scholarly journals Role of Inflammation in the Pathogenesis of Diabetic Peripheral Neuropathy

2019 ◽  
Vol 7 (14) ◽  
pp. 2267-2270 ◽  
Author(s):  
Daniela Ristikj-Stomnaroska ◽  
Valentina Risteska-Nejashmikj ◽  
Marija Papazova
Keyword(s):  
Peripheral Neuropathy ◽  
Peripheral Nerve ◽  
Diabetic Peripheral Neuropathy ◽  
Test Group ◽  
Nerve Damage ◽  
Control Group ◽  
Average Value ◽  
Peripheral Nerve Damage ◽  
Tnf Α

BACKGROUND: Diabetic peripheral neuropathy (DPN) means the presence of symptoms and/or signs of peripheral nerve damage that occur to people with diabetes, excluding all other causes of neuropathy. Chronic hyperglycaemia leads to increased secretion of tumour necrotic factor-alpha (TNF-α), with the development of micro and macroangiopathy, damage to nerve fibres and local demyelination. AIM: To determine the role of inflammation in the peripheral nerve damage process concerning people suffering from type II diabetes mellitus. MATERIAL AND METHODS: The study included a total of 80 subjects, men and women, divided into two groups: an examined group (n = 50) consisting of subjects with DPN at the age from 30 to 80 years and a control group (n = 30) of healthy subjects aged from 18 to 45. In the investigated group, a neurological examination was performed using the Diabetic Neuropathy Symptoms (DNS) Score and Electroneurography. All the subjects had the blood plasma concentration of TNF-α by ELISA technique. RESULTS: The average value of TNF-α in the test group was 8.24 ± 2.899 pg/ml, while the control group was 4.36 ± 2.622 pg/ml (p < 0.0001). The average value of TNF-α was correlated with the achieved DNS score in the investigated group (p = 0.005). Concerning the linear association of the concentration of TNF-α with the peripheral nerve velocity in the investigated group, no statistical significance was detected. CONCLUSION: Inflammation can play a role in the pathogenesis of diabetic autonomic neuropathy and cranial neuritis.

scholarly journals Persistent Neuropathy in Lepromatous Leprosy Patients

2021 ◽  
Author(s):  
Patricia Penna ◽  
Robson Vital ◽  
IZABELA PITTA ◽  
Mariana Hacker ◽  
Ana Salles ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Peripheral Nerve ◽  
Nerve Biopsy ◽  
Lepromatous Leprosy ◽  
Nerve Damage ◽  
Sensory Nerves ◽  
High Dose ◽  
Peripheral Nerve Damage ◽  
End Of Treatment ◽  
Leprosy Patients

Abstract Lepromatous leprosy (LL) patients have evidence of extensive peripheral nerve damage as soon as a diagnosis is made, but most of them have few or no symptoms related to peripheral neuropathy. Usually, they do not have the cardinal signal of leprosy neuritis. However, disability caused by peripheral nerve injuries has consequences throughout the entire life of these patients and the pathophysiological mechanisms of nerve damage are still poorly understood. The objective of this study was to evaluate the outcome of peripheral neuropathy in a group of LL patients in an attempt to understand the mechanisms of nerve damage. We evaluated medical records of 14 LL patients that had undergone a neurological evaluation at the beginning of Leprosy treatment then worsened at least 4 years after the end of treatment and underwent nerve biopsy. The symptoms at the beginning of treatment were compared with those at the time of the biopsy. Pain was a symptom in only one patient at the beginning and was a complaint in 9 patients by the time of biopsy. Neurological examination showed that the majority of patients already had alterations in medium and large caliber fibers at the beginning of the treatment, and pain increased by the time of biopsy, while neurological symptoms and signs deteriorated independently of the use of prednisone or thalidomide. Nerve Conduction Studies demonstrated that sensory nerves were the most affected. LL patients can develop a silent progressive degenerative peripheral neuropathy, which continues to develop despite high dose long term corticoid therapy.

