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Faridi Dastjerdi MA, Ghasemi G, Esmaeili H, Ghasemi Kahrizsangi N. Mind-Body Intervention for Diabetic Neuropathy: A Pilot Study on Yoga's Effects on Muscle Strength, Proprioception, Fear of Falling, Pain, and Quality of Life. Biol Res Nurs 2024:10998004241256097. [PMID: 38810022 DOI: 10.1177/10998004241256097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of an 8-week yoga intervention on muscle strength, proprioception, pain, concerns about falling, and quality of life in individuals diagnosed with diabetic neuropathy. METHODS A quasi-experimental design incorporating a pretest-posttest methodology and a control group was implemented in the present study. A total of 30 patients who were diagnosed with type 2 diabetes and neuropathy were recruited and randomly assigned to intervention (n = 15) or non-exercise control (n = 15). Yoga sessions were conducted for a duration of 60 min on three occasions per week, with participants requested to practice at home on other days. RESULTS The results showed significant main effects of time on the muscle strength (both flexor and extensor muscles, p < .001, ηp2 = 0.652 and p < .001, ηp2 = 0.539, respectively), proprioception error (p < .001, ηp2 = 0.807), pain intensity (p < .001, ηp2 = 0.538), concerns about falling (p < .001, ηp2 = 0.700), and overall score of quality of life (p < .001, ηp2 = 0.475). Moreover, there were significant group-by-time interactions for all variables (p < .001 for all). CONCLUSION The study reveals that yoga intervention can be an effective alternative therapeutic approach to medication for individuals with diabetic neuropathy. Yet, future studies are needed on a larger sample size to strengthen the present understanding of the advantageous impact of yoga intervention in this population.
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Affiliation(s)
- Mohammad Ali Faridi Dastjerdi
- Department of Sport Injuries & Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Gholamali Ghasemi
- Department of Sport Injuries & Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Hamed Esmaeili
- Department of Sport Injuries & Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
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Ventura-Martínez R, Ángeles-López GE, González-Ugalde D, Domínguez-Páez T, Navarrete-Vázquez G, Jaimez R, Déciga-Campos M. Antinociceptive effect of LMH-2, a new sigma-1 receptor antagonist analog of haloperidol, on the neuropathic pain of diabetic mice. Biomed Pharmacother 2024; 174:116524. [PMID: 38574622 DOI: 10.1016/j.biopha.2024.116524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024] Open
Abstract
This study evaluates the antiallodynic and antihyperalgesic effects of LMH-2, a new haloperidol (HAL) analog that acts as sigma-1 receptor (σ1 R) antagonist, in diabetic mice using a model of neuropathic pain induced by chronic hyperglycemia. Additionally, we compared its effects with those of HAL. Hyperglycemia was induced in mice by nicotinamide-streptozotocin administration (NA-STZ, 50-130 mg/kg). Four weeks later, mechanical allodynia was assessed using the up-down method, and hyperalgesia was evoked with formalin 0.5%. We evaluated antiallodynic and antihyperalgesic effects of LMH-2 (5.6-56.2 mg/kg), HAL (0.018-0.18 mg/kg) and gabapentin (GBP, 5.6-56.2 mg/kg). The results showed that LMH-2 had a more significant antiallodynic effect compared to HAL and GBP (90.4±8.7 vs 75.1±3.1 and 41.9±2.3%, respectively; P<0.05), as well as an antihyperalgesic effect (96.3±1.2 vs 86.9±7.41 and 86.9±4.8%, respectively; P<0.05). Moreover, the antiallodynic and antihyperalgesic effect of both LMH-2 and HAL were completely abolished by PRE-084 (σ1 R agonist); and partially by pramipexole (a D2-like receptor agonist). Finally, the effect of all treatments on the rotarod test, barra, open field and exploratory behaviors showed that LMH-2 did not alter the animals' balance or the exploratory behavior, unlike as HAL or GBP. The molecular docking included indicate that LMH-2 has lower affinity to the D2R than HAL. These results provide evidence that LMH-2 exerts its antinociceptive effects as a σ1 R antagonist without the adverse effects induced by HAL or GBP. Consequently, LMH-2 can be considered a good and safe strategy for treating neuropathic pain caused by hyperglycemia in patients with diabetes.
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Affiliation(s)
- Rosa Ventura-Martínez
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Av Universidad No. 3000, Col. Ciudad Universitaria, Alcaldía Coyoacán, Ciudad de México 04510, Mexico.
| | - Guadalupe Esther Ángeles-López
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Av Universidad No. 3000, Col. Ciudad Universitaria, Alcaldía Coyoacán, Ciudad de México 04510, Mexico
| | - Diana González-Ugalde
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional (IPN), Ciudad de México, Mexico
| | - Tania Domínguez-Páez
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional (IPN), Ciudad de México, Mexico
| | - Gabriel Navarrete-Vázquez
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos (UAEM), Cuernavaca, Morelos, Mexico
| | - Ruth Jaimez
- Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Av Universidad No. 3000, Col. Ciudad Universitaria, Alcaldía Coyoacán, Ciudad de México 04510, Mexico
| | - Myrna Déciga-Campos
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional (IPN), Ciudad de México, Mexico.
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Saleh DO, Sedik AA. Novel drugs affecting diabetic peripheral neuropathy. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2024; 27:657-670. [PMID: 38645500 PMCID: PMC11024403 DOI: 10.22038/ijbms.2024.75367.16334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/27/2023] [Indexed: 04/23/2024]
Abstract
Diabetic peripheral neuropathy (DPN) poses a significant threat, affecting half of the global diabetic population and leading to severe complications, including pain, impaired mobility, and potential amputation. The delayed manifestation of diabetic neuropathy (DN) makes early diagnosis challenging, contributing to its debilitating impact on individuals with diabetes mellitus (DM). This review examines the multifaceted nature of DPN, focusing on the intricate interplay between oxidative stress, metabolic pathways, and the resulting neuronal damage. It delves into the challenges of diagnosing DN, emphasizing the critical role played by hyperglycemia in triggering these cascading effects. Furthermore, the study explores the limitations of current neuropathic pain drugs, prompting an investigation into a myriad of pharmaceutical agents tested in both human and animal trials over the past decade. The methodology scrutinizes these agents for their potential to provide symptomatic relief for DPN. The investigation reveals promising results from various pharmaceutical agents tested for DPN relief, showcasing their efficacy in ameliorating symptoms. However, a notable gap persists in addressing the underlying problem of DPN. The results underscore the complexity of DPN and the challenges in developing therapies that go beyond symptomatic relief. Despite advancements in treating DPN symptoms, there remains a scarcity of options addressing the underlying problem. This review consolidates the state-of-the-art drugs designed to combat DPN, highlighting their efficacy in alleviating symptoms. Additionally, it emphasizes the need for a deeper understanding of the diverse processes and pathways involved in DPN pathogenesis.
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Affiliation(s)
- Dalia O. Saleh
- Pharmacology Department, Medical Research and Clinical Studies Institute, National Research Centre, 12622, Egypt
| | - Ahmed A. Sedik
- Pharmacology Department, Medical Research and Clinical Studies Institute, National Research Centre, 12622, Egypt
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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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Changkakoti L, Das JM, Borah R, Rajabalaya R, David SR, Balaraman AK, Pramanik S, Haldar PK, Bala A. Protein Kinase C (PKC)-mediated TGF-β Regulation in Diabetic Neuropathy: Emphasis on Neuro-inflammation and Allodynia. Endocr Metab Immune Disord Drug Targets 2024; 24:777-788. [PMID: 37937564 DOI: 10.2174/0118715303262824231024104849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/08/2023] [Accepted: 09/25/2023] [Indexed: 11/09/2023]
Abstract
According to the World Health Organization (WHO), diabetes has been increasing steadily over the past few decades. In developing countries, it is the cause of increased morbidity and mortality. Diabetes and its complications are associated with education, occupation, and income across all levels of socioeconomic status. Factors, such as hyperglycemia, social ignorance, lack of proper health knowledge, and late access to medical care, can worsen diabetic complications. Amongst the complications, neuropathic pain and inflammation are considered the most common causes of morbidity for common populations. This review is focused on exploring protein kinase C (PKC)-mediated TGF-946; regulation in diabetic complications with particular emphasis on allodynia. The role of PKC-triggered TGF-946; in diabetic neuropathy is not well explored. This review will provide a better understanding of the PKC-mediated TGF-946; regulation in diabetic neuropathy with several schematic illustrations. Neuroinflammation and associated hyperalgesia and allodynia during microvascular complications in diabetes are scientifically illustrated in this review. It is hoped that this review will facilitate biomedical scientists to better understand the etiology and target drugs effectively to manage diabetes and diabetic neuropathy.
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Affiliation(s)
- Liza Changkakoti
- Pharmacology and Drug Discovery Research Laboratory, Division of Life Sciences, Institute of Advanced Study in Science and Technology (IASST), An Autonomous Institute Under - Department of Science & Technology (Govt. of India) Vigyan Path, Guwahati, PIN- 781035 Assam, India
| | - Jitu Mani Das
- Pharmacology and Drug Discovery Research Laboratory, Division of Life Sciences, Institute of Advanced Study in Science and Technology (IASST), An Autonomous Institute Under - Department of Science & Technology (Govt. of India) Vigyan Path, Guwahati, PIN- 781035 Assam, India
| | - Rajiv Borah
- Department of Mechanical, Manufacturing and Biomedical Engineering, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Rajan Rajabalaya
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, BE 1410 Bandar Seri Begawan, Brunei Darussalam
| | - Sheba Rani David
- School of Pharmacology, University of Wyoming, Laramie, Wyoming, 82071, USA
| | - Ashok Kumar Balaraman
- Faculty of Pharmacy, MAHSA University, Bandar Saujana Putra, 42610, Jenjarom, Selangor, Malaysia
| | - Subrata Pramanik
- Jyoti and Bhupat Mehta School of Health Sciences & Technology, Indian Institute of Technology (IIT), Guwahati, Assam- 781039, India
| | - Pallab Kanti Haldar
- Department of Pharmaceutical Technology, Division of Pharmacology & Toxicology, Jadavpur University, Kolkata, 700032, India
| | - Asis Bala
- Pharmacology and Drug Discovery Research Laboratory, Division of Life Sciences, Institute of Advanced Study in Science and Technology (IASST), An Autonomous Institute Under - Department of Science & Technology (Govt. of India) Vigyan Path, Guwahati, PIN- 781035 Assam, India
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Ghaderpour S, Keyhanmanesh R, Hamidian G, Heydari H, Ghiasi F. The effects of voluntary exercise on histological and stereological changes of sciatic nerve, nitric oxide levels, and peripheral neuropathy caused by high-fat diet-induced type 2 diabetes in male rats. Behav Brain Res 2023; 451:114507. [PMID: 37236269 DOI: 10.1016/j.bbr.2023.114507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 05/28/2023]
Abstract
This research was conducted to investigate the possible beneficial impacts of voluntary exercise on sciatic tissue, nitric oxide levels, stereological changes, and peripheral neuropathy caused by "high-fat-diet (HFD)"-induced "type 2 diabetes mellitus (T2DM)" in male rats. Rats were put into four experimental groups at random: "healthy control (C), voluntary exercise (VE), diabetic (D), and diabetic rats treated by voluntary exercise (VED)"; each group contain eight animals. Animals in VE and VED groups performed "voluntary exercise (VE)" for ten weeks. Animals in D and VED groups became diabetic after receiving a HFD for four weeks and an intraperitoneal injection (IP) of "streptozotocin (STZ)" (35 mg/kg). In order to evaluate mechanical and thermal algesia, hot plate, tail withdrawal, and von Frey tests were carried out. At the end of this study, serum NOx levels were assessed, and histological and stereological analyses were conducted. Mechanical nociceptive thresholds indicated considerable reduction (p < 0.001) which was followed by a remarkable enhance (p < 0.001) in thermal nociceptive threshold of D group. Tissue changes were also seen in sciatic nerve of D group. Voluntary exercise modified thermal and mechanical sensitivity in diabetic rats. It also improved the damaged sciatic nerve in diabetic animals.
