2018
DOI: 10.1111/jdi.12833
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Diabetic neuropathy and the sensory neuron: New aspects of pathogenesis and their treatment implications

Abstract: Diabetic polyneuropathy (DPN) continues to be generally considered as a “microvascular” complication of diabetes mellitus alongside nephropathy and retinopathy. The microvascular hypothesis, however, might be tempered by the concept that diabetes directly targets dorsal root ganglion sensory neurons. This neuron‐specific concept, supported by accumulating evidence, might account for important features of DPN, such as its early sensory neuron degeneration. Diabetic sensory neurons develop neuronal atrophy along… Show more

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Cited by 121 publications
(80 citation statements)
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“…Investigations into DRG pathology in human diabetes are lacking because human DRG biopsies are not ethical to carry out and because there is a rapid degradation during the post‐mortem interval at autopsy . Therefore, it is difficult to obtain DRG for diagnosis and treatment of the biochemical alterations linked to diabetic neuropathy, for example.…”
Section: Resultssupporting
confidence: 88%
See 1 more Smart Citation
“…Investigations into DRG pathology in human diabetes are lacking because human DRG biopsies are not ethical to carry out and because there is a rapid degradation during the post‐mortem interval at autopsy . Therefore, it is difficult to obtain DRG for diagnosis and treatment of the biochemical alterations linked to diabetic neuropathy, for example.…”
Section: Resultssupporting
confidence: 88%
“…Patients with untreated diabetic neuropathy develop a gradual and insidious damage to the sensory peripheral nerves, which also involves the neuronal cell bodies, located in the DRG . Satellite cells and the DRG neuronal cell bodies form a functional unit and as such contribute to the functioning of DRG in disease (for review, see Reference ).…”
Section: Resultsmentioning
confidence: 92%
“…Diabetic neuropathy (DN) refers to a collection of clinically diverse disorders affecting the nervous system, with differing anatomic features, clinical courses and phenotypes 37 . Patients with DN have sensory loss or pain, but the symptoms differ depending on the nerves involved 18,38 . Diabetic polyneuropathy, which has a lifetime prevalence of approximately 50% in people with diabetes, is the most common complication from diabetes 39 .…”
Section: Resultsmentioning
confidence: 99%
“…Chronic hyperglycemia and increased levels of HbA1c lead to peripheral nerve injury through an array of complex mechanisms that include the overactivation of the polyol pathway and accumulation of sorbitol [4], alterations of myoinositol [5], protein synthesis deficiency (myelin among others) [6], formation of advanced glycation end products, and oxidative stress [6,7]. These interlinked metabolic pathways converge, activating the transcription factor NF-kB, which induces the expression of genes involved in inflammation, triggering pro-inflammatory and immune responses [3,[8][9][10]. Also, under hyperglycaemic conditions, microvascular alterations result and contribute to the development of DPN via tissue hypoxia and nerve ischemia [10][11][12].…”
Section: Introductionmentioning
confidence: 99%
“…These interlinked metabolic pathways converge, activating the transcription factor NF-kB, which induces the expression of genes involved in inflammation, triggering pro-inflammatory and immune responses [3,[8][9][10]. Also, under hyperglycaemic conditions, microvascular alterations result and contribute to the development of DPN via tissue hypoxia and nerve ischemia [10][11][12].…”
Section: Introductionmentioning
confidence: 99%