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Mansoor H, Lee IXY, Lin MTY, Ang HP, Xue YC, Krishaa L, Patil M, Koh SK, Tan HC, Zhou L, Liu YC. Topical and oral peroxisome proliferator-activated receptor-α agonist ameliorates diabetic corneal neuropathy. Sci Rep 2024; 14:13435. [PMID: 38862650 PMCID: PMC11167005 DOI: 10.1038/s41598-024-64451-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 06/10/2024] [Indexed: 06/13/2024] Open
Abstract
Diabetic corneal neuropathy (DCN) is a common diabetic ocular complication with limited treatment options. In this study, we investigated the effects of topical and oral fenofibrate, a peroxisome proliferator-activated receptor-α agonist, on the amelioration of DCN using diabetic mice (n = 120). Ocular surface assessments, corneal nerve and cell imaging analysis, tear proteomics and its associated biological pathways, immuno-histochemistry and western blot on PPARα expression, were studied before and 12 weeks after treatment. At 12 weeks, PPARα expression markedly restored after topical and oral fenofibrate. Topical fenofibrate significantly improved corneal nerve fibre density (CNFD) and tortuosity coefficient. Likewise, oral fenofibrate significantly improved CNFD. Both topical and oral forms significantly improved corneal sensitivity. Additionally, topical and oral fenofibrate significantly alleviated diabetic keratopathy, with fenofibrate eye drops demonstrating earlier therapeutic effects. Both topical and oral fenofibrate significantly increased corneal β-III tubulin expression. Topical fenofibrate reduced neuroinflammation by significantly increasing the levels of nerve growth factor and substance P. It also significantly increased β-III-tubulin and reduced CDC42 mRNA expression in trigeminal ganglions. Proteomic analysis showed that neurotrophin signalling and anti-inflammation reactions were significantly up-regulated after fenofibrate treatment, whether applied topically or orally. This study concluded that both topical and oral fenofibrate ameliorate DCN, while topical fenofibrate significantly reduces neuroinflammation.
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Affiliation(s)
| | - Isabelle Xin Yu Lee
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Molly Tzu-Yu Lin
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Heng Pei Ang
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Yao Cong Xue
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - L Krishaa
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Moushmi Patil
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Siew-Kwan Koh
- Ocular Proteomic Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Hong Chang Tan
- Department of Endocrinology, Singapore General Hospital, Singapore, Singapore
| | - Lei Zhou
- Department of Applied Biology and Chemical Technology, School of Optometry, Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Pak Shek Kok, Hong Kong
| | - Yu-Chi Liu
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, 11 Third Hospital Ave, Singapore, 168751, Singapore.
- Cornea and Refractive Surgery Group, Singapore Eye Research Institute, Singapore, Singapore.
- Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore, Singapore.
- Eye-Academic Clinical Program, Singapore Graduate Medical School, Duke-National University, Singapore, Singapore.
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
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Chen M, Pu L, Gan Y, Wang X, Kong L, Guo M, Yang H, Li Z, Xiong Z. The association between variability of risk factors and complications in type 2 diabetes mellitus: a retrospective study. Sci Rep 2024; 14:6357. [PMID: 38491155 PMCID: PMC10943073 DOI: 10.1038/s41598-024-56777-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
The variability in diabetes risk factors, such as uric acid and lipids, may influence the development of complications. This study aimed to investigate the influence of such variability on the occurrence of diabetic complications. A retrospective analysis of electronic medical records was conducted with type 2 diabetic patients who received treatment at a tertiary care hospital in Chengdu, Sichuan Province, between 2013 and 2022. The risk factor variability is presented as the standard deviation (SD). The associations between the variability and complications were examined using a binary logistic regression model. The study included 369 patients with type 2 diabetes. The findings revealed that outpatient special disease management served as a protective factor against the development of complications [OR = 0.53, 95% confidence interval (CI) (0.29-0.10)], particularly for the prevention of diabetic peripheral neuropathy [OR = 0.51, 95% CI (0.30-0.86)]. Variability in total cholesterol (TC-SD) was found to be a risk factor for the development of complications [OR = 2.42, 95% CI (1.18-4.97)] and acted as a risk factor for diabetic peripheral vasculopathy [OR = 2.50, 95% CI (1.25-5.02)]. TC-SD is a risk factor for the occurrence of diabetic peripheral neuropathy and diabetic peripheral vasculopathy, whereas outpatient special disease management functions as a protective factor against complications and diabetic peripheral neuropathy. Thus, in addition to glycaemic control, the regulation of lipid levels should be emphasized, particularly among patients without outpatient special disease management, to delay the onset of complications.
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Affiliation(s)
- Mengjie Chen
- School of Nursing, Chengdu Medical College, No. 601 Tian Hui Road, Rong Du Avenue, Chengdu, 610083, Sichuan, China
| | - Lihui Pu
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, 4111, Australia
- School of Nursing and Midwifery, Griffith University, Queensland, Australia
- Erasmus MC, University Medical Centre Rotterdam, Department Internal Medicine, Section Nursing Science, Rotterdam, The Netherlands
| | - Yuqin Gan
- School of Nursing, Chengdu Medical College, No. 601 Tian Hui Road, Rong Du Avenue, Chengdu, 610083, Sichuan, China
| | - Xiaoxia Wang
- School of Nursing, Chengdu Medical College, No. 601 Tian Hui Road, Rong Du Avenue, Chengdu, 610083, Sichuan, China
| | - Laixi Kong
- School of Nursing, Chengdu Medical College, No. 601 Tian Hui Road, Rong Du Avenue, Chengdu, 610083, Sichuan, China
| | - Maoting Guo
- School of Nursing, Chengdu Medical College, No. 601 Tian Hui Road, Rong Du Avenue, Chengdu, 610083, Sichuan, China
| | - Huiqi Yang
- Nanbu County People's Hospital, Nanchong, 637300, Sichuan, China
| | - Zhe Li
- Mental Health Center, West China Hospital, Sichuan University, No. 28 Dianxin South Road, Chengdu, 610041, Sichuan, China.
- Sichuan Clinical Medical Research Center for Mental Disorders, No. 28 Dianxin South Road, Chengdu, 610041, Sichuan, China.
| | - Zhenzhen Xiong
- School of Nursing, Chengdu Medical College, No. 601 Tian Hui Road, Rong Du Avenue, Chengdu, 610083, Sichuan, China.
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Gaur A, Varatharajan S, Katta R, Taranikanti M, John NA, Umesh M, Ganji V, Medala K. Assessment of Neuropathy by Temperature Threshold Testing in Type 2 Diabetes Mellitus. Int J Appl Basic Med Res 2024; 14:54-59. [PMID: 38504834 PMCID: PMC10947757 DOI: 10.4103/ijabmr.ijabmr_397_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/05/2024] [Accepted: 01/19/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction Diagnosing diabetic neuropathy is a challenge at times as it is asymptomatic. Diagnosing diabetic neuropathy involves the use of quantitative sensory testing, nerve conduction study, and autonomic testing. Tempearture threshold testing (TTT) can aid in diagnosing small fiber neuropathy at early stages. This study aimed to assess the small fiber neuropathy using TTT in diabetes mellitus (DM) and correlate with age, duration of diabetes, and lipid profile. Materials and Methods The study was commenced after obtaining ethics approval from the institute ethics committee. The study participants included 100 patients with type 2 DM of both genders between the ages of 40 and 65 years. The glycemic status and lipid profile were noted along with physical examination. Neuropathy assessment was done using Michigan Neuropathy Screening Instrument (MNSI) and TTT. Results The prevalence of small fiber neuropathy based on TTT was 63%. The lipid profile was similar in both the groups. The MNSI B scale had significantly higher scores in the neuropathy group. In the neuropathy group, the thresholds for hot were significantly greater in all four limbs and cold were significantly lower. Age and years of DM were positively correlated with the neuropathy. Hot threshold in the lower limb had shown a strong positive correlation. Conclusion The age and duration of diabetes are independent risk factors for diabetic peripheral neuropathy. Small fiber neuropathy is a prequel to the motor neuropathy. Hot threshold testing in the lower limb is more sensitive than cold threshold testing for diagnosing small fiber neuropathy.