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Affiliation(s)
- Saber Ghaderpour
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rana Keyhanmanesh
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gholamreza Hamidian
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Hamed Heydari
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Ghiasi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Gandhi GR, Hillary VE, Antony PJ, Zhong LLD, Yogesh D, Krishnakumar NM, Ceasar SA, Gan RY. A systematic review on anti-diabetic plant essential oil compounds: Dietary sources, effects, molecular mechanisms, and safety. Crit Rev Food Sci Nutr 2023; 64:6526-6545. [PMID: 36708221 DOI: 10.1080/10408398.2023.2170320] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is a multifaceted metabolic syndrome defined through the dysfunction of pancreatic β-cells driven by a confluence of genetic and environmental elements. Insulin resistance, mediated by interleukins and other inflammatory elements, is one of the key factors contributing to the progression of T2DM. Many essential oils derived from dietary plants are beneficial against various chronic diseases. We reviewed the anti-diabetic properties of dietary plant-derived essential oil compounds, with a focus on their molecular mechanisms by modulating specific signaling pathways and other critical inflammatory mediators involved in insulin resistance. High-quality literature published in the last 12 years, from 2010 to 2022, was collected from the Scopus, Web of Science, PubMed, and Embase databases using the search terms "dietary plants," "essential oils," "anti-diabetic," "insulin resistance," "antihyperglycemic," "T2DM," "anti-diabetic essential oils," and anti-diabetic mechanism." According to the results, the essential oil compounds, including cinnamaldehyde, carvacrol, zingerone, sclareol, zerumbone, myrtenol, thujone, geraniol, citral, eugenol, thymoquinone, thymol, citronellol, α-terpineol, and linalool have been demonstrated to contain strong anti-diabetic effects via modulating various signal transduction pathways linked to glucose metabolism. Additionally, in diabetes-related animal models, they can also considerably reduce the expression of TNF-α, IL-1β, IL-4, IL-6, iNOS, and COX-2. The main signaling molecules regulated by these compounds include AMPK, GLUT4, Caspase-3, PPARγ, PPARα, NF-κB, p-IκBα, MyD88, MCP-1, SREBP-1c, AGEs, RAGE, VEGF, Nrf2/HO-1, and SIRT-1. They can also significantly inhibit the generation of TBARS and MDA, reduce oxidative stress, increase insulin levels, adiponectin, and glycoprotein enzymes, boost antioxidant enzymes like SOD, CAT, and GPx, as well as reduce glutathione and vital glycolytic enzymes. Besides, they can significantly lower the levels of liver enzymes and lipid profile markers. Moreover, most essential oil compounds are generally safe based on animal studies. In conclusion, dietary plant-derived essential oil compounds have potential anti-diabetic effects by influencing different signaling pathways and molecular targets linked to glucose metabolism, and should be safe and beneficial against diabetes and related complications.
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Affiliation(s)
- Gopalsamy Rajiv Gandhi
- Division of Phytochemistry and Drug-Design, Department of Biosciences, Rajagiri College of Social Sciences (Autonomous), Kochi, India
| | - Varghese Edwin Hillary
- Division of Phytochemistry and Drug-Design, Department of Biosciences, Rajagiri College of Social Sciences (Autonomous), Kochi, India
| | | | - Linda L D Zhong
- Biomedical Sciences and Chinese Medicine, School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Devarajan Yogesh
- Department of Biochemistry, University of Madras, Chennai, India
| | | | - Stanislaus Antony Ceasar
- Division of Plant Molecular Biology and Biotechnology, Department of Biosciences, Rajagiri College of Social Sciences, Kochi, India
| | - Ren-You Gan
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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Syringic Acid Ameliorates Cardiac, Hepatic, Renal and Neuronal Damage Induced by Chronic Hyperglycaemia in Wistar Rats: A Behavioural, Biochemical and Histological Analysis. Molecules 2022; 27:molecules27196722. [PMID: 36235257 PMCID: PMC9573038 DOI: 10.3390/molecules27196722] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
This study investigated the effects of syringic acid (SA) on renal, cardiac, hepatic, and neuronal diabetic complications in streptozotocin-induced neonatal (nSTZ) diabetic rats. STZ (110 mg/kg i.p) was injected into Wistar rat neonates as a split dose (second and third postnatal day). Diabetes mellitus was diagnosed in adults by measuring fasting blood glucose levels, urine volume, and food and water intake. The treatment of SA (25 mg/kg, 50 mg/kg p.o) was given from the 8th to 18th postnatal week. To assess the development of diabetic complications and the effect of therapy, biochemical indicators in serum and behavioural parameters were recorded at specific intervals during the study period. SA (25 mg/kg, 50 mg/kg p.o) treatment reduced hyperglycaemia, polydipsia, polyphagia, polyuria, relative organ weight, cardiac hypertrophic indices, inflammatory markers, cell injury markers, glycated haemoglobin, histopathological score, and oxidative stress, and increased Na/K ATPase activity. These findings suggest that SA might significantly alleviate diabetic complications and/or renal, neuronal, cardiac, and hepatic damage in nSTZ diabetic rats.
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Tronstad C, Pabst O, Amini M, Kleggetveit IP, Elvebakk O, Martinsen OG, Jenssen TG, Hisdal J, Berg TJ, Qvigstad E. Development of a prototype toe sensor for detection of diabetic peripheral small fiber neuropathy. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:99-104. [PMID: 36086669 DOI: 10.1109/embc48229.2022.9871101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Diabetic peripheral neuropathy (DPN) affects a large proportion of people with diabetes, and early detection is essential to prevent further progression. Widespread clinical testing relies on simplicity and cost-effectiveness of examination. Early signs of DPN may be detected by assessing the sudomotor nerves, and sudomotor activity can be measured by bioimpedance. We present a prototype toe probe for DPN detection including sensors for measuring skin AC conductance, skin temperature and humidity. The prototype was tested on five participants with DPN and five healthy age-matched controls in a pilot study. Sudomotor sensor responses to a simple deep breathing test were very weak or absent in the DPN group, with all controls having larger responses than the DPN group. Evaporation was lower for the DPN group, and skin temperature was higher on average. For the same foot, the results for sudomotor responses were in agreement with sensory neurography amplitudes from the sural nerve whereas the monofilament test gave normal results for two of the DPN participants. If sufficient detection accuracy is confirmed in larger studies, the method may provide a simple and cost-effective tool to support clinical examination. Clinical Relevance- We present the early realization and testing of a simple device to support early detection of diabetic peripheral neuropathy.
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Bu Y, Shih KC, Tong L. The ocular surface and diabetes, the other 21st Century epidemic. Exp Eye Res 2022; 220:109099. [DOI: 10.1016/j.exer.2022.109099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022]
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Hirsch GE, Heck TG. Inflammation, oxidative stress and altered heat shock response in type 2 diabetes: the basis for new pharmacological and non-pharmacological interventions. Arch Physiol Biochem 2022; 128:411-425. [PMID: 31746233 DOI: 10.1080/13813455.2019.1687522] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Type 2 diabetes mellitus (DM2) is a chronic disease characterised by variable degrees of insulin resistance and impaired insulin secretion. Besides, several pieces of evidence have shown that chronic inflammation, oxidative stress, and 70 kDa heat shock proteins (HSP70) are strongly involved in DM2 and its complications, and various pharmacological and non-pharmacological treatment alternatives act in these processes/molecules to modulate them and ameliorate the disease. Besides, uncontrolled hyperglycaemia is related to several complications as diabetic retinopathy, neuropathy and hepatic, renal and cardiac complications. In this review, we address discuss the involvement of different inflammatory and pro-oxidant pathways related to DM2, and we described molecular targets modulated by therapeutics currently available to treat DM2.
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Affiliation(s)
- Gabriela Elisa Hirsch
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, Brazil
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Regional University of Northwestern region of the state of Rio Grande do Sul (UNIJUÍ), Rua do Comércio, Brazil
| | - Thiago Gomes Heck
- Research Group in Physiology, Department of Life Sciences, Regional University of Northwestern Rio Grande do Sul State (UNIJUÍ), Rua do Comércio, Brazil
- Postgraduate Program in Integral Attention to Health (PPGAIS-UNIJUÍ/UNICRUZ), Regional University of Northwestern region of the state of Rio Grande do Sul (UNIJUÍ), Rua do Comércio, Brazil
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12
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Tronstad C, Amini M, Olesen E, Qvigstad E, Pabst O, Martinsen T, Abie SM, Martinsen ØG, Hisdal J, Jenssen TG, Kalvøy H. Diabetic Foot Assessment using Skin Impedance in a Custom Made Sensor-sock. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2022; 13:136-142. [PMID: 36694878 PMCID: PMC9837869 DOI: 10.2478/joeb-2022-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Diabetic peripheral neuropathy (DPN) may lead to several changes in the skin, and some of these may influence the skin impedance spectrum. In the present study we have developed a prototype solution for skin impedance spectroscopy at selected skin sites (big toe pulp, heel and toe ball) that was tested in a pilot study on five patients with DPN and five healthy controls. At the big toe, most of the controls had markedly lower impedance than the DPN group, especially in the range of 1-100 kHz. The separation between the groups seems to be weaker at the heel and weakest at the toeball. The results may indicate that monitoring of the skin impedance spectrum may be a method for detection of skin changes associated with DPN, encouraging further studies with the big toe sensor in particular.