Autologous bone marrow mononuclear cell transplantation therapy improved symptoms in patients with refractory diabetic peripheral neuropathy via the mechanisms of paracrine and immunomodulation

2020 ◽  
Author(s):  
Wei Wei ◽  
Li Li ◽  
Lin Deng ◽  
Zhong-jing Wang ◽  
Jing-jian Dong ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Peripheral Neuropathy ◽  
Growth Factor ◽  
Diabetic Peripheral Neuropathy ◽  
Autologous Bone Marrow ◽  
Control Group ◽  
Bone Marrow Mononuclear Cell ◽  
Cd34 Cells ◽  
Tnf Α ◽  
Autologous Bone

Abstract Background: We recently reported that transplantation of autologous bone marrow mononuclear cells (BM-MNCs) may be an effective and promising therapy to treat refractory diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). This study was designed to investigate the potential mechanisms of BM-MNCs therapy.Methods: This clinical study recruited 60 patients with DPN, 30 T2DM patients without complications, 30 healthy control participants. All clinical parameters, the levels of inflammatory markers and growth factors in three groups were compared. All patients with DPN received one intramuscular injection of BM-MNCs and clinical follow-ups after the therapy for 2 days, 1, 4, 12, 24, and 48 weeks. Then they were divided into the responder and non-responder groups based on the improvement of nerve conduction velocity. Binary logistic regression was performed to evaluate the corresponding prognostic factors for BM-MNCs treatment.Results: Patients in DPN group had higher level of tumor necrosis factor-α (TNF-α) and lower level of vascular endothelial growth factor (VEGF) than those in control group. DPN group had the highest level of soluble intercellular adhesion molecule-1 (sICAM-1) among three groups. The level of nerve growth factor (NGF) in DPN group was slightly lower than that in DM group. Neuropathic symptoms were significantly improved after BM-MNCs injection. Thirty five of 54 patients with DPN (64.8%) reached the primary endpoint, and were regarded as the responders. Compared to non-responders, responders were younger, had a longer history of diabetes, and had higher numbers of mobilized CD34+ cells and BM-MNCs. The levels of TNF-α and sICAM-1 decreased just after BM-MNCs injection in both groups and slowly reverted to baseline levels. The durations of downtrend of TNF-α and sICAM-1 in responder group lasted longer than that in non-responder group. Serum level of VEGF in responder group increased immediately after BM-MNC therapy, and reached the highest point after the injection for 12 weeks. On the other hand, VEGF levels in the non-responder group only increased slightly. The number of applied CD34+ cells (OR=1.567, 95% CI 1.106-2.222, p=0.012) and duration of diabetes (OR=0.760, 95% CI 0.597-0.967, p=0.025) were the independent predictors of responding to BM-MNCs therapy. No adverse event associated with the treatment was observed during follow-up observations.Conclusions: BM-MNCs transplantation is an effective and promising therapeutic strategy to treat refractory DPN. The immune regulation and paracrine function of BM-MNCs may contribute to the improvement of DPN.

scholarly journals The Macrophage Responses during Diabetic Oral Ulcer Healing by Liquid Coconut Shell Smoke: An Immunohistochemical Analysis

2020 ◽  
Vol 14 (03) ◽  
pp. 410-414 ◽  
Author(s):  
Meircurius Dwi Condro Surboyo ◽  
Fatma Yasmin Mahdani ◽  
Diah Savitri Ernawati ◽  
Andari Sarasati ◽  
Fianza Rezkita
Keyword(s):  
Ulcer Healing ◽  
Test Group ◽  
Food Preservation ◽  
Oral Ulcer ◽  
Coconut Shell ◽  
Control Group ◽  
Natural Food ◽  
Oral Ulcers ◽  
Tnf Α