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Affiliation(s)
- Archana Gaur
- Department of Physiology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | | | - Roja Katta
- Department of Physiology, ESIC Medical College and Hospital, Hyderabad, Telangana, India
| | - Madhuri Taranikanti
- Department of Physiology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Nitin Ashok John
- Department of Physiology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Madhusudhan Umesh
- Department of Physiology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Vidya Ganji
- Department of Physiology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Kalpana Medala
- Department of Physiology, All India Institute of Medical Sciences, Hyderabad, Telangana, India
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Zhang H, Chen Y, Zhu W, Niu T, Song B, Wang H, Wang W, Zhang H. The mediating role of HbA1c in the association between elevated low-density lipoprotein cholesterol levels and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus. Lipids Health Dis 2023; 22:102. [PMID: 37443036 DOI: 10.1186/s12944-023-01865-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Increased levels of low-density lipoprotein cholesterol (LDL-C) have been identified as one potential risk factor for diabetic peripheral neuropathy (DPN) in patients. The current study seeks to clarify the link between LDL-C, hyperglycemia, and DPN in patients with type 2 diabetes mellitus (T2DM). METHODS Here, a total of 120 T2DM individuals were recruited. These volunteers with T2DM were divided into 2 groups, based on the presence or absence of peripheral neuropathy. Additionally, their baseline characteristics were compared. Association among LDL-C and glycosylated hemoglobin (HbA1c) levels and DPN, particularly with respect to specific nerve conduction velocity were analyzed. To identify factors influencing DPN, regression was performed. Furthermore, mediation analysis was employed to evaluate the indirect, direct and total effects of LDL-C on specific nerve conduction velocity, with HbA1c serving as a mediator. RESULTS Compared to 55 patients without DPN, 65 patients with DPN demonstrated elevated levels of LDL-C and HbA1c. Both LDL-C and HbA1c have been found to be associated with reduced the motor fiber conduction velocities of Ulnar (or the Common peroneal) nerve in diabetic patients. HbA1c is one of the known risk factors for DPN in individuals with T2DM. Further mediation analysis revealed that the effect of LDL-C on the Ulnar (or the Common peroneal) nerve motor fiber conduction velocities are fully mediated by HbA1c in patients with T2DM. CONCLUSIONS The impact of elevated LDL-C levels upon the Ulnar (or the Common peroneal) nerve motor fiber conduction velocities in patients with T2DM was found to be entirely mediated by increased HbA1c levels.
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Affiliation(s)
- Hui Zhang
- Henan Key Laboratory of Rare Diseases, Endocrinology and Metabolism Center, The First Affiliated Hospital and College of Clinical Medicine of Henan of Science and Technology, Luoyang, China
| | - Yang Chen
- Department of Endocrinology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wenwen Zhu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Tong Niu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Bing Song
- Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Hongxiao Wang
- Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Wei Wang
- Department of Endocrinology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China.
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
| | - Haoqiang Zhang
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
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Naseem N, Ahmad MF, Malik S, Khan RH, Siddiqui WA. The potential of esculin in ameliorating Type-2 diabetes mellitus induced neuropathy in Wistar rats and probing its inhibitory mechanism of insulin aggregation. Int J Biol Macromol 2023; 242:124760. [PMID: 37156314 DOI: 10.1016/j.ijbiomac.2023.124760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
Diabetic neuropathy encompasses multiple pathological disturbances, many of which coincide with the pathophysiological mechanisms of neurodegenerative disorders. In the present study, various biophysical techniques like Rayleigh light scattering assay, Thioflavin T assay, far-UV Circular Dichroism spectroscopy, Transmission electron microscopy have unveiled the anti-fibrillatory effect of esculin upon human insulin fibrillation. MTT cytotoxicity assay demonstrated the biocompatibility of esculin and in-vivo studies such as behavioral tests like hot plate test, tail immersion test, acetone drop test, plantar test were performed for validating diabetic neuropathy. Assessment of levels of serum biochemical parameters, oxidative stress parameters, pro-inflammatory cytokines as well as neuron specific markers was done in the current study. Rat brains were subjected to histopathology and their sciatic nerves were subjected to transmission electron microscopy to analyze myelin structure alterations. All these results reveal that esculin ameliorates diabetic neuropathy in experimental diabetic rats. Conclusively, our study demonstrates the anti-amyloidogenic potential of esculin in the form of inhibition of human insulin fibrillation, making it a promising candidate in combating neurodegenerative disorders in the near future and the results of various behavioral, biochemical, and molecular studies reveal that esculin possesses anti-lipidemic, anti-inflammatory, anti-oxidative and neuroprotective properties which help in ameliorating diabetic neuropathy in streptozotocin induced diabetic Wistar rats.
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Affiliation(s)
- Nida Naseem
- Research Lab-1, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002, India
| | - Md Fahim Ahmad
- Research Lab-1, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002, India
| | - Sadia Malik
- Research Lab-3, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002, India
| | - Rizwan Hasan Khan
- Research Lab-3, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002, India.
| | - Waseem A Siddiqui
- Research Lab-1, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002, India.
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6
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Jiao Y, Li YZ, Zhang YH, Cui W, Li Q, Xie KL, Yu Y, Yu YH. Lysine demethylase KDM5B down-regulates SIRT3-mediated mitochondrial glucose and lipid metabolism in diabetic neuropathy. Diabet Med 2023; 40:e14964. [PMID: 36130801 DOI: 10.1111/dme.14964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/06/2022] [Accepted: 09/14/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Diabetic peripheral neuropathy (DPN) is a common neurological complication of diabetes mellitus without efficient interventions. Both lysine demethylase 5B (KDM5B) and sirtuin-3 (SIRT3) have been found to regulate islet function and glucose homeostasis. KDM5B was predicted to bind to the SIRT3 promoter by bioinformatics. Here, we investigated whether KDM5B affected DPN development via modulating SIRT3. METHODS The db/db mice and high glucose-stimulated Schwann cells (RSC96) were used as in vivo and in vitro models of DPN, respectively. Glucose level, glucose and insulin tolerance of mice were measured. Neurological function was evaluated by motor nerve conduction velocity (MNCV), tactile allodynia assay and thermal sensitivity assay. Adenosine triphosphate level, oxygen consumption rate, extracellular acidification rate, β-oxidation rate, acetyl-CoA level, acetylation levels and activities of long-chain acyl CoA dehydrogenase (LCAD) and pyruvate dehydrogenase (PDH) were detected. Methyl thiazolyl tetrazolium assay was adopted to determine cell viability. Reactive oxygen species (ROS) production was detected by MitoSox staining. Western blotting for measuring target protein levels. Molecular mechanisms were investigated by co-immunoprecipitine (Co-IP), chromatin immunoprecipitation (ChIP) and luciferase reporter assay. RESULTS KDM5B was up-regulated, while SIRT3 was down-regulated in DPN models. SIRT3 overexpression or AMPK activation ameliorated mitochondrial metabolism dysfunction and ROS overproduction during DPN. KDM5B overexpression triggered mitochondrial metabolism disorder and oxidative stress via directly transcriptional inhibiting SIRT3 expression by demethylating H3K4me3 or indirectly repressing AMPK pathway-regulated SIRT3 expression. CONCLUSION KDM5B contributes to DPN via regulating SIRT3-mediated mitochondrial glucose and lipid metabolism. KDM5B inhibition may be an effective intervention for DPN.