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Affiliation(s)
- Christian Tronstad
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway
| | - Maryam Amini
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway
| | - Eline Olesen
- Department of Physics, University of Oslo, Oslo, Norway
| | - Elisabeth Qvigstad
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Oliver Pabst
- Department of Physics, University of Oslo, Oslo, Norway
| | - Tormod Martinsen
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway
| | - Sisay M. Abie
- Faculty of Ecology and Natural Resource Management, Norwegian University of Life Sciences, Oslo Ås, Norway
| | - Ørjan G. Martinsen
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway
- Department of Physics, University of Oslo, Oslo, Norway
| | - Jonny Hisdal
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway
| | - Trond G. Jenssen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Håvard Kalvøy
- Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo, Norway
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13
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Jesus CHA, Scarante FF, Schreiber AK, Gasparin AT, Redivo DDB, Rosa ES, Cunha JMD. Comparative study of cold hyperalgesia and mechanical allodynia in two animal models of neuropathic pain: different etiologies and distinct pathophysiological mechanisms. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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14
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Animal models of diabetic microvascular complications: Relevance to clinical features. Biomed Pharmacother 2021; 145:112305. [PMID: 34872802 DOI: 10.1016/j.biopha.2021.112305] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes has become more common in recent years worldwide, and this growth is projected to continue in the future. The primary concern with diabetes is developing various complications, which significantly contribute to the disease's mortality and morbidity. Over time, the condition progresses from the pre-diabetic to the diabetic stage and then to the development of complications. Years and enormous resources are required to evaluate pharmacological interventions to prevent or delay the progression of disease or complications in humans. Appropriate screening models are required to gain a better understanding of both pathogenesis and potential therapeutic agents. Different species of animals are used to evaluate the pharmacological potentials and study the pathogenesis of the disease. Animal models are essential for research because they represent most of the structural, functional, and biochemical characteristics of human diseases. An ideal screening model should mimic the pathogenesis of the disease with identifiable characteristics. A thorough understanding of animal models is required for the experimental design to select an appropriate model. Each animal model has certain advantages and limitations. The present manuscript describes the animal models and their diagnostic characteristics to evaluate microvascular diabetic complications.
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Olson LC, Redden JT, Schwartz Z, Cohen DJ, McClure MJ. Advanced Glycation End-Products in Skeletal Muscle Aging. Bioengineering (Basel) 2021; 8:bioengineering8110168. [PMID: 34821734 PMCID: PMC8614898 DOI: 10.3390/bioengineering8110168] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 12/17/2022] Open
Abstract
Advanced age causes skeletal muscle to undergo deleterious changes including muscle atrophy, fast-to-slow muscle fiber transition, and an increase in collagenous material that culminates in the age-dependent muscle wasting disease known as sarcopenia. Advanced glycation end-products (AGEs) non-enzymatically accumulate on the muscular collagens in old age via the Maillard reaction, potentiating the accumulation of intramuscular collagen and stiffening the microenvironment through collagen cross-linking. This review contextualizes known aspects of skeletal muscle extracellular matrix (ECM) aging, especially the role of collagens and AGE cross-linking, and underpins the motor nerve’s role in this aging process. Specific directions for future research are also discussed, with the understudied role of AGEs in skeletal muscle aging highlighted. Despite more than a half century of research, the role that intramuscular collagen aggregation and cross-linking plays in sarcopenia is well accepted yet not well integrated with current knowledge of AGE’s effects on muscle physiology. Furthermore, the possible impact that motor nerve aging has on intramuscular cross-linking and muscular AGE levels is posited.
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Affiliation(s)
- Lucas C. Olson
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
- Department of Gerontology, College of Health Professions, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - James T. Redden
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
| | - Zvi Schwartz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
- Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - David J. Cohen
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
| | - Michael J. McClure
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA; (L.C.O.); (J.T.R.); (Z.S.); (D.J.C.)
- Correspondence:
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Mehta K, Behl T, Kumar A, Uddin MS, Zengin G, Arora S. Deciphering the Neuroprotective Role of Glucagon-like Peptide-1 Agonists in Diabetic Neuropathy: Current Perspective and Future Directions. Curr Protein Pept Sci 2021; 22:4-18. [PMID: 33292149 DOI: 10.2174/1389203721999201208195901] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/15/2020] [Accepted: 11/25/2020] [Indexed: 11/22/2022]
Abstract
Diabetic neuropathy is referred to as a subsequential and debilitating complication belonging to type 1 and type 2 diabetes mellitus. It is a heterogeneous group of disorders with a particularly complex pathophysiology and also includes multiple forms, ranging from normal discomfort to death. The evaluation of diabetic neuropathy is associated with hyperglycemic responses, resulting in an alteration in various metabolic pathways, including protein kinase C pathway, polyol pathway and hexosamine pathway in Schwann and glial cells of neurons. The essential source of neuronal destruction is analogous to these respective metabolic pathways, thus identified as potential therapeutic targets. These pathways regulating therapeutic medications may be used for diabetic neuropathy, however, only target specific drugs could have partial therapeutic activity. Various antidiabetic medications have been approved and marketed, which possess the therapeutic ability to control hyperglycemia and ameliorate the prevalence of diabetic neuropathy. Among all antidiabetic medications, incretin therapy, including Glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors, are the most favorable medications for the management of diabetes mellitus and associated peripheral neuropathic complications. Besides enhancing glucose-evoked insulin release from pancreatic β-cells, these therapeutic agents also play a vital role to facilitate neurite outgrowth and nerve conduction velocity in dorsal root ganglion. Furthermore, incretin therapy also activates cAMP and ERK signalling pathways, resulting in nerve regeneration and repairing. These effects are evidently supported by a series of preclinical data and investigations associated with these medications. However, the literature lacks adequate clinical trial outcomes related to these novel antidiabetic medications. The manuscript emphasizes the pathogenesis, current pharmacological approaches and vivid description of preclinical and clinical data for the effective management of diabetic neuropathy.
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Affiliation(s)
- Keshav Mehta
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Arun Kumar
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - M Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh
| | - Gokhan Zengin
- Department of Biology, Faculty of Science, Selcuk Uniersity Campus, Konya, Turkey
| | - Sandeep Arora
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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Yu MX, Lei B, Song X, Huang YM, Ma XQ, Hao CX, Yang WH, Pan ML. Compound XiongShao Capsule ameliorates streptozotocin-induced diabetic peripheral neuropathy in rats via inhibiting apoptosis, oxidative - nitrosative stress and advanced glycation end products. JOURNAL OF ETHNOPHARMACOLOGY 2021; 268:113560. [PMID: 33161027 DOI: 10.1016/j.jep.2020.113560] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/09/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Compound XiongShao Capsule (CXSC), a traditional herb formula, has been approved for using to treat diabetic peripheral neuropathy (DPN) by the Shanghai Food and Drug Administration, with significant efficacy in clinic. AIM OF THE STUDY This study aimed to investigate the multidimensional pharmacological mechanisms and synergism of CXSC against DPN in rats. METHODS The quality analysis of CXSC was performed by high-performance liquid chromatography (HPLC) and thin-layer chromatography. Rats with DPNinduced by streptozotocin/high-fat diet for 4 weeks were treated with CXSC at three doses (1.2 g/kg, 0.36 g/kg, and 0.12 g/kg), or epalrestat (15 mg/kg) daily for 8 weeks continuously. During the treatment period, body weight, serum glucose levels, and nerve function, including nerve conduction velocity (NCV), and mechanical and thermal hyperalgesia were tested and assessed every 4 weeks. In the 13th week, the histopathological examination in the sciatic nerve was performed using a transmission electron microscope. The expression of apoptosis-related proteins of BAX, BCL2, and caspase-3 in the sciatic nerve was examined using hematoxylin and eosin staining. The serum levels of advanced glycation end products (AGEs), oxidative-nitrosative stress biomarkers of superoxide dismutase (SOD), and nitric oxide synthase (NOS) were measured using a rat-specific ELISA kit. RESULTS CXSC had no significant effect on body weight or serum glucose levels (P > 0.05), but it significantly improved mechanical hyperalgesia (F5,36 = 18.24, P < 0.0001), thermal hyperalgesia (F5,36 = 8.45, P < 0.0001), and NCV (motor NCV: F5,36 = 7.644, P < 0.0001, sensory NCV: F5,36 = 12.83, P < 0.0001). Besides, it maintained myelin and axonal structure integrity, downregulated the expression of apoptosis-related proteins in the sciatic nerve tissue, reduced AGEs and NOS levels, and enhanced antioxidant enzyme SOD activities in the serum. CONCLUSION CXSC exerted neuroprotective effects against rats with DPN through multidimensional pharmacological mechanisms including antiapoptotic activity in the sciatic nerve and downregulation of the level of serum NOS, SOD and AGEs.
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Affiliation(s)
- Mei-Xiang Yu
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Bo Lei
- Center of Pharmacological Evaluation and Research, Shanghai Institute of Pharmaceutical Industry, Shanghai, 200025, China
| | - Xin Song
- Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 201100, China
| | - Yong-Mei Huang
- Jinshan Hospital, Shanghai Fudan University School of Medicine, Shanghai, 201508, China
| | - Xiao-Qin Ma
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Chen-Xia Hao
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Wan-Hua Yang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.
| | - Man-Li Pan
- Center of Pharmacological Evaluation and Research, Shanghai Institute of Pharmaceutical Industry, Shanghai, 200025, China.
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Early Detection of Diabetic Peripheral Neuropathy: A Focus on Small Nerve Fibres. Diagnostics (Basel) 2021; 11:diagnostics11020165. [PMID: 33498918 PMCID: PMC7911433 DOI: 10.3390/diagnostics11020165] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/14/2021] [Accepted: 01/20/2021] [Indexed: 02/07/2023] Open
Abstract
Diabetic peripheral neuropathy (DPN) is the most common complication of both type 1 and 2 diabetes. As a result, neuropathic pain, diabetic foot ulcers and lower-limb amputations impact drastically on quality of life, contributing to the individual, societal, financial and healthcare burden of diabetes. DPN is diagnosed at a late, often pre-ulcerative stage due to a lack of early systematic screening and the endorsement of monofilament testing which identifies advanced neuropathy only. Compared to the success of the diabetic eye and kidney screening programmes there is clearly an unmet need for an objective reliable biomarker for the detection of early DPN. This article critically appraises research and clinical methods for the diagnosis or screening of early DPN. In brief, functional measures are subjective and are difficult to implement due to technical complexity. Moreover, skin biopsy is invasive, expensive and lacks diagnostic laboratory capacity. Indeed, point-of-care nerve conduction tests are convenient and easy to implement however questions are raised regarding their suitability for use in screening due to the lack of small nerve fibre evaluation. Corneal confocal microscopy (CCM) is a rapid, non-invasive, and reproducible technique to quantify small nerve fibre damage and repair which can be conducted alongside retinopathy screening. CCM identifies early sub-clinical DPN, predicts the development and allows staging of DPN severity. Automated quantification of CCM with AI has enabled enhanced unbiased quantification of small nerve fibres and potentially early diagnosis of DPN. Improved screening tools will prevent and reduce the burden of foot ulceration and amputations with the primary aim of reducing the prevalence of this common microvascular complication.
