New therapeutic approach promises to avoid amputation by diabetic neuropathy

New research indicates that blood vessels and supporting cells appear to be key partners in the repair of nerves destroyed by diabetic neuropathy. Developing this partnership with nerve cells can make the difference between success and failure in efforts to regenerate damaged nerves.

About 20% of diabetics suffer from neuropathy, a tingling, burning or painful numbness in hands and feet which reflects the damage to the nerves and sometimes lead to infections and amputation of fingers, hands or feet. Current treatments for diabetic neuropathy focus on relief of symptoms but not treat the cause of the disease, repairing nerve damage. Previous research has shown that the long extensions of nerve cells, known as axons regenerate slowly in diabetics, according to researcher Michael Polydefkis.

Seeking the reasons behind this slow regeneration, Polydefkis and colleagues recruited 10 patients with diabetic neuropathy and 10 healthy people with similar ages and performed skin biopsies from the thigh of each participant with a tiny punch (3 mm). Several months later, they performed four 4-mm biopsies from the same place to see how the nerves, blood vessels and nerve support cells called Schwann cells were growing again in the healing of the biopsy site.

Both in patients with neuropathy and in healthy subjects, results showed that the first site to grow blood vessels were healing, followed soon after by Schwann cells and axons, which seemed to use blood vessels as scaffolds. However, the whole process significantly delayed for patients with neuropathy. Not only was slower in regenerating axons compared with healthy patients, as expected, but the rate of blood vessel growth was also slower and less Schwann cells accompanied the growth of axons in the skin that healed.

"Our results suggest that regenerative abnormalities associated with diabetes are common. They are not only affecting the nerves, are also affecting the growth of blood vessels and proliferation of Schwann cells," says Polydefkis.

In addition, he said, the findings might explain why the problems related to blood vessels, such as heart attacks and strokes, often accompany diabetes. The slow regeneration of damaged blood vessels could contribute to these diseases as well.

The researcher says the findings provide new potential targets for the treatment of neuropathy and vascular problems. By promoting the growth of blood vessels and Schwann cells, scientists can accelerate the regeneration of axons and successfully repair damaged nerves and blood vessels, potentially fighting diabetic neuropathy and vascular complications simultaneously.

Germany

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