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Affiliation(s)
- Yang Jiao
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
- Tianjin Institute of Anesthesiology, Tianjin, People's Republic of China
| | - Yi-Ze Li
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
- Tianjin Institute of Anesthesiology, Tianjin, People's Republic of China
| | - Yue-Hua Zhang
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
- Tianjin Institute of Anesthesiology, Tianjin, People's Republic of China
| | - Wei Cui
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
- Tianjin Institute of Anesthesiology, Tianjin, People's Republic of China
| | - Qing Li
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
- Tianjin Institute of Anesthesiology, Tianjin, People's Republic of China
| | - Ke-Liang Xie
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
- Tianjin Institute of Anesthesiology, Tianjin, People's Republic of China
| | - Yang Yu
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
- Tianjin Institute of Anesthesiology, Tianjin, People's Republic of China
| | - Yong-Hao Yu
- Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
- Tianjin Institute of Anesthesiology, Tianjin, People's Republic of China
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7
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Chen H, Liao C, Yang X, Zhou H, Wu Y, Sun Q, Li S, Zhang W. Multi-omics analysis revealed the role of CYP1A2 in the induction of mechanical allodynia in type 1 diabetes. Front Genet 2023; 14:1151340. [PMID: 37035728 PMCID: PMC10076588 DOI: 10.3389/fgene.2023.1151340] [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: 01/26/2023] [Accepted: 03/10/2023] [Indexed: 04/11/2023] Open
Abstract
Background: Mechanical allodynia (MA) is one of the leading clinical symptoms of painful diabetic peripheral neuropathy (PDPN), which is a primary reason for non-traumatic amputations, foot ulceration, and gait abnormalities in patients with diabetes. However, the pathogenic mechanisms of MA have not yet been fully elucidated, and there is no effective treatment. This study aims to study the potential pathogenetic mechanisms of MA and to provide targets for the therapy of MA. Methods: A single intraperitoneal injection of streptozotocin induced type 1 diabetes in rat models. Subsequently, rats were divided into the control group, the diabetic group without MA, and the diabetic group with MA based on weekly behavioral assays. The differentially expressed lipids in the sciatic nerve of each group were detected using untargeted lipidomics, and the differentially expressed genes in the sciatic nerve of each group were detected by transcriptomics. The pathogenesis of MA was predicted using integrated analysis and validated by immunofluorescence staining and transmission electron microscopy. Results: Untargeted lipidomics revealed the accumulation of a more severe lipid in MA rats. Transcriptomics results suggested that differentially expressed genes in MA rats were primarily related to lipid droplets and myelin sheath. Integrated analysis results indicated that the downregulation of Cytochrome P450 1A2 (CYP1A2) expression was closely linked to lipid metabolism disorders. Immunofluorescence staining demonstrated that down-regulation of CYP1A2 expression occurred in MA rats. Transmission electron microscopy results showed that more severe lipid droplet accumulation and myelin sheath degeneration occurred in MA rats. Conclusion: Our findings imply that the downregulation of CYP1A2 expression leads to disorders of lipid metabolism and further leads to lipid droplet accumulation and myelin sheath degeneration, which might ultimately lead to the development of MA. Therefore, our study contributes to promoting the understanding of the molecular mechanisms of MA and providing potential targets for the clinical treatment of MA.
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Nedyalkova M, Robeva R, Elenkova A, Simeonov V. Chemometric exploratory data analysis for patients with diabetes type 2 and diabetic complications. PHYSICAL SCIENCES REVIEWS 2022. [DOI: 10.1515/psr-2020-0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
The present study deals with the interpretation and modeling of clinical data for patients with diabetes mellitus type 2 (DMT2) additionally diagnosed with complications of the disease by the use of multivariate statistical methods. The major goal is to determine some specific clinical descriptors characterizing each health problem by applying the options of the exploratory data analysis. The results from the statistical analysis are commented in details by medical reasons for each of the complications. It was found that each of the complications is characterized by specific medical descriptors linked into each one of the five latent factors identified by factor and principal components analysis. Such an approach to interpret concomitant to DMT2 complications is original and allows a better understanding of the role of clinical parameters for diagnostic and prevention goals.
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Affiliation(s)
- Miroslava Nedyalkova
- Chair of General and Inorganic Chemistry, Faculty of Chemistry and Pharmacy, University of Sofia “St. Kl. Okhridski”, 1 , J. Bourchier Blvd. , 1164 Sofia , Bulgaria
| | - Ralitsa Robeva
- USHATE “Acad. Iv. Penchev”, Department of Endocrinology , Medical Faculty, Medical University-Sofia , 2, Zdrave Str. , 1431 Sofia , Bulgaria
| | - Atanaska Elenkova
- USHATE “Acad. Iv. Penchev”, Department of Endocrinology , Medical Faculty, Medical University-Sofia , 2, Zdrave Str. , 1431 Sofia , Bulgaria
| | - Vasil Simeonov
- Chair of Analytical Chemistry, Faculty of Chemistry and Pharmacy, University of Sofia “St. Kl. Okhridski”, 1 , J. Bourchier Blvd. , 1164 Sofia , Bulgaria
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9
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Statins Neuromuscular Adverse Effects. Int J Mol Sci 2022; 23:ijms23158364. [PMID: 35955495 PMCID: PMC9369175 DOI: 10.3390/ijms23158364] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022] Open
Abstract
Statins are drugs widely prescribed in high-risk patients for cerebrovascular or cardiovascular diseases and are, usually, safe and well tolerated. However, these drugs sometimes may cause neuromuscular side effects that represent about two-third of all adverse events. Muscle-related adverse events include cramps, myalgia, weakness, immune-mediated necrotizing myopathy and, more rarely, rhabdomyolysis. Moreover, they may lead to peripheral neuropathy and induce or unmask a preexisting neuromuscular junction dysfunction. A clinical follow up of patients assuming statins could reveal early side effects that may cause neuromuscular damage and suggest how to better modulate their use. In fact, statin dechallenge or cessation, or the alternative use of other lipid-lowering agents, can avoid adverse events. This review summarizes the current knowledge on statin-associated neuromuscular adverse effects, diagnosis, and management. It is conceivable that the incidence of neuromuscular complications will increase because, nowadays, use of statins is even more diffused than in the past. On this purpose, it is expected that pharmacogenomic and environmental studies will help to timely predict neuromuscular complications due to statin exposure, leading to a more personalized therapeutic approach.