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Lee KA, Park TS, Jin HY. Non-glucose risk factors in the pathogenesis of diabetic peripheral neuropathy. Endocrine 2020; 70:465-478. [PMID: 32895875 DOI: 10.1007/s12020-020-02473-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 08/23/2020] [Indexed: 11/29/2022]
Abstract
In this review, we consider the diverse risk factors in diabetes patients beyond hyperglycemia that are being recognized as contributors to diabetic peripheral neuropathy (DPN). Interest in such alternative mechanisms has been encouraged by the recognition that neuropathy occurs in subjects with metabolic syndrome and pre-diabetes and by the reporting of several large clinical studies that failed to show reduced prevalence of neuropathy after intensive glucose control in patients with type 2 diabetes. Animal models of obesity, dyslipidemia, hypertension, and other disorders common to both pre-diabetes and diabetes have been used to highlight a number of plausible pathogenic mechanisms that may either damage the nerve independent of hyperglycemia or augment the toxic potential of hyperglycemia. While pathogenic mechanisms stemming from hyperglycemia are likely to be significant contributors to DPN, future therapeutic strategies will require a more nuanced approach that considers a range of concurrent insults derived from the complex pathophysiology of diabetes beyond direct hyperglycemia.
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Affiliation(s)
- Kyung Ae Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonbuk National University, Medical School, Jeonju, South Korea
| | - Tae Sun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonbuk National University, Medical School, Jeonju, South Korea
| | - Heung Yong Jin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Jeonbuk National University Hospital, Jeonbuk National University, Medical School, Jeonju, South Korea.
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20
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Fan B, Chopp M, Zhang ZG, Liu XS. Emerging Roles of microRNAs as Biomarkers and Therapeutic Targets for Diabetic Neuropathy. Front Neurol 2020; 11:558758. [PMID: 33192992 PMCID: PMC7642849 DOI: 10.3389/fneur.2020.558758] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
Diabetic neuropathy (DN) is the most prevalent chronic complication of diabetes mellitus. The exact pathophysiological mechanisms of DN are unclear; however, communication network dysfunction among axons, Schwann cells, and the microvascular endothelium likely play an important role in the development of DN. Mounting evidence suggests that microRNAs (miRNAs) act as messengers that facilitate intercellular communication and may contribute to the pathogenesis of DN. Deregulation of miRNAs is among the initial molecular alterations observed in diabetics. As such, miRNAs hold promise as biomarkers and therapeutic targets. In preclinical studies, miRNA-based treatment of DN has shown evidence of therapeutic potential. But this therapy has been hampered by miRNA instability, targeting specificity, and potential toxicities. Recent findings reveal that when packaged within extracellular vesicles, miRNAs are resistant to degradation, and their delivery efficiency and therapeutic potential is markedly enhanced. Here, we review the latest research progress on the roles of miRNAs as biomarkers and as potential clinical therapeutic targets in DN. We also discuss the promise of exosomal miRNAs as therapeutics and provide recommendations for future research on miRNA-based medicine.
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Affiliation(s)
- Baoyan Fan
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
| | - Michael Chopp
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States.,Department of Physics, Oakland University, Rochester, MI, United States
| | - Zheng Gang Zhang
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
| | - Xian Shuang Liu
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
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21
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Beneficial effects of ferulic acid alone and in combination with insulin in streptozotocin induced diabetic neuropathy in Sprague Dawley rats. Life Sci 2020; 255:117856. [DOI: 10.1016/j.lfs.2020.117856] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 12/20/2022]
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22
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Li SJ, Feng D. Lumbar sympathetic pulsed radiofrequency combined with continuous epidural infusion for treatment of painful diabetic neuropathy: A report of two cases and a literature review. J Int Med Res 2020:300060518786903. [PMID: 32521585 DOI: 10.1177/0300060518786903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Diabetic neuropathy (DN), one of the most common late complications of diabetes mellitus, significantly affects distinct regions of the nervous system. Pain management is challenging in DN as no effective therapies exist that reverse the pathological course of DN. Several drugs are recommended as the first-line treatment for painful DN, but these are associated with various side-effects in the long term. This report presents two cases with painful DN who underwent lumbar sympathetic pulsed radiofrequency combined with continuous epidural infusion. The two cases were followed for 30 days. Lumbar sympathetic pulsed radiofrequency combined with continuous epidural infusion offered effective pain relief and improved the health-related quality of life in two patients with DN over this time period.
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Affiliation(s)
- Shao-Jun Li
- Department of Pain Management, Wuhan First Hospital, Wuhan, Hubei Province, China
| | - Dan Feng
- Department of Pain Management, Wuhan First Hospital, Wuhan, Hubei Province, China
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Chistyakova OV, Sukhov IB, Dobretsov MG, Kubasov IV. A Study of Rat Myocardial Na/K-ATPase
Activity
in Experimental Conditions of Prediabetes and Diabetes Mellitus. J EVOL BIOCHEM PHYS+ 2020. [DOI: 10.1134/s0022093020020118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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The impact of demographic and clinical characteristics on diabetic painful neuropathy. ACTA ACUST UNITED AC 2020; 58:13-19. [PMID: 31446430 DOI: 10.2478/rjim-2019-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Diabetic neuropathy (DN) is one of the most devastating complications of diabetes mellitus; however, in contrast to other countries, there are no scientific studies in Portugal evaluating the impact of demographic and clinical characteristics of this pathological entity. The aim of this study was to evaluate the impact of gender, metabolic control, age of diabetic patients, as well as time of disease progression, the appearance of complaints related to neuropathic pain. MATERIAL AND METHODS A multicentre study with a non-probabilistic, convenience sample of 359 patients was performed employing the quantitative method, using the Statistical Package for Social Science 24 software. The p-value of p < 0.05 was defined to consider a result statistically significant. The Spearman correlation coefficient (r) was determined to determine the relationship between categorical variables. RESULTS There was no statistically significant difference in the prevalence of DN between genders (p = 0.633 and r = 0.025). There was a statistically significant relationship between the value of HbA1c and DN, with p = 0.010 and r = 0.136. There is a relationship between age and complaints of neuropathic pain, with p = 0.034 and r = 0.112. The variable, time of disease progression, is also correlated with the appearance of complaints of neuropathic pain with p = 0.020 and r = 0.112. CONCLUSION The prevalence of neuropathic pain in subjects with diabetes is not negligible and is associated with modifiable risk factors that can be identified, possibly modified and prevented. The correct approach for these patients, which involves screening and early treatment, is decisive improving functionality and quality of life.
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New Concepts in the Management of Charcot Neuroarthropathy in Diabetes. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1307:391-415. [PMID: 32124412 DOI: 10.1007/5584_2020_498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Charcot Neuroarthropathy (CN) is an uncommon, debilitating and often underdiagnosed complication of chronic diabetes mellitus though, it can also occur in other medical conditions resulting from nerve injury. Till date, the etiology of CN remains unknown, but enhanced osteoclastogenesis is believed to play a central role in the pathogenesis of CN, in the presence of neuropathy. CN compromises the overall health and quality of life. Delayed diagnosis can result in a severe deformity that can act as a gateway to ulceration, infection and in the worst case, can lead to limb loss. In an early stage of CN, immobilization with offloading plays a key role to a successful treatment. Medical therapies seem to have limited role in the treatment of CN.In case of severe deformity, proper footwear or bracing may help prevent further deterioration and development of an ulcer. In individuals with a concomitant ulcer with osteomyelitis, soft tissue infection and severe deformity, where conservative measures fall short, surgical intervention becomes the only choice of treatment. Early diagnosis and proper management at an early stage can help prevent the occurrence of CN and amputation.
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Early Detection of Diabetic Polyneuropathy Using Paired Stimulation Studies of the Sensory Nerves. Am J Phys Med Rehabil 2019; 98:982-988. [DOI: 10.1097/phm.0000000000001229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pappolla MA, Manchikanti L, Andersen CR, Greig NH, Ahmed F, Fang X, Seffinger MA, Trescot AM. Is insulin resistance the cause of fibromyalgia? A preliminary report. PLoS One 2019; 14:e0216079. [PMID: 31059525 PMCID: PMC6502334 DOI: 10.1371/journal.pone.0216079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/11/2019] [Indexed: 12/21/2022] Open
Abstract
Fibromyalgia (FM) is one of the most frequent generalized pain disorders with poorly understood neurobiological mechanisms. This condition accounts for an enormous proportion of healthcare costs. Despite extensive research, the etiology of FM is unknown and thus, there is no disease modifying therapy available for this condition. We show that most (if not all) patients with FM belong to a distinct population that can be segregated from a control group by their glycated hemoglobin A1c (HbA1c) levels, a surrogate marker of insulin resistance (IR). This was demonstrated by analyzing the data after introducing an age stratification correction into a linear regression model. This strategy showed highly significant differences between FM patients and control subjects (p < 0.0001 and p = 0.0002, for two separate control populations, respectively). A subgroup of patients meeting criteria for pre-diabetes or diabetes (patients with HbA1c values of 5.7% or greater) who had undergone treatment with metformin showed dramatic improvements of their widespread myofascial pain, as shown by their scores using a pre and post-treatment numerical pain rating scale (NPRS) for evaluation. Although preliminary, these findings suggest a pathogenetic relationship between FM and IR, which may lead to a radical paradigm shift in the management of this disorder.
