Quantitative analysis of corneal nerve fibers in type 2 diabetics with and without diabetic peripheral neuropathy: Comparison of manual and automated assessments

2019 ◽  
Vol 151 ◽  
pp. 33-38 ◽  
Author(s):  
Qingchun Li ◽  
Ying Zhong ◽  
Tiansong Zhang ◽  
Ruiyun Zhang ◽  
Qi Zhang ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Nerve Fibers ◽  
Type 2 Diabetics ◽  
Corneal Nerve

scholarly journals The Association between Serum Cytokines and Damage to Large and Small Nerve Fibers in Diabetic Peripheral Neuropathy

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Francesca Magrinelli ◽  
Chiara Briani ◽  
Marcello Romano ◽  
Susanna Ruggero ◽  
Elisabetta Toffanin ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Nerve Fiber ◽  
Diabetic Peripheral Neuropathy ◽  
Motor Nerve ◽  
Serum Levels ◽  
Nerve Fibers ◽  
Fiber Damage ◽  
Serum Cytokines ◽  
Small Nerve

Diabetic peripheral neuropathy (DPN) is a frequent complication of type 2 diabetes mellitus (DM) and may involve small and large peripheral nerve fibers. Recent evidence suggests a role of cytokines in DPN. The paper is aimed at exploring whether the serum concentration of cytokines is associated with small and large nerve fiber function and with neuropathic pain (NP). We recruited a group of 32 type 2 DM patients who underwent serum cytokines (TNF-α, IL-2, IL-4, IL-6, and IL-10) dosage as well as electrodiagnostic and quantitative sensory testing (QST) assessment to explore damage to large and small nerve fibers. Raised serum levels of IL-6 and IL-10 correlated with markers of large nerve fiber sensory and motor axonal damage. Raised IL-10 serum level was associated with signs of motor nerve demyelination. No differences were found in pain characteristics and electrodiagnostic and QST markers of small nerve fiber function in relation to cytokines serum levels. IL-6 and IL-10 serum levels were associated with large nerve fiber damage but not to small fibers function or NP. IL-6 and IL-10 cytokines might play a role in the pathogenesis of nerve fiber damage or represent a compensatory or neuroprotective mechanism.

scholarly journals Nerve and Vascular Biomarkers in Skin Biopsies Differentiate Painful From Painless Peripheral Neuropathy in Type 2 Diabetes

2021 ◽  
Vol 2 ◽  
Author(s):  
Pallai Shillo ◽  
Yiangos Yiangou ◽  
Philippe Donatien ◽  
Marni Greig ◽  
Dinesh Selvarajah ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Blood Vessels ◽  
Diabetic Peripheral Neuropathy ◽  
Nerve Fibers ◽  
Pain Mechanisms ◽  
Painful Diabetic Peripheral Neuropathy ◽  
Skin Biopsies ◽  
Vascular Biomarkers

Painful diabetic peripheral neuropathy can be intractable with a major impact, yet the underlying pain mechanisms remain uncertain. A range of neuronal and vascular biomarkers was investigated in painful diabetic peripheral neuropathy (painful-DPN) and painless-DPN and used to differentiate painful-DPN from painless-DPN. Skin biopsies were collected from 61 patients with type 2 diabetes (T2D), and 19 healthy volunteers (HV). All subjects underwent detailed clinical and neurophysiological assessments. Based on the neuropathy composite score of the lower limbs [NIS(LL)] plus seven tests, the T2D subjects were subsequently divided into three groups: painful-DPN (n = 23), painless-DPN (n = 19), and No-DPN (n = 19). All subjects underwent punch skin biopsy, and immunohistochemistry used to quantify total intraepidermal nerve fibers (IENF) with protein gene product 9.5 (PGP9.5), regenerating nerve fibers with growth-associated protein 43 (GAP43), peptidergic nerve fibers with calcitonin gene-related peptide (CGRP), and blood vessels with von Willebrand Factor (vWF). The results showed that IENF density was severely decreased (p < 0.001) in both DPN groups, with no differences for PGP9.5, GAP43, CGRP, or GAP43/PGP9.5 ratios. There was a significant increase in blood vessel (vWF) density in painless-DPN and No-DPN groups compared to the HV group, but this was markedly greater in the painful-DPN group, and significantly higher than in the painless-DPN group (p < 0.0001). The ratio of sub-epidermal nerve fiber (SENF) density of CGRP:vWF showed a significant decrease in painful-DPN vs. painless-DPN (p = 0.014). In patients with T2D with advanced DPN, increased dermal vasculature and its ratio to nociceptors may differentiate painful-DPN from painless-DPN. We hypothesized that hypoxia-induced increase of blood vessels, which secrete algogenic substances including nerve growth factor (NGF), may expose their associated nociceptor fibers to a relative excess of algogens, thus leading to painful-DPN.