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10
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Pasha R, Azmi S, Ferdousi M, Kalteniece A, Bashir B, Gouni-Berthold I, Malik RA, Soran H. Lipids, Lipid-Lowering Therapy, and Neuropathy: A Narrative Review. Clin Ther 2022; 44:1012-1025. [PMID: 35810030 DOI: 10.1016/j.clinthera.2022.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/23/2022] [Accepted: 03/26/2022] [Indexed: 11/17/2022]
Abstract
Statins, or 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, are the mainstay of treatment for hypercholesterolemia as they effectively reduce LDL-C levels and risk of atherosclerotic cardiovascular disease. Apart from hyperglycemia, dyslipidemia and HDL dysfunction are known risk factors for neuropathy in people with obesity and diabetes. Although there are case reports of statin-induced neuropathy, ad hoc analyses of clinical trials and observational studies have shown that statins may improve peripheral neuropathy. However, large randomized controlled trials and meta-analyses of cardiovascular outcome trials with statins and other lipid-lowering drugs have not reported on neuropathy outcomes. Because neuropathy was not a prespecified outcome in major cardiovascular trials, one cannot conclude whether statins or other lipid-lowering therapies increase or decrease the risk of neuropathy. The aim of this review was to assess if statins have beneficial or detrimental effects on neuropathy and whether there is a need for large well-powered interventional studies using objective neuropathy end points.
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Affiliation(s)
- Raabya Pasha
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Shazli Azmi
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Trust, Manchester, United Kingdom
| | - Maryam Ferdousi
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Trust, Manchester, United Kingdom
| | - Alise Kalteniece
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Trust, Manchester, United Kingdom
| | - Bilal Bashir
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Ioanna Gouni-Berthold
- Polyclinic for Endocrinology, Diabetes, and Preventive Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Rayaz A Malik
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Handrean Soran
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Trust, Manchester, United Kingdom.
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He J, Li Z, Xia P, Shi A, FuChen X, Zhang J, Yu P. Ferroptosis and Ferritinophagy in Diabetes Complications. Mol Metab 2022; 60:101470. [PMID: 35304332 PMCID: PMC8980341 DOI: 10.1016/j.molmet.2022.101470] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 11/27/2022] Open
Abstract
With long-term metabolic malfunction, diabetes can cause more serious damage to the whole body tissue and organs, resulting in a variety of complications. Therefore, it is particularly important to further explore the pathogenesis of diabetes complications and develop drugs for prevention and treatment. In recent years, ferroptosis has been recognized as a new regulatory mode of cell death different from apoptosis and necrosis, which involves the regulation of nuclear receptor coactivator 4 (NCOA4)-mediated ferritinophagy. Evidence shows that ferroptosis and ferritinophagy provide a significant role in the occurrence and development of diabetes complications. This article systematically reviews the current understanding of ferroptosis and ferritinophagy, focusing on their potential mechanisms, connection, and regulation. We discuss their involvement in diabetes complications and consider emerging therapeutic opportunities and the associated challenges with future prospects.
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Affiliation(s)
- Jiahui He
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China
| | - Zhangwang Li
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China
| | - Panpan Xia
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China; Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China
| | - Ao Shi
- School of Medicine, St. George University of London, London, UK; School of Medicine, University of Nicosia, Nicosia, Cyprus
| | - Xinxi FuChen
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China; Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China
| | - Jing Zhang
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China; Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China.
| | - Peng Yu
- The Second Clinical Medical College of Nanchang University, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China; Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Jiangxi, Nanchang 330006, China.
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12
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Kollmer J, Bendszus M. Magnetic Resonance Neurography: Improved Diagnosis of Peripheral Neuropathies. Neurotherapeutics 2021; 18:2368-2383. [PMID: 34859380 PMCID: PMC8804110 DOI: 10.1007/s13311-021-01166-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 12/15/2022] Open
Abstract
Peripheral neuropathies account for the most frequent disorders seen by neurologists, and causes are manifold. The traditional diagnostic gold-standard consists of clinical neurologic examinations supplemented by nerve conduction studies. Due to well-known limitations of standard diagnostics and atypical clinical presentations, establishing the correct diagnosis can be challenging but is critical for appropriate therapies. Magnetic resonance neurography (MRN) is a relatively novel technique that was developed for the high-resolution imaging of the peripheral nervous system. In focal neuropathies, whether traumatic or due to nerve entrapment, MRN has improved the diagnostic accuracy by directly visualizing underlying nerve lesions and providing information on the exact lesion localization, extension, and spatial distribution, thereby assisting surgical planning. Notably, the differentiation between distally located, complete cross-sectional nerve lesions, and more proximally located lesions involving only certain fascicles within a nerve can hold difficulties that MRN can overcome, when basic technical requirements to achieve sufficient spatial resolution are implemented. Typical MRN-specific pitfalls are essential to understand in order to prevent overdiagnosing neuropathies. Heavily T2-weighted sequences with fat saturation are the most established sequences for MRN. Newer techniques, such as T2-relaxometry, magnetization transfer contrast imaging, and diffusion tensor imaging, allow the quantification of nerve lesions and have become increasingly important, especially when evaluating diffuse, non-focal neuropathies. Innovative studies in hereditary, metabolic or inflammatory polyneuropathies, and motor neuron diseases have contributed to a better understanding of the underlying pathomechanism. New imaging biomarkers might be used for an earlier diagnosis and monitoring of structural nerve injury under causative treatments in the future.
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Affiliation(s)
- Jennifer Kollmer
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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13
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Okdahl T, Brock C. Molecular Aspects in the Potential of Vitamins and Supplements for Treating Diabetic Neuropathy. Curr Diab Rep 2021; 21:31. [PMID: 34448953 PMCID: PMC8397661 DOI: 10.1007/s11892-021-01397-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 01/16/2023]
Abstract
To discuss and provide evidence-based data on dietary supplements as part of treating diabetic neuropathy RECENT FINDINGS: Few randomized controlled trials are available, but some have shown beneficial efficacy of various dietary supplements on objective primary endpoints including nerve conduction velocities and axon potentials as well as subjective patient-reported outcomes. No medical cure for diabetic neuropathy exists, and prevention is therefore crucial. Tight glucose control slows the progression of nerve damage in diabetes, but an unmet clinical need for effective interventions is warranted. Consequently, a growing number of patients turn to dietary supplements proposed to possess neuroprotective properties. However, the postulated effects are often not evidence-based as they have not been tested scientifically. Taken together, this review will focus on dietary supplements investigated in clinical trials for their potential capabilities in targeting the molecular mechanisms involved in the underlying pathogenesis of diabetic neuropathy.