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Affiliation(s)
- Miguel A. Pappolla
- Department of Neurology, University of Texas Medical Branch, Galveston, Texas, United States of America
- St. Michael’s Pain & Spine Clinics, Houston, Texas, United States of America
- * E-mail:
| | - Laxmaiah Manchikanti
- Department of Anesthesiology, LSU School of Medicine Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Clark R. Andersen
- Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Nigel H. Greig
- Drug Design and Development Section, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Fawad Ahmed
- St. Michael’s Pain & Spine Clinics, Houston, Texas, United States of America
| | - Xiang Fang
- Department of Neurology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Michael A. Seffinger
- Department of Neuromusculoskeletal Medicine, College of Osteopathic Medicine of the Pacific, Pomona, California, United States of America
| | - Andrea M. Trescot
- Pain and Headache Center, Eagle River, Alaska, United States of America
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Structure–function relationships in peripheral nerve contributions to diabetic peripheral neuropathy. Pain 2019; 160 Suppl 1:S29-S36. [DOI: 10.1097/j.pain.0000000000001530] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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29
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de Campos Lima T, Santos DDO, Lemes JBP, Chiovato LM, Lotufo CMDC. Hyperglycemia induces mechanical hyperalgesia and depolarization of the resting membrane potential of primary nociceptive neurons: Role of ATP-sensitive potassium channels. J Neurol Sci 2019; 401:55-61. [PMID: 31015148 DOI: 10.1016/j.jns.2019.03.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 03/13/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
Abstract
Cumulating data suggests that ion channel alterations in nociceptive neurons might be involved in the development of diabetic painful neuropathy. In the present study we investigated the involvement of ATP-sensitive potassium (K+ATP) channels in the acute effect of high glucose solution in vitro and in vivo. High glucose concentrations depolarized cultured nociceptive neurons and depolarization was blocked by the K+ATP opener, diazoxide or by insulin. Glucose injection at the rat dorsal root ganglia (L5) resulted in acute mechanical hyperalgesia that was blocked by diazoxide. Mannitol injection indicates that osmolarity changes are not responsible for glucose effect. Therefore, this study suggests that K+ATP channels expressed in peripheral sensory neurons might be involved in the development of diabetic painful neuropathy. Since sulfonylureas, that act by blocking K+ATP are used for diabetes treatment, it is important to evaluate the possible side effects of such drugs at primary sensory neurons.
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Affiliation(s)
- Taís de Campos Lima
- Department of Physiology, Federal University of Uberlândia, Minas Gerais, Brazil
| | | | | | - Luana Mota Chiovato
- Department of Physiology, Federal University of Uberlândia, Minas Gerais, Brazil
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Yang Y, Fang H, Xu G, Zhen Y, Zhang Y, Tian J, Zhang D, Zhang G, Xu J. Liraglutide improves cognitive impairment via the AMPK and PI3K/Akt signaling pathways in type 2 diabetic rats. Mol Med Rep 2018; 18:2449-2457. [PMID: 29916537 DOI: 10.3892/mmr.2018.9180] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 02/14/2018] [Indexed: 12/17/2022] Open
Abstract
Liraglutide is a type of glucagon‑like‑peptide 1 receptor agonist, which has been reported as a novel type of antidiabetic agent with numerous benefits, including cardiovascular and neuroprotective effects. To the best of our knowledge, few studies to date have reported the potential mechanism underlying the neuroprotective effects of liraglutide on rats with type 2 diabetes mellitus (T2DM). The present study aimed to investigate the neuroprotective actions of liraglutide in diabetic rats and to determine the mechanisms underlying these effects. A total of 30 male T2DM Goto‑Kakizaki (GK) rats (age, 32 weeks; weight, 300‑350 g) and 10 male Wistar rats (age, 32 weeks; weight, 300‑350 g) were used in the present study. Wistar rats received vehicle treatment, and GK rats randomly received treatment with vehicle, low dose of liraglutide (75 µg/kg) or high dose of liraglutide (200 µg/kg) for 28 days. Cognitive deficits were evaluated using the Morris water maze test. The expression levels of phosphoinositide 3‑kinase (PI3K), protein kinase B (Akt), phosphorylated (p)‑Akt, AMP‑activated protein kinase (AMPK), mammalian target of rapamycin (mTOR), Beclin‑1, microtubule‑associated protein light chain 3 (LC)‑3 II, caspase‑3, B‑cell lymphoma 2 (Bcl‑2)‑associated X protein and Bcl‑2 were assessed by western blot analysis. The results demonstrated that diabetic GK rats exhibited cognitive dysfunction, whereas treatment with liraglutide alleviated the learning and memory deficits, particularly in the high‑dose liraglutide group. The expression levels of Beclin‑1 and LC‑3 II were decreased in GK rats; however, this decrease was alleviated in the presence of liraglutide. Liraglutide also reversed T2DM model‑induced increases in mTOR, and decreases in p‑AMPK, PI3K and p‑Akt expression, and modulated the expression of apoptosis‑associated proteins. Furthermore, the administration of liraglutide inhibited apoptosis and exerted a protective effect against cognitive deficits via the activation of autophagy. In conclusion, the protective effects of liraglutide may be associated with increased mTOR expression via activation of the AMPK and PI3K/Akt signaling pathways.
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Affiliation(s)
- Ying Yang
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China
| | - Hui Fang
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China
| | - Gang Xu
- Department of Burns and Orthopedics, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China
| | - Yanfeng Zhen
- Second Department of Endocrinology, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China
| | - Yazhong Zhang
- Second Department of Endocrinology, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China
| | - Jinli Tian
- Second Department of Endocrinology, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China
| | - Dandan Zhang
- Second Department of Endocrinology, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China
| | - Guyue Zhang
- Second Department of Endocrinology, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China
| | - Jing Xu
- Second Department of Endocrinology, Tangshan Gongren Hospital, Tangshan, Hebei 063000, P.R. China
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Azzopardi K, Gatt A, Chockalingam N, Formosa C. Hidden dangers revealed by misdiagnosed diabetic neuropathy: A comparison of simple clinical tests for the screening of vibration perception threshold at primary care level. Prim Care Diabetes 2018; 12:111-115. [PMID: 29029862 DOI: 10.1016/j.pcd.2017.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/15/2017] [Accepted: 09/15/2017] [Indexed: 01/09/2023]
Abstract
AIM Diabetic peripheral neuropathy is an important complication and contributes to the morbidity of diabetes mellitus. Evidence indicates early detection of diabetic peripheral neuropathy results in fewer foot ulcers and amputations. The aim of this study was to compare different screening modalities in the detection of diabetic peripheral neuropathy in a primary care setting. METHOD A prospective non-experimental comparative multi-centre cross sectional study was conducted in various Primary Health Centres. One hundred participants living with Type 2 diabetes for at least 10 years were recruited using a convenience sampling method. The Vibratip, 128Hz tuning fork and neurothesiometer were compared in the detection of vibration perception. RESULTS This study showed different results of diabetic peripheral neuropathy screening tests, even in the same group of participants. This study has shown that the percentage of participants who did not perceive vibrations was highest when using the VibraTip (28.5%). This was followed by the neurothesiometer (21%) and the 128Hz tuning fork (12%) (p<0.001). CONCLUSION Correct diagnosis and treatment of neuropathy in patients with diabetes is crucial. This study demonstrates that some instruments are more sensitive to vibration perception than others. We recommend that different modalities should be used in patients with diabetes and when results do not concur, further neurological evaluation should be performed. This would significantly reduce the proportion of patients with diabetes who would be falsely identified as having no peripheral neuropathy and subsequently denied the benefit of beneficial and effective secondary risk factor control.
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Affiliation(s)
| | - Alfred Gatt
- Faculty of Health Sciences, University of Malta, Malta; Faculty of Health Sciences, Staffordshire University, United Kingdom.
| | - Nachiappan Chockalingam
- Faculty of Health Sciences, University of Malta, Malta; Faculty of Health Sciences, Staffordshire University, United Kingdom.
| | - Cynthia Formosa
- Faculty of Health Sciences, University of Malta, Malta; Faculty of Health Sciences, Staffordshire University, United Kingdom.
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Muramatsu K, Ikutomo M, Tamaki T, Shimo S, Niwa M. Effect of streptozotocin-induced diabetes on motor representations in the motor cortex and corticospinal tract in rats. Brain Res 2018; 1680:115-126. [PMID: 29273401 DOI: 10.1016/j.brainres.2017.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 12/07/2017] [Accepted: 12/13/2017] [Indexed: 12/13/2022]
Abstract
Motor disorders in patients with diabetes are associated with diabetic peripheral neuropathy, which can lead to symptoms such as lower extremity weakness. However, it is unclear whether central motor system disorders can disrupt motor function in patients with diabetes. In a streptozotocin-induced rat model of type 1 diabetes, we used intracortical microstimulation to evaluate motor representations in the motor cortex, recorded antidromic motor cortex responses to spinal cord stimulation to evaluate the function of corticospinal tract (CST) axons, and used retrograde labeling to evaluate morphological alterations of CST neurons. The diabetic rats exhibited size reductions in the hindlimb area at 4 weeks and in trunk and forelimb areas after 13 weeks, with the hindlimb and trunk area reductions being the most severe. Other areas were unaffected. Additionally, we observed reduced antidromic responses in CST neurons with axons projecting to lumbar spinal segments (CST-L) but not in those with axons projecting to cervical segments (CST-C). This was consistent with the observation that retrograde-labeled CST-L neurons were decreased in number following tracer injection into the spinal cord in diabetic animals but that CST-C neurons were preserved. These results show that diabetes disrupts the CST system components controlling hindlimb and trunk movement. This disruption may contribute to lower extremity weakness in patients.
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Affiliation(s)
- Ken Muramatsu
- Department of Physical Therapy, Health Science University, Yamanashi, Japan.
| | - Masako Ikutomo
- Department of Physical Therapy, Health Science University, Yamanashi, Japan
| | - Toru Tamaki
- Department of Physical Therapy, Health Science University, Yamanashi, Japan
| | - Satoshi Shimo
- Department of Occupational Therapy, Health Science University, Yamanashi, Japan
| | - Masatoshi Niwa
- Department of Occupational Therapy, Kyorin University, Tokyo, Japan
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Lin YJ, Zhen YZ, Wei JB, Wei J, Dai J, Gao JL, Li KJ, Hu G. Rhein lysinate protects renal function in diabetic nephropathy of KK/HlJ mice. Exp Ther Med 2017; 14:5801-5808. [PMID: 29285124 PMCID: PMC5740561 DOI: 10.3892/etm.2017.5283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 08/14/2017] [Indexed: 12/17/2022] Open
Abstract
The purpose of the present study was to assess the protective effects of rhein lysinate (RHL) in a KK/HlJ mouse model of diabetic nephropathy (DN) and to explore its mechanism of action. A total of 4 groups were established: C57BL/J control, the KK/HlJ model and 25 and 50 mg/kg/day RHL-treated KK/HlJ groups. The KK/HlJ mouse model of DN was established by streptozotocin injection, followed by maintenance on a specific diet. The albumin-to-creatinine ratio (ACR) was determined at 5 weeks and at 16 weeks, the kidneys were harvested, and morphological examination and immunohistochemical analysis were performed. The levels of malondialdehyde (MDA), as well as superoxide dismutase (SOD) and glutathione peroxidase (GSH-px) activities in the kidneys were measured using appropriate assay kits. The expression of inflammatory factors and associated proteins was analyzed using western blot analysis. At 5 weeks, the levels of ACR in KK/HlJ mice were increased, which was inhibited by treatment with RHL. Treatment with RHL (50 mg/kg/day) decreased the body weight of KK/HlJ mice. Compared with the C57BL/J control, the KK/HlJ model mice had a significantly lower activity of SOD and GSH-px in the kidneys, but had significantly higher levels of MDA. Treatment of KK/HlJ mice with RHL significantly increased the activities SOD and GSH-px, and reduced the MAD level in the kidneys. Renal tubular epithelial cell edema was observed in KK/HlJ mice but not in C57BL/J mice. RHL decreased the incidence of renal tubular epithelial cell edema and significantly decreased the expression of TNF-α and IL-6 as well as the expression and phosphorylation of NF-κB in the kidneys. Therefore, DN is associated with the expression of inflammatory factors, renal tubular epithelial cell edema and renal dysfunction in KK/HlJ mice. RHL improves renal function by decreasing kidney inflammation.
