to earlier decrease of blood perfusion in diabetic nerves under radial compression. These results provide information about the biomechanical and microcirculation changes of peripheral nerves inflicted by diabetes and may also serve as a reference for clinical nerve repair and regeneration for patients with diabetic neuropathy.
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Affiliation(s)
- Rung-Jian Chen
- Department of Mechanical Engineering, National Cheng Kung University, 1 Ta-Hsueh Road, Tainan, Taiwan, ROC
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Abstract
The extracellular matrix of peripheral nerve plays a vital role in terms of normal nerve fibre function and also in the regenerative response following nerve injury. Nerve fibre loss is a major feature of diabetic neuropathy; however, the regenerative response is limited and this may be associated with changes in the composition of the extracellular matrix. Glycoproteins and collagens are major components of the extracellular matrix and are known to be important in terms of axonal growth. This work has therefore examined whether changes in the expression of two major glycoproteins, laminin and tenascin, and three collagen types (IV, V and VI) occur in the endoneurial and perineurial connective tissue compartments of human diabetic nerve. Despite being known to have a positive effect in terms of axonal growth, laminin levels were not elevated in the diabetic nerves. However, the pattern of tenascin expression did differ between the two groups being found in association with axon myelin units in the diabetic samples only. The pattern of collagen IV expression was the same in both tissue groups and was not found to be up-regulated. However, levels of collagen V and VI were both significantly increased in the endoneurium and for collagen VI also in the perineurium.
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Affiliation(s)
- Rebecca Hill
- The Department of Biological Sciences, The University of Hull, UK.
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Bahcelioglu M, Elmas C, Kurkcuoglu A, Calguner E, Erdogan D, Kadoglu D, Gzil R. Age-Related Immunohistochemical and Ultrastructural Changes in Rat Oculomotor Nerve. Anat Histol Embryol 2008; 37:279-84. [DOI: 10.1111/j.1439-0264.2008.00841.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hayami T, Iramina K, Chen X, Sunagawa K. Simulation study on the effect of fiber loss to the compound action potential of a sural nerve. ACTA ACUST UNITED AC 2007; 2007:2396-9. [PMID: 18002476 DOI: 10.1109/iembs.2007.4352810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This paper reports the result of computer simulation about compound action potential of a sural nerve with and without fiber loss. A compound action potential is a wave of electric potential detectable on the skin after electric stimulation of a peripheral nerve. The loss of nerve fibers, which is observed in some neuropathies, is considered as the cause of low amplitude and slow conduction of the wave. To quantify the relationship between fiber loss and compound action potential, computer simulation of the stimulation of a human sural nerve was executed. As a result, the conduction velocity of the first negative peak of the compound action potential was substantially reduced in case of thick fiber loss, and was slightly enlarged in case of thin fiber loss. However the amplitude of the peak was not always reduced. The effect of thin fiber loss was observed in the amplitude of the second positive peak and the second negative peak.
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Affiliation(s)
- Takehito Hayami
- Digital Medicine Initiative, Kyushu University, Fukuoka, 8128582, Japan.
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Schiavoni MCL, Fazan VPS. There is no relation between the fascicular and the endoneural blood vessel areas on the cervical vagus nerve of normotensive rats. J Neurosci Methods 2006; 158:171-8. [PMID: 16814392 DOI: 10.1016/j.jneumeth.2006.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Revised: 05/09/2006] [Accepted: 05/24/2006] [Indexed: 11/18/2022]
Abstract
The aim of this study was to determine the existence of a relation between the fascicular area and total vessel area on the cervical vagus nerve of Wistar-Kyoto female rats. Animals aged 30, 180 or 360 days had their right vagus nerves prepared for epoxy resin embedding and light microscopy study. Semithin serial sections were studied every 100 microm of the longitudinal extension of the nerve. The fascicular area and the total endoneural vessel area were obtained for each nerve segment (proximal, middle and distal) and compared between segments and ages. The relation between fascicular area and endoneural vessel area was accessed by linear regression analysis and correlation coefficient calculations. No significant relationship between the two variables was detected in all nerves studied. This suggests that the entrance of blood vessels to the endoneural space is not accompanied by an increase in the fascicular area and this may have implications on the fiber density calculations since, in the presence of large vessels, this density can be underestimated if the vessel area is not discounted. The endoneural vessel area increased from proximal to distal in all groups but got smaller with ageing, suggesting that older animals may be more susceptible to nerve ischemia.
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Affiliation(s)
- Maria Cristina Lopes Schiavoni
- Department of Neurology, School of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes 3900, Ribeirão Preto, São Paulo 14049-900, Brazil
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Huber JD, VanGilder RL, Houser KA. Streptozotocin-induced diabetes progressively increases blood-brain barrier permeability in specific brain regions in rats. Am J Physiol Heart Circ Physiol 2006; 291:H2660-8. [PMID: 16951046 DOI: 10.1152/ajpheart.00489.2006] [Citation(s) in RCA: 137] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study investigated the effects of streptozotocin-induced diabetes on the functional integrity of the blood-brain barrier in the rat at 7, 28, 56, and 90 days, using vascular space markers ranging in size from 342 to 65,000 Da. We also examined the effect of insulin treatment of diabetes on the formation and progression of cerebral microvascular damage and determined whether observed functional changes occurred globally throughout the brain or within specific brain regions. Results demonstrate that streptozotocin-induced diabetes produced a progressive increase in blood-brain barrier permeability to small molecules from 28 to 90 days and these changes in blood-brain barrier permeability were region specific, with the midbrain most susceptible to diabetes-induced microvascular damage. In addition, results showed that insulin treatment of diabetes attenuated blood-brain barrier disruption, especially during the first few weeks; however, as diabetes progressed, it was evident that microvascular damage occurred even when hyperglycemia was controlled. Overall, results of this study suggest that diabetes-induced perturbations to cerebral microvessels may disrupt homeostasis and contribute to long-term cognitive and functional deficits of the central nervous system.
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Affiliation(s)
- Jason D Huber
- Dept. of Basic Pharmaceutical Sciences, West Virginia University, Morgantown, WV 26506, USA.
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