Abstract Objectives Liquid coconut shell smoke (LC-SS) is used in natural food preservation for a long history. The purpose of this study was to analyze the role of LC-SS in macrophage responses during diabetic oral ulcer healing as medication. Materials and Methods Oral ulcers were induced in the labial lower mucosa of the research subjects using a round steel blade following diabetic induction by means of alloxan. Twenty-four diabetic Wistar rats presenting oral ulcers were divided into two groups, a test group, which was given topical treatment of LC-SS and a control group, which was given benzydamine hydrochloride (BHCl). The role of LC-SS in macrophages was assessed by means of immunohistochemistry for nuclear factor kappa B (NF-κB) and tumor necrosis factor-α (TNF-α) expression. Result LC-SS increased macrophages compared with BHCl (p = 0.000). The LC-SS affected only TNF-α expression by stimulating NF-κB expression (p = 0.046) but did not macrophage numbers (p = 0.861). Conclusion LC-SS has a stronger effect compared with BHCl on diabetic oral ulcer healing by increasing macrophage response to produce TNF-α while decreasing NF-κB expression.

The Role of Muscle Thickness and Echogenicity in the Diagnosis of Diabetic Peripheral Neuropathy

2021 ◽  
Vol 19 (8) ◽  
pp. 113-118
Author(s):  
Zahid M. Kadhim ◽  
Meqat M. Alkhafaji
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Muscle Thickness ◽  
Biceps Femoris ◽  
Lower Limbs ◽  
Control Group ◽  
Medical City ◽  
And Control ◽  
Muscle Ultrasound

Objectives: This study aims to find the thickness of muscles of lower limbs in patients with diabetic peripheral neuropathy (DPN) along with echogenicity and applying these two findings in the diagnosis of the disease. Methods: This is a case-control study conducted in the clinical neurophysiology unit in Merjan medical city. It includes 73 patients diagnosed to have DPN based on characteristic history and physical examination and documented by nerve conduction study. These patients are matched to 73 control that has matched age and sex to the patient group. Patient and control are examined by high-resolution ultrasound (12 MHz linear probes). We assess muscle thickness and echogenicity of the tibialis anterior, biceps femoris, and abductor halluces brevis. Results: The study showed that there was a statistically significant decrease in muscle thickness and increase in echogenicity in all tested muscles when compared to the control group. Also, we calculated the cut-off value with sensitivity and specificity of muscle thickness in the diagnosis of DPN. Conclusion: Muscle ultrasound is a useful complementary test for the diagnosis of DPN.

Efficacy of Habb-e-Asab in diabetic peripheral neuropathy: a randomized placebo control study

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Fathima Nafha Nizamdeen ◽  
Mohd Aleemuddin Quamri ◽  
Md Anzar Alam
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Test Group ◽  
Control Group ◽  
Placebo Control ◽  
Placebo Control Study ◽  
Unani Medicine ◽  
And Control ◽  
Control Study

Abstract Objectives Diabetic peripheral neuropathy (DPN) is a common diabetes complication. The prevalence of neuropathy is 55% for type 1 and 66% for type 2 diabetes. In Unani medicine neuropathy is known as Khidr (numbness). It is treated with drugs possessing hypoglycemic and analgesic properties, etc. Habb-e-Asab, a polyherbal Unani formulation used for the treatment of Waja-ul-Asab (neuralgia) is routinely used for its indications in neurological pain in Unani medicine. The aim of this study to investigate the efficacy of Habb-e-Asab in diabetic peripheral neuropathy. Methods Thirty patients with DPN were randomly assigned to test (n=20) and control (n=10) groups in a randomized single-blind placebo control study. For 45 days, the test group was given 250 mg Habb-e-Asab twice a day and the control group 250 mg placebo twice a day. The subjective parameters Pain in feet, burning in feet, and tingling in feet was assessed by the arbitrary scale and VAS fortnightly and objective parameters MNSI, and VPT was assessed in pre–post-treatment. Results The research drug revealed highly statistically significant with p<0.001 on VAS score and MNSI whereas VPT is significant with p<0.01 on few points. But control group exhibits no significant effect in any of the parameters. No adverse effects had been reported in either group. Conclusions Our finding indicated that the Habb-e-Asab for 45 days improved and reduced the severity of DPN in a patient with diabetes (CTRI/2018/02/011725).

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