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Affiliation(s)
- Ya-Jun Lin
- The Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing 100730, P.R. China
| | - Yong-Zhan Zhen
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Jing-Bo Wei
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Jie Wei
- The Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing 100730, P.R. China
| | - Jing Dai
- Department of Endocrinology, Peking University Fifth School of Clinical Medicine, Beijing Hospital, Beijing 100730, P.R. China
| | - Jun-Ling Gao
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Kai-Ji Li
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Gang Hu
- The Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing 100730, P.R. China
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Fujishiro M, Kushiyama A, Yamazaki H, Kaneko S, Koketsu Y, Yamamotoya T, Kikuchi T, Sakoda H, Suzuki R, Kadowaki T. Gastrointestinal symptom prevalence depends on disease duration and gastrointestinal region in type 2 diabetes mellitus. World J Gastroenterol 2017; 23:6694-6704. [PMID: 29085214 PMCID: PMC5643290 DOI: 10.3748/wjg.v23.i36.6694] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/12/2017] [Accepted: 06/01/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To unravel relationships between gastrointestinal (GI) symptoms impairing quality of life (QOL) and clinical profiles of diabetes mellitus (DM) patients.
METHODS We enrolled 134 outpatients with type 2 DM. Mean age was 64.7 years, mean body mass index was 24.7 kg/m2, mean glycated hemoglobin was 7.1%, and mean DM duration was 13.7 years. GI symptom-related QOL was determined using the Izumo scale, based on five factors, i.e., heartburn, gastralgia, postprandial fullness, constipation and diarrhea. The sum of scores obtained for the three questions in each domain was calculated, and subjects with a score of 5 or higher were considered to be symptomatic with impaired QOL. JMP Clinical version 5.0 was used for all statistical analyses.
RESULTS Lower abdominal symptoms were found to be more frequent than those affecting the upper abdomen. Diabetic duration and medications showed associations with GI symptoms. We identified differences in peak prevalences of the five symptoms. Gastralgia (P = 0.02 vs 10-14 years) and total GI symptoms (P = 0.01 and P = 0.02 vs 5-9 years and 10-14 years, respectively) peaked at a diabetes duration of 15-19 years. Heartburn (P = 0.004) and postprandial fullness (P = 0.03) tended to increase with disease duration. Constipation and diarrhea showed bimodal peaks, with the first early and the second late (e.g., P = 0.03 at 15-19 years vs 10-14 years for diarrhea) in the disease course. Finally, GI symptoms showed clustering that reflected the region of the GI tract affected, i.e., constipation and diarrhea had similar frequencies (P < 0.0001).
CONCLUSION Our study highlights the importance of questioning patients about QOL impairment due to abdominal symptoms, especially in the early and the late periods of diabetes.
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Affiliation(s)
- Midori Fujishiro
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Akifumi Kushiyama
- Division of Diabetes and Metabolism, Institute for Adult Diseases, Asahi Life Foundation, Tokyo 103-0002, Japan
| | - Hiroki Yamazaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Sunao Kaneko
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Yuko Koketsu
- Department of Diabetes and Metabolic Diseases, Shinko Hospital, Kobe 651-0072, Japan
| | - Takeshi Yamamotoya
- Department of Medical Science, Graduate School of Medicine, University of Hiroshima, Hiroshima 734-8553, Japan
| | - Takako Kikuchi
- Division of Diabetes and Metabolism, Institute for Adult Diseases, Asahi Life Foundation, Tokyo 103-0002, Japan
| | - Hideyuki Sakoda
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kiyotakecho Kihara, Miyazaki 889-1692, Japan
| | - Ryo Suzuki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan
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35
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Kishore L, Kaur N, Singh R. Bacosine isolated from aerial parts of Bacopa monnieri improves the neuronal dysfunction in Streptozotocin-induced diabetic neuropathy. J Funct Foods 2017. [DOI: 10.1016/j.jff.2017.04.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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36
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Muramatsu K, Niwa M, Tamaki T, Ikutomo M, Masu Y, Hasegawa T, Shimo S, Sasaki SI. Effect of streptozotocin-induced diabetes on motoneurons and muscle spindles in rats. Neurosci Res 2016; 115:21-28. [PMID: 27826051 DOI: 10.1016/j.neures.2016.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/17/2016] [Accepted: 10/27/2016] [Indexed: 12/30/2022]
Abstract
This study examined the alterations in the number and size of motoneurons innervating the medial gastrocnemius (MG) and biceps femoris (BF) motor nuclei in diabetic rats (12 or 22 weeks after injection of streptozotocin) and age-matched controls using retrograde labeling technique. Additionally, morphological alterations of muscle spindles in BF and MG muscles were tested. Significantly fewer labeled MG motoneurons were found in 12- and 22-week diabetic rats as compared with age-matched control animals. In contrast, the number of BF motoneurons was preserved in each group. Compared to control animals, the ratio of larger motoneurons of MG and BF muscle were decreased at 12 weeks, and smaller MG motoneurons were drastically decreased at 22 weeks. Moreover, MG muscle spindle showed reduction of its number and increase of intrafusal muscle fibers; however, BF muscle spindles showed little or no difference from control animals. We conclude that there is an early loss of alpha motoneurons for both MG and BF muscles followed by a later loss of gamma motoneurons in MG muscle in diabetic animals. Moreover, loss of gamma motoneuron might induce atrophy of MG muscle spindles.
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Affiliation(s)
- Ken Muramatsu
- Department of Physical Therapy, Health Science University, Yamanashi, Japan.
| | - Masatoshi Niwa
- Department of Occupational Therapy, Kyorin University, Tokyo, Japan
| | - Toru Tamaki
- Department of Physical Therapy, Health Science University, Yamanashi, Japan
| | - Masako Ikutomo
- Department of Physical Therapy, Health Science University, Yamanashi, Japan
| | - Yujiro Masu
- Department of Physical Therapy, Health Science University, Yamanashi, Japan
| | - Tatsuya Hasegawa
- Division of Human Environmental Science, Mount Fuji Research Institute, Yamanashi, Japan
| | - Satoshi Shimo
- Department of Occupational Therapy, Health Science University, Yamanashi, Japan
| | - Sei-Ichi Sasaki
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
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37
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Rahimi M, Vinciguerra M, Daghighi M, Özcan B, Akbarkhanzadeh V, Sheedfar F, Amini M, Mazza T, Pazienza V, Motazacker MM, Mahmoudi M, De Rooij FWM, Sijbrands E, Peppelenbosch MP, Rezaee F. Age-related obesity and type 2 diabetes dysregulate neuronal associated genes and proteins in humans. Oncotarget 2016; 6:29818-32. [PMID: 26337083 PMCID: PMC4745765 DOI: 10.18632/oncotarget.4904] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 08/07/2015] [Indexed: 12/29/2022] Open
Abstract
Despite numerous developed drugs based on glucose metabolism interventions for treatment of age-related diseases such as diabetes neuropathies (DNs), DNs are still increasing in patients with type 1 or type 2 diabetes (T1D, T2D). We aimed to identify novel candidates in adipose tissue (AT) and pancreas with T2D for targeting to develop new drugs for DNs therapy. AT-T2D displayed 15 (e.g. SYT4 up-regulated and VGF down-regulated) and pancreas-T2D showed 10 (e.g. BAG3 up-regulated, VAV3 and APOA1 down-regulated) highly differentially expressed genes with neuronal functions as compared to control tissues. ELISA was blindly performed to measure proteins of 5 most differentially expressed genes in 41 human subjects. SYT4 protein was upregulated, VAV3 and APOA1 were down-regulated, and BAG3 remained unchanged in 1- Obese and 2- Obese-T2D without insulin, VGF protein was higher in these two groups as well as in group 3- Obese-T2D receiving insulin than 4-lean subjects. Interaction networks analysis of these 5 genes showed several metabolic pathways (e.g. lipid metabolism and insulin signaling). Pancreas is a novel site for APOA1 synthesis. VGF is synthesized in AT and could be considered as good diagnostic, and even prognostic, marker for age-induced diseases obesity and T2D. This study provides new targets for rational drugs development for the therapy of age-related DNs.
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Affiliation(s)
- Mehran Rahimi
- Faculty of Medical Science, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Manlio Vinciguerra
- Institute for Liver and Digestive Health, Division of Medicine, University College London (UCL), London, UK.,Gastroenterology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Mojtaba Daghighi
- Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Behiye Özcan
- Department of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Fareeba Sheedfar
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marzyeh Amini
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tommaso Mazza
- Bioinformatics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Valerio Pazienza
- Gastroenterology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Mahdi M Motazacker
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
| | - Morteza Mahmoudi
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States.,Department of Nanotechnology and Nanotechnology Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Felix W M De Rooij
- Department of Cardiovascular Genetics, Metabolism, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eric Sijbrands
- Department of Cardiovascular Genetics, Metabolism, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maikel P Peppelenbosch
- Department of Gastroenterology and Hepatology, Erasmus Medical Center, University of Rotterdam, Rotterdam, The Netherlands
| | - Farhad Rezaee
- Department of Gastroenterology and Hepatology, Erasmus Medical Center, University of Rotterdam, Rotterdam, The Netherlands.,Department of Cell Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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38
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Bioactive Compounds and Their Neuroprotective Effects in Diabetic Complications. Nutrients 2016; 8:nu8080472. [PMID: 27483315 PMCID: PMC4997385 DOI: 10.3390/nu8080472] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 07/22/2016] [Accepted: 07/27/2016] [Indexed: 12/14/2022] Open
Abstract
Hyperglycemia, hyperlipidemia and impaired insulin signaling during the development of diabetes can cause diabetic complications, such as diabetic neuropathy, resulting in significant morbidity and mortality. Although various therapeutics are available for the treatment of diabetic neuropathy, no absolute cure exists, and additional research is necessary to comprehensively understand the underlying pathophysiological pathways. A number of studies have demonstrated the potential health benefits of bioactive compounds, i.e., flavonoids and vitamins, which may be effective as supplementary treatments for diabetes and its complications. In this review, we highlight the most recent reports about the mechanisms of action of bioactive compounds (flavonoids and vitamins) possessing potential neuroprotective properties in diabetic conditions. Additional clinical studies are required to determine the appropriate dose and duration of bioactive compound supplementation for neuroprotection in diabetic patients.