Vitamin D Status in a Bulgarian Population With Type 2 Diabetes and Diabetic Foot Ulcers

2020 ◽  
pp. 153473462096582
Author(s):  
Ani S. Todorova ◽  
Edward B. Jude ◽  
Rumyana B. Dimova ◽  
Nevena Y. Chakarova ◽  
Mina S. Serdarova ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Diabetic Peripheral Neuropathy ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vitamin D Status ◽  
Active Infection

The aim of this study was to assess vitamin D status in patients with type 2 diabetes and diabetic foot ulcers (DFU). A total of 242 participants with type 2 diabetes, mean age 59.1 ± 10 years, mean body mass index 31.4 ± 6.3 kg/m2, and estimated glomerular filtration rate ≥45 mL/min/1.73m2, were divided into 2 groups: 73 with DFU (35 with and 38 without active infection) and 169 without DFU (106 with diabetic peripheral neuropathy, 63 without complications). Neuropathy was assessed by 10 g monofilament, Rydel-Seiffer 128 Hz tuning fork, and temperature discrimination. Serum 25(OH)D (25-hydroxy vitamin D) was assessed by ECLIA (electro-chemiluminescence immunoassay) method. Median 25(OH)D level was 12.6 ng/mL (IQR [interquartile range] 9.3-17.6 ng/mL) in the studied cohort. The DFU group presented with lower 25(OH)D level as compared with diabetic patients without foot ulcers (non-DFU group): 11.6 ng/mL (IQR 8.5-15.8 ng/mL) versus 13.5 ng/mL (IQR 9.6-18.6 ng/mL), P = .001; the diabetic peripheral neuropathy subgroup demonstrated lower 25(OH)D level in comparison with participants without complications: 12.5 ng/mL (IQR 9-17.2 ng/mL) versus 15.9 ng/mL (IQR 10.4-20.8 ng/mL), P = .031. This remained significantly different even after correction for age and duration of diabetes. There was no difference in 25(OH)D level between the subgroups according to the presence of active infection. In conclusion, vitamin D deficiency may play a role in the development of diabetes complications.

Diabetic neuropathy: Epidemiological, pathogenetic, and clinical aspects with special emphasis on type 2 diabetes mellitus

1983 ◽  
Vol 104 (4_Suppl) ◽  
pp. S89-S94
Author(s):  
E. Matikainen ◽  
J. Juntunen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Control ◽  
Clinical Aspects ◽  
Type 2 Diabetics ◽  
Insulin Dependent

ABSTRACT. Peripheral neuropathy is a frequent complication of diabetes mellitus. Alterations of the peripheral nervous system in diabetics have been studied in numerous investigations. There are many factors known to participate in the development of this complication, e.g. the age of the patient, duration of the diabetes, quality of the diabetic control etc. The role of different types of diabetes in development of neuropathy is still largely unclear since investigations on this aspect are few. It seems, however, that peripheral neuropathy in type 2 (non-insulin dependent) diabetes is common but often mild. The differential diagnosis of the peripheral neuropathy in type 2 diabetics is more difficult than in type 1 (insulin dependent) diabetics, since these patients tend to be older and also may have other concomitant disorders. In this paper the clinical features and pathogenetic mechanisms of neuropathy in type 2 diabetes are briefly discussed.

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