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Affiliation(s)
- Tina Okdahl
- grid.5117.20000 0001 0742 471XMech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, 9000 Aalborg, Denmark
| | - Christina Brock
- grid.5117.20000 0001 0742 471XMech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, 9000 Aalborg, Denmark
- grid.5117.20000 0001 0742 471XDepartment of Clinical Medicine, Aalborg University, Aalborg, Denmark
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14
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Bondar A, Popa AR, Papanas N, Popoviciu M, Vesa CM, Sabau M, Daina C, Stoica RA, Katsiki N, Stoian AP. Diabetic neuropathy: A narrative review of risk factors, classification, screening and current pathogenic treatment options (Review). Exp Ther Med 2021; 22:690. [PMID: 33986855 PMCID: PMC8111877 DOI: 10.3892/etm.2021.10122] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
Diabetic neuropathy (DN) is a frequent complication of diabetes mellitus (DM) with severe consequences as it progresses and influences all human body systems. This review discusses the risk factors for DN, the main characteristics of the clinical forms of DN, the screening methods and the current therapeutic options. Distal symmetric DN is the primary clinical form, and DM patients should be screened for this complication. The most important treatment of DN remains good glucose control, generally defined as HbA1c ≤7%. Symptomatic treatment improves life quality in diabetic patients. Pharmacological agents such as alpha (α)-lipoic acid and benfotiamine have been validated in several studies since they act on specific pathways such as increased oxidative stress (α-lipoic acid exerts antioxidant effects) and the excessive production of advanced glycosylation products (benfotiamine may inhibit their production via the normalization of glucose). Timely diagnosis of DN is significant to avoid several complications, including lower limb amputations and cardiac arrhythmias.
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Affiliation(s)
- Andrei Bondar
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania.,Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Amorin Remus Popa
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania.,Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Nikolaos Papanas
- Second Department of Internal Medicine, 'Democritus' University of Thrace Diabetes Centre, 68100 Alexandroupolis, Greece
| | - Mihaela Popoviciu
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania.,Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Cosmin Mihai Vesa
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania.,Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Monica Sabau
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania.,Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Cristian Daina
- Department of Psychiatry, Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania.,Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Roxana Adriana Stoica
- Department of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Niki Katsiki
- Second Propaedeutic Department of Internal Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
| | - Anca Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
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15
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Mandal N, Grambergs R, Mondal K, Basu SK, Tahia F, Dagogo-Jack S. Role of ceramides in the pathogenesis of diabetes mellitus and its complications. J Diabetes Complications 2021; 35:107734. [PMID: 33268241 PMCID: PMC8663915 DOI: 10.1016/j.jdiacomp.2020.107734] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 12/12/2022]
Abstract
Diabetes mellitus (DM) is a systemic metabolic disease that affects 463 million adults worldwide and is a leading cause of cardiovascular disease, blindness, nephropathy, peripheral neuropathy, and lower-limb amputation. Lipids have long been recognized as contributors to the pathogenesis and pathophysiology of DM and its complications, but recent discoveries have highlighted ceramides, a class of bioactive sphingolipids with cell signaling and second messenger capabilities, as particularly important contributors to insulin resistance and the underlying mechanisms of DM complications. Besides their association with insulin resistance and pathophysiology of type 2 diabetes, evidence is emerging that certain species of ceramides are mediators of cellular mechanisms involved in the initiation and progression of microvascular and macrovascular complications of DM. Advances in our understanding of these associations provide unique opportunities for exploring ceramide species as potential novel therapeutic targets and biomarkers. This review discusses the links between ceramides and the pathogenesis of DM and diabetic complications and identifies opportunities for novel discoveries and applications.
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Affiliation(s)
- Nawajes Mandal
- The University of Tennessee Health Science Center, Department of Ophthalmology, Memphis, TN 38163, USA.; The University of Tennessee Health Science Center, Department of Anatomy and Neurobiology, Memphis, TN 38163, USA..
| | - Richard Grambergs
- The University of Tennessee Health Science Center, Department of Ophthalmology, Memphis, TN 38163, USA
| | - Koushik Mondal
- The University of Tennessee Health Science Center, Department of Ophthalmology, Memphis, TN 38163, USA
| | - Sandip K Basu
- The University of Tennessee Health Science Center, Department of Ophthalmology, Memphis, TN 38163, USA
| | - Faiza Tahia
- The University of Tennessee Health Science Center, Department of Ophthalmology, Memphis, TN 38163, USA.; The University of Tennessee Health Science Center, Department of Pharmaceutical Sciences, College of Pharmacy, Memphis, TN 38163, USA
| | - Sam Dagogo-Jack
- The University of Tennessee Health Science Center, Division of Endocrinology, Memphis, TN 38163, USA.; The University of Tennessee Health Science Center, Clinical Research Center, Memphis, TN 38163, USA..
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16
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Maiga Y, Diallo S, Konipo FDN, Sangho O, Sangaré M, Diallo SH, Mahamadou S, Péréon Y, Giumelli B, Coulibaly A, Daou M, Traoré Z, Sow Sylla D, Albakaye M, Guinto CO, Ouologem M, Sissoko AS, Traoré HA, Coulibaly SP, Damier P, Attal N, Nizard J. Diabetic polyneuropathy with/out neuropathic pain in Mali: A cross-sectional study in two reference diabetes treatment centers in Bamako (Mali), Western Africa. PLoS One 2020; 15:e0241387. [PMID: 33166296 PMCID: PMC7652324 DOI: 10.1371/journal.pone.0241387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 10/13/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Diabetic polyneuropathy (DPN) with or without neuropathic pain is a frequent complication of diabetes. This work aimed to determine the prevalence of diabetic polyneuropathy, to describe its epidemiological aspects, and to analyze the therapeutic itinerary of patients with DPN. METHODS This was a cross-sectional, descriptive study performed synchronously over six months at two major follow-up sites for patients with diabetes in Mali. DPN was diagnosed based on the Michigan Neuropathy Screening Instrument (MNSI). The neuropathic nature of the pain and the quality of life of patients were evaluated by the DN4 and the ED-5D scale, respectively. We used three (3) different questionnaires to collect data from patients (one at inclusion and another during the follow-up consultation) and from the caregivers of patients with DPN. RESULTS We included 252 patients with diabetes, and DPN was found to have a healthcare facility-based prevalence of 69.8% (176/252). The sex ratio was approximately three females for every male patient. The patients were mostly 31 to 60 years of age, 83% had type 2 diabetes, and 86.9% had neuropathic pain Approximately half of the patients (48.3%) had autonomic neuropathy and they reported moderate to intense pain, which was mainly described as a burning sensation. The patients exhibited impaired exteroceptive and proprioceptive sensations in 51.7% of cases. The patients smoked tobacco in 3.4% of cases, while 36.6% of the patients were obese and had dyslipidemia. The caregivers clearly indicated that appropriate medications were not readily accessible or available for their patients with DPN. CONCLUSION The healthcare facility-based prevalence of DPN with or without neuropathic pain was high in our cohort. These inexpensive and easy-to-use tools (MNSI, DN4) can be used to adequately diagnose DPN in the African context. In Mali, screening and early treatment of patients at risk of DPN should allow for a reduction of the burden of the disease, while caregivers need to be adequately trained to manage DPN.