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39
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de Souza RJ, de Souza A, Nagvekar MD. Nerve conduction studies in diabetics presymptomatic and symptomatic for diabetic polyneuropathy. J Diabetes Complications 2015; 29:811-7. [PMID: 26049172 DOI: 10.1016/j.jdiacomp.2015.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 05/12/2015] [Accepted: 05/14/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE We performed nerve conduction studies (NCS) on diabetics with and without symptoms of diabetic polyneuropathy (DPN) and evaluated correlations with glycaemic control and clinical features. METHODS Consecutive patients were recruited in three groups: "normals" (nondiabetics without peripheral nerve disease); "presymptomatic diabetics" (diabetes without DPN); and "symptomatic diabetics". Clinical questionnaire and neurological examination were administered, and NCS were performed using standard techniques. RESULTS 153 patients were recruited (51 normals, 50 presymptomatic diabetics, 52 symptomatic). Glycosylated haemoglobin and duration of DM were higher in symptomatic diabetics, with symptoms present for 1-60 months (mean 14.5). Alterations in NCS included prolonged latencies, lowered amplitudes and slowed conduction velocities, following a pattern of initially reduced sensory amplitudes and slowed motor velocities, with later reduced motor and sensory amplitudes and prolonged motor latencies. Neuropathic pain, clinical signs and glycosylated haemoglobin correlated with these changes. CONCLUSIONS Even in asymptomatic patients, NCS show diffuse changes, in a predictable pattern. Electrophysiological parameters correlate with neuropathic pain, physical findings and glycosylated haemoglobin levels. SIGNIFICANCE We demonstrate that NCS changes in DPN follow a predictable pattern, correlating with clinical features and long-term glycaemic control.
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Affiliation(s)
- Rainha J de Souza
- Department of Physiology, Goa Medical College, Bambolim, Goa, 403202, India
| | - Aaron de Souza
- Department of Neurology, Goa Medical College, Bambolim, Goa, 403202, India.
| | - Meera D Nagvekar
- Department of Physiology, Goa Medical College, Bambolim, Goa, 403202, India
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40
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Song X, Wang W, Kang Y, Zhang X, Jiang Y, Yue Z, Tang Z. Tangzhining exhibits a protective effect against cognitive dysfunction in diabetic rats. Int J Clin Exp Med 2015; 8:9013-9021. [PMID: 26309554 PMCID: PMC4538009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/23/2015] [Indexed: 06/04/2023]
Abstract
Previous studies have suggested that diabetes significantly impairs the cognitive function. Tangzhining (TZN), as a kind of Traditional Chinese Medicine (TCM), has been widely used to treat diabetes in China. However, the effect of TZN on treatment of diabetes-induced learning and memory deficits has not been well documented. The present study was to investigate the effect of TZN on diabetes-induced learning and memory deficits and delineate the underlying molecular mechanism. Diabetic rats were randomly grouped and treated with various doses of TZN (0.47, 0.94 and 1.4 g/kg) by intraperitoneal injection. Using the Morris water maze, TZN treatment (0.94 g/kg and 1.4 g/kg) reduced markedly the escape latency and path length of diabetic rats. The morphological changes of pyramidal cells in hippocampus of diabetic rats were apparently reversed and improved by TZN treatment, in comparison with that in diabetic rats without TZN treatment. Moreover, the results of Western blot analysis showed that TZN treatment significantly increased the protein expression of glutamic acid decarboxylase (GAD) and excitatory amino acid carrier 1 (EAAC1) in hippocampus of diabetic rats. Furthermore, TZN treatment increased the protein expression of N-methyl-D-aspartic acid (NMDA) receptor subunits including NR1 and NR2B. Taken together, our data suggest that TZN sustains the balance between glutamate (Glu) and GABA by regulating GAD and EAAC1, and maintains the NMDA receptors activity for learning and memory function through regulating the subunits NR1 and NR2B.
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41
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Yin DEH, Liang XC, Zhao LI, Zhang H, Sun Q, Wang PY, Sun LQ. Jinmaitong decreases sciatic nerve DNA oxidative damage and apoptosis in a streptozotocin-induced diabetic rat model. Exp Ther Med 2015; 10:778-786. [PMID: 26622393 DOI: 10.3892/etm.2015.2543] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 02/16/2015] [Indexed: 01/17/2023] Open
Abstract
Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes. Jinmaitong (JMT), a Traditional Chinese Medicine, improves certain symptoms of DPN, such as limb pain and numbness. The aim of the present study was to investigate the effects of JMT on DNA oxidative damage and apoptosis in the sciatic nerve of diabetic rats. The rats were divided into a normal and a diabetic group. Diabetes was induced using streptozotocin (60 mg/kg). The diabetic model (DM) rats received vitamin C (0.05 g/kg/day) or JMT [low-dosage (L), 0.44 g/kg/day; medium-dosage (M), 0.88 g/kg/day or high-dosage (H), 1.75 g/kg/day]. After 16 weeks, the mechanical pain threshold of the rats was evaluated. The expression of 8-hydroxy-deoxyguanosine (8-OHdG), nicotinamide adenine dinucleotide phosphate (NADPH) oxidase p22phox, B-cell lymphoma 2 (Bcl-2), caspase 3 and cleaved-poly(ADP-ribose) polymerase 1 (PARP-1) in the sciatic nerve tissues was measured using the reverse transcription-quantitative polymerase chain reaction, immunohistochemistry and western blotting. JMT had no effect on body weight and fasting blood glucose levels. Following treatment, the rats in the JMT groups had an improved pain threshold compared with the DM controls (JMT-L, 52.9±6.5 g; JMT-M, 74.7±9.3 g; and JMT-H, 61.7±2.0 g vs. DM control, 35.32±12.06 g; all P<0.01), while the threshold in the JMT-M rats was similar to that of normal controls (P>0.05). 8-OHdG and NADPH oxidase p22phox expression was significantly decreased in the three JMT groups compared with that in the DM controls (all P<0.05). Following JMT treatment, Bcl-2 levels were increased, while caspase 3 and cleaved-PARP-1 levels were decreased compared with those in the DM controls (all P<0.01). In conclusion, JMT may reduce DNA oxidative damage to the sciatic nerve in diabetic rats, as well as regulate genes involved in peripheral neuronal cell apoptosis, suggesting that JMT could be used to prevent or treat DPN in diabetic patients.
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Affiliation(s)
- DE-Hai Yin
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Beijing 100032, P.R. China
| | - Xiao-Chun Liang
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Beijing 100032, P.R. China
| | - L I Zhao
- Department of Nephrology and Endocrinology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, P.R. China
| | - Hong Zhang
- Cell Resource Center, School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China
| | - Qing Sun
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Beijing 100032, P.R. China
| | - Pu-Yan Wang
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Beijing 100032, P.R. China
| | - Lian-Qing Sun
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Beijing 100032, P.R. China
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Bunner AE, Wells CL, Gonzales J, Agarwal U, Bayat E, Barnard ND. A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study. Nutr Diabetes 2015; 5:e158. [PMID: 26011582 PMCID: PMC4450462 DOI: 10.1038/nutd.2015.8] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 03/12/2015] [Accepted: 04/09/2015] [Indexed: 12/23/2022] Open
Abstract
Background: Diabetic neuropathy is a common and often debilitating condition for which available treatments are limited. Because a low-fat plant-based diet has been shown to improve glycemic control in individuals with type 2 diabetes, we hypothesized that such a diet would reduce painful symptoms of diabetic neuropathy. Methods: In this 20-week pilot study, individuals with type 2 diabetes and painful diabetic neuropathy were randomly assigned to two groups. The intervention group was asked to follow a low-fat, plant-based diet, with weekly classes for support in following the prescribed diet, and to take a vitamin B12 supplement. The control group was asked to take the same vitamin B12 supplement, but received no other intervention. At baseline, midpoint and 20 weeks, clinical, laboratory and questionnaire data were collected. Questionnaires included an analog ‘worst pain' scale, Michigan Neuropathy Screening Instrument, global impression scale, Short Form McGill Pain Questionnaire, Neuropathy Total Symptom Score, a weekly pain diary and Norfolk Quality of Life Questionnaire. Results: After 20 weeks, body weight change with the intervention was −6.4 kg (95% confidence interval (CI) −9.4 to −3.4, P<0.001) in an effect size analysis. Electrochemical skin conductance in the foot improved by an average of 12.4 microseimens (95% CI 1.2–23.6, P=0.03) with the intervention in an effect size analysis. The between-group difference in change in pain, as measured by the McGill pain questionnaire, was −8.2 points (95% CI −16.1 to −0.3, P=0.04). Michigan Neuropathy Screening Instrument questionnaire score change was −1.6 points (95% CI −3.0 to −0.2, P=0.03). Conclusions: Improvements were seen in some clinical and pain measures. This pilot study suggests the potential value of a plant-based diet intervention, including weekly support classes, for treating painful diabetic neuropathy.
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Affiliation(s)
- A E Bunner
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - C L Wells
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - J Gonzales
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - U Agarwal
- California State University, East Bay, Student Health and Counseling Services, Hayward, CA, USA
| | - E Bayat
- George Washington Medical Faculty Associates, Washington, DC, USA
| | - N D Barnard
- 1] Physicians Committee for Responsible Medicine, Washington, DC, USA [2] George Washington University School of Medicine, Washington, DC, USA
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Lee CC, Perkins BA, Kayaniyil S, Harris SB, Retnakaran R, Gerstein HC, Zinman B, Hanley AJ. Peripheral Neuropathy and Nerve Dysfunction in Individuals at High Risk for Type 2 Diabetes: The PROMISE Cohort. Diabetes Care 2015; 38:793-800. [PMID: 25665810 DOI: 10.2337/dc14-2585] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/05/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Emerging evidence suggests that peripheral neuropathy begins in the early stages of diabetes pathogenesis. Our objective was to describe the prevalence of peripheral neuropathy and nerve dysfunction according to glucose tolerance and metabolic syndrome status and examine how these conditions are associated with neurological changes in individuals at risk for type 2 diabetes. RESEARCH DESIGN AND METHODS We studied 467 individuals in the longitudinal PROMISE (Prospective Metabolism and Islet Cell Evaluation) cohort. Peripheral neuropathy was defined by Michigan Neuropathy Screening Instrument (MNSI) scores (>2), and the severity of nerve dysfunction was measured objectively by vibration perception thresholds (VPTs) using a neurothesiometer. Metabolic syndrome was defined using the International Diabetes Federation/American Heart Association harmonized criteria. RESULTS The prevalence of peripheral neuropathy was 29%, 49%, and 50% for normal glycemia, prediabetes, and new-onset diabetes, respectively (P < 0.001 for trend). The mean VPT was 6.5 V for normal glycemia, 7.9 V for prediabetes, and 7.6 V for new-onset diabetes (P = 0.024 for trend). Prediabetes was associated with higher MNSI scores (P = 0.01) and VPTs (P = 0.004) versus normal glycemia, independent of known risk factors. Additionally, progression of glucose intolerance over 3 years predicted a higher risk of peripheral neuropathy (P = 0.007) and nerve dysfunction (P = 0.002). Metabolic syndrome was not independently associated with MNSI scores or VPTs. CONCLUSIONS In individuals with multiple risk factors for diabetes, prediabetes was associated with similar risks of peripheral neuropathy and severity of nerve dysfunction as new-onset diabetes. Prediabetes, but not metabolic syndrome, was independently associated with both the presence of peripheral neuropathy and the severity of nerve dysfunction.
