Diabetic neuropathy: cellular mechanisms as therapeutic targets.
Authors Vincent AM, Callaghan BC, Smith AL, Feldman EL
Submitted By Eva Feldman on 2/22/2012
Status Published
Journal Nature reviews. Neurology
Year 2011
Date Published 10/1/2011
Volume : Pages 7 : 573 - 583
PubMed Reference 21912405
Abstract In patients with diabetes, nerve injury is a common complication that leads to
chronic pain, numbness and substantial loss of quality of life. Good glycemic
control can decrease the incidence of diabetic neuropathy, but more than half of
all patients with diabetes still develop this complication. There is no approved
treatment to prevent or halt diabetic neuropathy, and only symptomatic pain
therapies, with variable efficacy, are available. New insights into the
mechanisms leading to the development of diabetic neuropathy continue to point
to systemic and cellular imbalances in metabolites of glucose and lipids. In the
PNS, sensory neurons, Schwann cells and the microvascular endothelium are
vulnerable to oxidative and inflammatory stress in the presence of these altered
metabolic substrates. This Review discusses the emerging cellular mechanisms
that are activated in the diabetic milieu of hyperglycemia, dyslipidemia and
impaired insulin signaling. We highlight the pathways to cellular injury,
thereby identifying promising therapeutic targets, including mitochondrial
function and inflammation.

Investigators with authorship
Eva FeldmanUniversity of Michigan