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Affiliation(s)
- Youssoufa Maiga
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
- Laboratory of Therapeutics (EA3826), Faculty of Medicine of Nantes, University of Nantes, Nantes, France
| | - Salimata Diallo
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | | | - Oumar Sangho
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Modibo Sangaré
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Seybou H. Diallo
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | | | - Yann Péréon
- Reference Center of Neuromuscular Diseases Atlantique-Occitanie-Caraïbes, Hôtel-Dieu, UHC of Nantes, Nantes, France
| | | | - Awa Coulibaly
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Mariam Daou
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | | | - Djeneba Sow Sylla
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
- Center for Combating Diabetes in Mali (CCD), Bamako, Mali
| | - Mohamed Albakaye
- Department of Neurology, Gabriel Touré Teaching Hospital, Bamako, Mali
| | - Cheick Oumar Guinto
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Madani Ouologem
- Faculty of Dental Surgery, University of Nantes, Nantes, France
| | - Adama S. Sissoko
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | - Hamar A. Traoré
- Faculty of Medicine, University of Technical Sciences and Technologies, Bamako, Mali
| | | | | | - Nadine Attal
- INSERM U 98, CET, CHU Ambroise Paré, 92100 Boulogne-Billancourt, France
| | - Julien Nizard
- Laboratory of Therapeutics (EA3826), Faculty of Medicine of Nantes, University of Nantes, Nantes, France
- Faculty of Medicine, University of Nantes, Nantes, France
- Federal Pain Palliative Care and Support, Laboratory of Therapeutics, Nantes UHC, Nantes, France
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17
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Zografou I, Iliadis F, Sambanis C, Didangelos T. Validation of Neuropad in the Assessment of Peripheral Diabetic Neuropathy in Patients with Diabetes Mellitus Versus the Michigan Neuropathy Screening Instrument, 10g Monofilament Application and Biothesiometer Measurement. Curr Vasc Pharmacol 2020; 18:517-522. [DOI: 10.2174/1570161117666190723155324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/30/2019] [Accepted: 07/05/2019] [Indexed: 12/24/2022]
Abstract
Objective:
Sudomotor dysfunction is a feature of Diabetic Peripheral Neuropathy (DPN). The
indicator plaster Neuropad can provide an easy and accurate way to diagnose DPN. The aim of the present
study was to evaluate Neuropad’s specificity, sensitivity and accuracy in detecting DPN in patients
with Diabetes Mellitus (DM).
Methods:
A total of 174 patients with DM (79 with type 1 DM, 88 women), mean age 49.8 ± 16.1 years
and mean DM duration 17.3 ± 7.7 years were included in the present study. The following methods
were used to diagnose DPN: the Michigan Neuropathy Screening Instrument Questionnaire and Examination
(MNSIQ and MNSIE, respectively), application of 10 g monofilament (MONO) and measurement
of vibration perception threshold with biothesiometer (BIO). Neuropad was applied to both feet in
all patients and according to the presence or absence of color change of the sticker, patients were divided
in two groups: group A (n = 82, complete change in color from blue to pink, depicting normal
perspiration) and group B (n = 92, incomplete or no change, depicting abnormal perspiration).
Results:
MNSIQ and MNSIE were positive for DPN in 111 and 119 patients, respectively. BIO was
abnormal in 109 and MONO in 59 patients. Sensitivity of Neuropad testing was 95% vs. MONO, 73%
vs. BIO, 73% vs. MNSIE and 75% vs. ΜNSIQ. Specificity was 69, 81, 90 and 92%, respectively and
accuracy of the test was 78, 76, 78 and 83%, respectively.
Conclusion:
Neuropad has a high sensitivity and specificity in detecting DPN vs. MNSIQ, MNSIE and
BIO. Neuropad has a high sensitivity but moderate specificity vs. MONO. The accuracy of the test was
high in all measurements.
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Affiliation(s)
- Ioanna Zografou
- Diabetes Center, 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Fotios Iliadis
- Diabetes Center, 1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, ''AHEPA'' Hospital, Thessaloniki, Greece
| | - Christos Sambanis
- Diabetes Center, 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Triantafyllos Didangelos
- Diabetes Center, 1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, ''AHEPA'' Hospital, Thessaloniki, Greece
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18
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Zhang Q, Song W, Liang X, Xie J, Shi Y, Shi X, Qiu B, Chen X. A Metabolic Insight Into the Neuroprotective Effect of Jin-Mai-Tong (JMT) Decoction on Diabetic Rats With Peripheral Neuropathy Using Untargeted Metabolomics Strategy. Front Pharmacol 2020; 11:221. [PMID: 32194428 PMCID: PMC7066215 DOI: 10.3389/fphar.2020.00221] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/18/2020] [Indexed: 12/20/2022] Open
Abstract
Jin-Mai-Tong (JMT) decoction is a traditional Chinese compound prescription for treating diabetic peripheral neuropathy (DPN). The aim of this study is to investigate the neuroprotective effect of JMT decoction on diabetic rats with peripheral neuropathy and to elucidate the potential mechanism based on a metabolomics approach. Sprague-Dawley (SD) rats were randomly divided into four groups: control group, Streptozotocin (STZ) induced model group, JMT low dose (JMT-L) treated group and JMT high dose (JMT-H) treated group. After 12 weeks of treatment, behavioral changes, small fiber loss, and histopathological damages of sciatic nerves were estimated. Serum samples were collected for untargeted metabolomics analysis based on UPLC/QTOF-MS and multivariate statistics. As a result, JMT treatment at two dosages (13.9 and 27.8 g/kg⋅d) evidently improved the mechanical pain threshold (P < 0.05), increased the intraepidermal nerve fiber density (IENFD) and subepidermal nerve fiber density (SNFD) (P < 0.05), and renovated the demyelination and axonal atrophy of sciatic nerves on DPN rats. Furthermore, metabolomics study revealed that the serum metabolic profiles altered significantly among the control group and the STZ-induced model group. A total of 21 metabolites were identified as potential biomarkers related to the therapeutic effect of JMT decoction. Among them, 16 biomarkers were found in both JMT-H and JMT-L treated groups, while the five others were specific to JMT-H group. These metabolites mainly involved in lipid metabolism, tricarboxylic acid (TCA) cycle, amino acid metabolism, and so on. Besides, correlation analysis indicated that both mechanical pain threshold and distal nerve fiber density were negatively correlated with the serum levels of metabolites from lipid metabolism and TCA cycle. In conclusion, the results demonstrated that JMT decoction has an obvious protective effect against DPN, which could be mediated via ameliorating the metabolic disorders in diabetic rats with peripheral neuropathy.
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Affiliation(s)
- Qian Zhang
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Song
- Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaochun Liang
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Xie
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yue Shi
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaohu Shi
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Bintao Qiu
- Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiuting Chen
- Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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19
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Abstract
The frequently prescribed drug class of statins have pleiotropic effects and have been implicated in neuropathic pain syndromes. This narrative review examines studies of statin-induced neuropathic pain which to date have been conducted only in animal models. However, the pathophysiology of diabetic neuropathy in humans may shed some light on the etiology of neuropathic pain. Statins have exhibited a paradoxical effect in that statins appear to reduce neuropathic pain in animals but have been associated with neuropathic pain in humans. While there are certain postulated mechanisms offering elucidation as to how statins might be associated with neuropathic pain, there is, as the American Heart Association stated, to date no definitive association between statins and neuropathic pain. Statins are important drugs that reduce cardiovascular risk factors and should be prescribed to appropriate patients with these risk factors but some of this population is also at elevated risk for neuropathic pain from other causes.