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Affiliation(s)
- C Christine Lee
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Bruce A Perkins
- Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sheena Kayaniyil
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Stewart B Harris
- Centre for Studies in Family Medicine, University of Western Ontario, London, ON, Canada
| | - Ravi Retnakaran
- Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, ON, Canada Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Hertzel C Gerstein
- Division of Endocrinology and Metabolism and the Population Health Research Institute, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Bernard Zinman
- Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, ON, Canada Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, ON, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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The Combined Extract of Zingiber officinale and Zea mays (Purple Color) Improves Neuropathy, Oxidative Stress, and Axon Density in Streptozotocin Induced Diabetic Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:301029. [PMID: 25969689 PMCID: PMC4410543 DOI: 10.1155/2015/301029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 03/10/2015] [Indexed: 01/01/2023]
Abstract
Based on the protective effect of the combined extract of purple waxy corn and ginger (PWCG) on oxidative stress related disorders in diabetic condition, we aimed to determine the effect of PWCG on the functional, biochemical, and structural change of the lesion nerve in streptozotocin- (STZ-) diabetic rats. PWCG at doses of 100, 200, and 300 mg·kg−1 BW were orally given to STZ-diabetic rats which were subjected to chronic constriction (CCI) at right sciatic nerve for 21 days. The blood sugar was assessed before and at the end of study whereas the sciatic function index (SFI), paw withdrawal threshold intensity (PWTI), and paw withdrawal latency (PWL) were assessed every 3 days until the end of study. At the end of study, the determination of nerve conduction velocity (NCV), axon density, oxidative stress status, and aldose reductase (AR) activity of the lesion nerve were performed. It was found that PWCG improved SFI, PWTI, PWL, and NCV together with the improved oxidative stress status and the axon density in the lesion nerve. No changes of AR activity or blood sugar level were observed. Therefore, PWCG might improve the functional and structural changes in STZ-diabetic rats plus CCI via the improved oxidative stress status.
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Ruhdorfer AS, Azaryan M, Kraus J, Grinzinger S, Hitzl W, Ebmer J, Dellon AL, Hölzl B. Selecting a prospective test for early detection of diabetic polyneuropathy. Microsurgery 2015; 35:512-7. [PMID: 25847628 DOI: 10.1002/micr.22409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 11/06/2022]
Abstract
Microneurolysis of entrapped peripheral nerve has the best chance of success when compression has not created significant axonal loss. The purpose of this study is to learn the best way to identify potential surgical candidates at the earliest time for intervention, by examining patients in a clinical setting using objective, electrodiagnostic nerve conduction studies (NCS), and subjective touch threshold studies, Semmes-Weinstein monofilaments (SWM) and Pressure-Specified Sensory Device™ (PSSD). Fifty-five patients with diabetic polyneuropathy over the age of 30 years were included. Neuropathy symptom score was the gold standard for statistical calculation, with a prevalence of 70%. In the symptomatic population, prevalence was 64% for NCS (n = 25), 59% for SWM (n = 43), and 88% for PSSD (n = 51). In the asymptomatic population, prevalence was 70% for NCS, 27% for SWM, and 92% for PSSD. It is concluded that the PSSD is the most sensitive device of those tested for identifying peripheral neuropathy in an at risk population of patients.
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Affiliation(s)
- Anja S Ruhdorfer
- Department of Internal Medicine, Landesklinik St. Veit im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria.,Department of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria
| | - Mihran Azaryan
- Department of Internal Medicine, Landesklinik St. Veit im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria
| | - Joerg Kraus
- Department of Neurology, Christian-Doppler-Klinik, SALK, Paracelsus Medical University, Salzburg, Austria
| | - Susanne Grinzinger
- Department of Neurology, Christian-Doppler-Klinik, SALK, Paracelsus Medical University, Salzburg, Austria
| | - Wolfgang Hitzl
- Research Office (biostatistics), Paracelsus Medical University, Salzburg, Austria
| | - Johannes Ebmer
- Department of Internal Medicine, Landesklinik St. Veit im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria
| | - A Lee Dellon
- Professor of Plastic Surgery and Neurosurgery, Johns Hopkins University, Baltimore, MD
| | - Bertram Hölzl
- Department of Internal Medicine, Landesklinik St. Veit im Pongau, SALK, Paracelsus Medical University, Salzburg, Austria
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Modulating actions of NMDA receptors on pronociceptive effects of locally injected remifentanil in diabetic rats. Pharmacol Rep 2014; 66:1065-72. [DOI: 10.1016/j.pharep.2014.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 06/30/2014] [Accepted: 07/21/2014] [Indexed: 01/14/2023]
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Etemad A, Sheikhzadeh F, Asl NA. Evaluation of brain-derived neurotrophic factor in diabetic rats. Neurol Res 2014; 37:217-22. [DOI: 10.1179/1743132814y.0000000428] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Visnagri A, Kandhare AD, Chakravarty S, Ghosh P, Bodhankar SL. Hesperidin, a flavanoglycone attenuates experimental diabetic neuropathy via modulation of cellular and biochemical marker to improve nerve functions. PHARMACEUTICAL BIOLOGY 2014; 52:814-828. [PMID: 24559476 DOI: 10.3109/13880209.2013.870584] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Diabetic neuropathy (DN) is one of the most common long-term complications of diabetes mellitus and clinically can be characterized by an elevated nociceptive response with electrophysiological conduction abnormalities. The present investigation was designed to evaluate the neuroprotective effect of hesperidin against STZ induced diabetic neuropathic pain in laboratory rats. MATERIALS AND METHODS DN was induced in Sprague-Dawley rats (150-200 g) by intraperitoneal administration of streptozotocin (STZ) (55 mg/kg, p.o.). Rats were divided into various groups, namely, STZ control (vehicle), hesperidin (25, 50, and 100 mg/kg, p.o.), insulin (10 IU/kg, s.c.), and combination of hesperidin (100 mg/kg, p.o.) with insulin (10 IU/kg, s.c.) for 4 weeks. Various behavioral (allodynia and hyperalgesia), biochemical parameters [oxido-nitosative stress, Na-K-ATPase, aldose reductase (AR)], and molecular changes (TNF-α and IL-1β) along with hemodynamic changes were determined. RESULTS Rats treated with hesperidin (50 and 100 mg/kg, p.o., 4 weeks) significantly reduced (p < 0.05) hyperglycemia and its metabolic abnormalities induced by intraperitoneal administration of STZ. The decreased nociceptive threshold, motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV), serum insulin as well as Na-K-ATPase activity were significantly increase (p < 0.05) by hesperidin (50 and 100 mg/kg, p.o.) treatment. It significantly attenuated (p < 0.05) elevated glycated hemoglobin, AR activity, oxido-nitrosative stress, neural calcium, and pro-inflammatory cytokines (TNF-α and IL-1β) levels. Histological aberration induced after STZ administration was restored by administration of hesperidin (50 and 100 mg/kg, p.o.) CONCLUSION In combination with insulin, hesperidin not only attenuated the diabetic condition but also reversed neuropathic pain via control over hyperglycemia as well as hyperlipidemia to down-regulate generation of free radical, release of pro-inflammatory cytokines as well as elevation in membrane bound enzyme.
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Affiliation(s)
- Asjad Visnagri
- Department of Pharmacology, Poona College of Pharmacy, Bharati Vidyapeeth Deemed University , Pune, Maharashtra , India
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Hajializadeh Z, Nasri S, Kaeidi A, Sheibani V, Rasoulian B, Esmaeili-Mahani S. Inhibitory effect of Thymus caramanicus Jalas on hyperglycemia-induced apoptosis in in vitro and in vivo models of diabetic neuropathic pain. JOURNAL OF ETHNOPHARMACOLOGY 2014; 153:596-603. [PMID: 24650998 DOI: 10.1016/j.jep.2014.02.049] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 02/24/2014] [Accepted: 02/26/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Since Thymus caramanicus Jalas is used as a folk medicine for the treatment of rheumatism, skin disorders, bacterial infections and diabetes and it contain antioxidant agents, we decided to investigate the possible effects of Thymus caramanicus Jalas (TCJ) extract on in vitro and in vivo models of diabetic neuropathy. MATERIALS AND METHODS The high glucose-induced cell injury in Pheochromocytoma (PC12) cells and streptozotocin-induced diabetic rats were used. Tail-flick and rotarod treadmill assessments were used to determine nociceptive threshold and motor coordination. Cell viability was determined by MTT assay test. Western blotting was performed to measurement of apoptosis markers. RESULTS The data showed that elevation of glucose consecutively increases functional cell injury and apoptosis. Furthermore, diabetic rats developed thermal hyperalgesia and motor deficit. Activated caspase 3, cytochrome c release and Bax/Bcl-2 ratio were significantly increased in high glucose-treated PC12 cells and in spinal cord of diabetic animals. TCJ extract (60 and 80 µg/ml) attenuates high glucose-induced PC12 cells damage and apoptosis. In diabetic animals, TCJ extract at daily doses of 100 and 150 mg/kg ameliorated hyperalgesia and suppressed spinal apoptosis. CONCLUSION The data indicate that TCJ extract has neuroprotective effects against high glucose-induced neural damage. These protective effects are mediated, at least in part, through attenuation of neural apoptosis and suggest therapeutic potential of TCJ extract in amelioration of diabetic neuropathy.
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Affiliation(s)
- Zahra Hajializadeh
- Laboratory of Molecular Neuroscience, Kerman Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran; Department of Biology, PayamNoor University, 19395-4697 Tehran, Iran
| | - Sima Nasri
- Department of Biology, PayamNoor University, 19395-4697 Tehran, Iran
| | - Ayat Kaeidi
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Vahid Sheibani
- Laboratory of Molecular Neuroscience, Kerman Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Bahram Rasoulian
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Saeed Esmaeili-Mahani
- Department of Biology, Faculty of Sciences, Shahid Bahonar University of Kerman, P.O. Box 76135-133, Kerman, Iran.
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