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20
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Jende JME, Groener JB, Rother C, Kender Z, Hahn A, Hilgenfeld T, Juerchott A, Preisner F, Heiland S, Kopf S, Pham M, Nawroth P, Bendszus M, Kurz FT. Association of Serum Cholesterol Levels With Peripheral Nerve Damage in Patients With Type 2 Diabetes. JAMA Netw Open 2019; 2:e194798. [PMID: 31150078 PMCID: PMC6547108 DOI: 10.1001/jamanetworkopen.2019.4798] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Lowering serum cholesterol levels is a well-established treatment for dyslipidemia in patients with type 2 diabetes (T2D). However, nerve lesions in patients with T2D increase with lower serum cholesterol levels, suggesting that lowering serum cholesterol levels is associated with diabetic polyneuropathy (DPN) in patients with T2D. OBJECTIVE To investigate whether there is an association between serum cholesterol levels and peripheral nerve lesions in patients with T2D with and without DPN. DESIGN, SETTING, AND PARTICIPANTS This single-center, cross-sectional, prospective cohort study was performed from June 1, 2015, to March 31, 2018. Observers were blinded to clinical data. A total of 256 participants were approached, of whom 156 were excluded. A total of 100 participants consented to undergo magnetic resonance neurography of the right leg at the Department of Neuroradiology and clinical, serologic, and electrophysiologic assessment at the Department of Endocrinology, Heidelberg University Hospital, Heidelberg, Germany. EXPOSURES Quantification of the nerve's diameter and lipid equivalent lesion (LEL) load with a subsequent analysis of all acquired clinical and serologic data with use of 3.0-T magnetic resonance neurography of the right leg with 3-dimensional reconstruction of the sciatic nerve. MAIN OUTCOMES AND MEASURES The primary outcome was lesion load and extension. Secondary outcomes were clinical, serologic, and electrophysiologic findings. RESULTS A total of 100 participants with T2D (mean [SD] age, 64.6 [0.9] years; 68 [68.0%] male) participated in the study. The LEL load correlated positively with the nerve's mean cross-sectional area (r = 0.44; P < .001) and the maximum length of a lesion (r = 0.71; P < .001). The LEL load was negatively associated with total serum cholesterol level (r = -0.41; P < .001), high-density lipoprotein cholesterol level (r = -0.30; P = .006), low-density lipoprotein cholesterol level (r = -0.33; P = .003), nerve conduction velocities of the tibial (r = -0.33; P = .01) and peroneal (r = -0.51; P < .001) nerves, and nerve conduction amplitudes of the tibial (r = -0.31; P = .02) and peroneal (r = -0.28; P = .03) nerves. CONCLUSIONS AND RELEVANCE The findings suggest that lowering serum cholesterol levels in patients with T2D and DPN is associated with a higher amount of nerve lesions and declining nerve conduction velocities and amplitudes. These findings may be relevant to emerging therapies that promote an aggressive lowering of serum cholesterol levels in patients with T2D.
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Affiliation(s)
- Johann M. E. Jende
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan B. Groener
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research (DZD), München-Neuherberg, Germany
| | - Christian Rother
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Zoltan Kender
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Artur Hahn
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Fabian Preisner
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
- Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Kopf
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research (DZD), München-Neuherberg, Germany
| | - Mirko Pham
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
- Department of Neuroradiology, Würzburg University Hospital, Würzburg, Germany
| | - Peter Nawroth
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Diabetes and Cancer, Helmholtz Diabetes Center, Helmholtz Center Munich, Munich, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix T. Kurz
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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21
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Bahrambeigi S, Rahimi M, Yousefi B, Shafiei-Irannejad V. New potentials for 3-hydroxy-3-methyl-glutaryl-coenzymeA reductase inhibitors: Possible applications in retarding diabetic complications. J Cell Physiol 2019; 234:19393-19405. [PMID: 31004363 DOI: 10.1002/jcp.28682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/25/2019] [Accepted: 04/05/2019] [Indexed: 12/12/2022]
Abstract
The prevalence of diabetes mellitus is increasing all over the world and it is apparent that treatment of diabetic complications has the same importance as primary diabetes treatment and glycemic control. Diabetic complications occur as a result of prolonged hyperglycemia and its consequences, such as advanced glycation end products and reactive oxygen species. Impairment of lipid profile is also contributed to worsening diabetic complications. Therefore, it seems that the application of lipid-lowering agents may have positive effects on reversing diabetic complications besides glycemic control. Statins, a group of lipid-lowering compounds, have been shown to exert antioxidant, immunomodulatory, anti-inflammatory, and antiproliferative properties beyond their lipid-lowering effects. Furthermore, they have been reported to improve diabetic complications with different pathways. In this review, we will discuss the clinical importance, molecular biology of the most important microvascular/macrovascular diabetic complications, possible application of statins and their mechanism of action in retarding these complications.
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Affiliation(s)
- Saman Bahrambeigi
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahdi Rahimi
- Ageing Research Institute, Physical Medicine and Rehabilitation Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahman Yousefi
- Ageing Research Institute, Physical Medicine and Rehabilitation Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Shafiei-Irannejad
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran
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22
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Amara F, Hafez S, Orabi A, El Etriby A, Abdel Rahim AA, Zakaria E, Koura F, Talaat FM, Gawish H, Attia I, Abdel Aziz MF, El Hefnawy MHMF, Kamar M, Halawa MR, El-Sayed MS, El Kafrawy NA, Khalil SHA, Assaad SN. Review of Diabetic Polyneuropathy: Pathogenesis, Diagnosis and Management According to the Consensus of Egyptian Experts. Curr Diabetes Rev 2019; 15:340-345. [PMID: 30813879 PMCID: PMC7061978 DOI: 10.2174/1573399815666190226150402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/08/2019] [Accepted: 02/18/2019] [Indexed: 12/27/2022]
Abstract
Diabetic polyneuropathy (DPN) is a complex and multifactorial entity in which various factors besides hyperglycemia play an important role. Symptoms of DPN are sensory, motor or autonomic. Intensive research proved that oxidative stress is the common denominator for the four major destructive pathways of hyperglycemia including increased hexosamine pathway flux, activation of Protein kinase-C (PKC) pathway, increased Advanced Glycated End-products (AGEs) formation, and increased Polyol Pathway flux. National data in Egypt confirms that more than 60% of Egyptian diabetic patients suffer from neuropathy. The most common complications of DPN are Cardiac Autonomic Neuropathy (CAN), diabetic foot and ulcers, neuromuscular disability, and anxiety. In addition, DPN affects the Quality of Life (QoL). According to common clinical practice, the common diagnostic tools are bed-side diagnosis and electrophysiological tests. Early diagnosis is critical to improve the prognosis of DPN and therapeutic intervention in the early phase. In this review, we provide a clear understanding of the pathogenesis, early diagnosis and the good management of DPN. Since the pathogenesis of DPN is multifactorial, its management is based on combination therapy of symptomatic; either pharmacological or non-pharmacological treatments, and pathogenic treatment. Alpha Lipoic Acid (ALA) is a potent anti-oxidant that has several advantages as a pathogenic treatment of DPN. So, in clinical practice, ALA may be prescribed for patients with early neuropathic deficits and symptoms. Patient education has an important role in the managemement of DPN.
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Affiliation(s)
- Fahmy Amara
- Emeritus Professor of Endocrinology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Sherif Hafez
- Professor of Internal Medicine and Endocrinology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Abbas Orabi
- Professor of Diabetes and Endocrinology, Faculty of Medicine, Zagazig University, Al Sharqia, Egypt
| | - Adel El Etriby
- Professor of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Aly Ahmed Abdel Rahim
- Professor of Diabetes and Metabolism, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ebtissam Zakaria
- Professor of Internal Medicine and Endocrinology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Farouk Koura
- Emeritus Professor of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Farouk Mohamed Talaat
- Professor of Neuropsychiatry, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hanan Gawish
- Professor of Diabetes and Endocrinology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ihab Attia
- Professor of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | - Mohamed Kamar
- Professor of Diabetes and Endocrinology, Faculty of Medicine, Zagazig University, Al Sharqia, Egypt
| | - Mohamed Reda Halawa
- Professor of Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Shawky El-Sayed
- Professor and Head of Internal Medicine Department, Diabetes and Endocrinology Unit, Faculty of Medicine, Benha University, Benha, Egypt
| | - Nabil Abdelfatah El Kafrawy
- Member of the Egyptian National Committee of Diabetes and Professor of Internal Medicine and Diabetology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Samir Helmy Assaad Khalil
- Professor of Internal Medicine and Unit of Diabetology, Lipidology and Metabolism, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Samir Naem Assaad
- Professor of Internal Medicine and Endocrinology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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23
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Vural G, Gümüsyayla Ş. Monocyte-to-high density lipoprotein ratio is associated with a decreased compound muscle action potential amplitude in patients with diabetic axonal polyneuropathy. Medicine (Baltimore) 2018; 97:e12857. [PMID: 30334993 PMCID: PMC6212287 DOI: 10.1097/md.0000000000012857] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The monocyte-to-high density lipoprotein ratio (MHR) has recently been implemented as an indicator of inflammation and oxidative stress. The present study characterized MHR in patients with diabetic polyneuropathy (DPN), in which oxidative stress and microvascular damage play a role in pathogenesis, relative to patients with non-DPN, diabetic patients without polyneuropathy, and healthy individuals. We further aimed to evaluate the association between MHR and the decreased compound muscle action potential (CMAP) amplitude of patients with diabetic axonal polyneuropathy.We enrolled 90 patients with DPN, 75 patients with nonDPN, 92 diabetic patients without polyneuropathy, and 67 healthy individuals; The monocyte, high-density lipoprotein cholesterol (HDL-C) values were obtained for all participants and MHR was calculated for each individual. Intergroup comparison was performed. The relationship between MHR and the posterior tibial nerve CMAP amplitudes was examined.Statistically significant negative correlation was observed between MHR and the posterior tibial nerve CMAP amplitudes of patients with DPN. The MHR values of the patients with DPN were significantly higher than those of the patients with non-DPN, diabetic patients without polyneuropathy and the control group.This study demonstrated that diabetic patients with higher MHR values may be more likely to develop polyneuropathy.
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24
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Karásek D, Vaverková H. [Diabetic dyslipidemia and microvascular complications of diabetes]. VNITRNI LEKARSTVI 2018; 64:17-24. [PMID: 29498871 DOI: 10.36290/vnl.2018.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Diabetic dyslipidemia is one of the main risk factors for atherosclerosis. Although its participation in diabetic microvascular complications is not that dominant, dyslipidemia may play an important role in formation and progression of these complications. Pathophysiological mechanisms by which diabetic dyslipidemia affects the etiopathogenesis of diabetic nephropathy, retinopathy, neuropathy and diabetic foot are presented. The data from clinical studies and treatment possibilities for particular microvascular complications using lipid-lowering therapy are discussed.Key words: diabetes mellitus - diabetic foot - dyslipidemia - nephropathy - neuropathy - retinopathy.
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25
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Zheng J, Wang Y, Han S, Luo Y, Sun X, Zhu N, Zhao L, Li J. Identification of Protein Kinase C Isoforms Involved in Type 1 Diabetic Encephalopathy in Mice. J Diabetes Res 2018; 2018:8431249. [PMID: 29744369 PMCID: PMC5878894 DOI: 10.1155/2018/8431249] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/23/2018] [Indexed: 12/12/2022] Open
Abstract
Diabetic encephalopathy is a complication of diabetes mellitus characterized by impaired cognitive functions. Protein kinase C (PKC) isoforms are rarely reported on diabetic encephalopathy, although they have been believed to play crucial roles in other diabetic complications. In this study, streptozotocin- (STZ-) induced diabetic mice were found to exhibit learning and memory deficits in the Morris water maze test. Meanwhile, the expression of cPKCβII, nPKCε, and cPKCγ did not change in the hippocampus, cortex, and striatum at 2 and 8 weeks after STZ injection. The nPKCε translocation to the membrane, where it is activated, was not altered in the above brain regions at 2 and 8 weeks after STZ injection. Nevertheless, cPKCβII translocation to the membrane was significantly decreased in the cortex and hippocampus at 8 weeks after STZ injection. The translocation of cPKCγ from the cytosol to the membrane was remarkably decreased in the hippocampus at 2 and 8 weeks and in the cortex and striatum at 8 weeks after STZ injection. In addition, deletion of cPKCγ aggravated the impairment of spatial learning and memory. In conclusion, our results suggest that the decrease in the activity of cPKCβII and cPKCγ, especially cPKCγ, may play key roles in the pathogenesis of diabetic encephalopathy.
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Affiliation(s)
- Jiayin Zheng
- Department of Neurobiology and Center of Stroke, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Yue Wang
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Song Han
- Department of Neurobiology and Center of Stroke, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Yanlin Luo
- Department of Neurobiology and Center of Stroke, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Xiuli Sun
- Department of Neurobiology and Center of Stroke, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Ning Zhu
- Department of Neurobiology and Center of Stroke, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Li Zhao
- Department of Neurobiology and Center of Stroke, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Junfa Li
- Department of Neurobiology and Center of Stroke, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China
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26
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Biochemical and clinical relevance of alpha lipoic acid: antioxidant and anti-inflammatory activity, molecular pathways and therapeutic potential. Inflamm Res 2017; 66:947-959. [PMID: 28676917 DOI: 10.1007/s00011-017-1079-6] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 06/20/2017] [Accepted: 06/27/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The molecular nature of lipoic acid (LA) clarifies its capability of taking part to a variety of biochemical reactions where redox state is meaningful. The pivotal action of LA is the antioxidant activity due to its ability to scavenge and inactivate free radicals. Furthermore, LA has been shown to chelate toxic metals both directly and indirectly by its capability to enhance intracellular glutathione (GSH) levels. This last property is due to its ability to interact with GSH and recycle endogenous GSH. LA exhibits significant antioxidant activity protecting against oxidative damage in several diseases, including neurodegenerative disorders. Interestingly, LA is unique among natural antioxidants for its capability to satisfy a lot of requirements, making it a potentially highly effective therapeutic agent for many conditions related with oxidative damage. In particular, there are evidences showing that LA has therapeutic activity in lowering glucose levels in diabetic conditions. Similarly, LA supplementation has multiple beneficial effects on the regression of the mitochondrial function and on oxidative stress associated with several diseases and aging. AIM The aim of the present review is to describe the molecular mechanisms underlying the beneficial effects of LA under various experimental conditions and disease and how to exploit such effect for clinical purposes. CONCLUSION LA has pleiotropic effects in different pathways related with several diseases, its use as a potential therapeutic agent is very promising.
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27
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Tavakoli M, Gogas Yavuz D, Tahrani AA, Selvarajah D, Bowling FL, Fadavi H. Diabetic Neuropathy: Current Status and Future Prospects. J Diabetes Res 2017; 2017:5825971. [PMID: 28770231 PMCID: PMC5523192 DOI: 10.1155/2017/5825971] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 01/26/2023] Open
Affiliation(s)
- Mitra Tavakoli
- University of Exeter, Exeter, UK
- University of Manchester, Manchester, UK
- *Mitra Tavakoli:
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