Novel therapeutical approaches based on neurobiological and genetic strategies for diabetic polyneuropathy – A review

Sher, Emina Karahmet; Džidić-Krivić, Amina; Karahmet, Alma; Beća-Zećo, Merima; Farhat, Esma Karahmet; Softić, Adaleta; Sher, Farooq

doi:10.1016/j.dsx.2023.102901

Cited by 4 publications

(1 citation statement)

References 68 publications

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“…DKD can be categorized into two distinct phenotypes: (1) the classical albuminuric phenotype, which exhibits histological signs of diabetic glomerulopathy, and the non-albuminuric phenotype, characterized by prevalent atherosclerosis, atypical vascular lesions and/or tubulointerstitial fibrosis with a relatively intact glomerular structure. All patients should conduct thorough evaluations of nephropathy (including albumin, estimated glomerular filtrate [eGFR]), neuropathy (incorporating a detailed history, temperature assessment, pinprick sensation, vibration sensation, and monofilament testing), and retinopathy (requiring a comprehensive eye examination) at the initial onset of T2D, and no later than 5 years after the diagnosis of TID, and at least annually thereafter [ 3 , 4 ]. Among them, the diagnosis of diabetic autonomic neuropathy is an exclusive diagnosis, which needs to comprehensively consider the patient’s history of diabetes, clinical symptoms, and related examinations.…”

Section: Introductionmentioning

confidence: 99%

Recent Advances in the Management of Diabetic Kidney Disease: Slowing Progression

Wang,

Zhang

2024

IJMS

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Diabetic kidney disease (DKD) is a major cause of chronic kidney disease (CKD), and it heightens the risk of cardiovascular incidents. The pathogenesis of DKD is thought to involve hemodynamic, inflammatory, and metabolic factors that converge on the fibrotic pathway. Genetic predisposition and unhealthy lifestyle practices both play a significant role in the development and progression of DKD. In spite of the recent emergence of angiotensin receptors blockers (ARBs)/angiotensin converting enzyme inhibitor (ACEI), sodium-glucose cotransporter 2 (SGLT2) inhibitors, and nonsteroidal mineralocorticoid receptors antagonists (NS-MRAs), current therapies still fail to effectively arrest the progression of DKD. Glucagon-like peptide 1 receptor agonists (GLP-1RAs), a promising class of agents, possess the potential to act as renal protectors, effectively slowing the progression of DKD. Other agents, including pentoxifylline (PTF), selonsertib, and baricitinib hold great promise as potential therapies for DKD due to their anti-inflammatory and antifibrotic properties. Multidisciplinary treatment, encompassing lifestyle modifications and drug therapy, can effectively decelerate the progression of DKD. Based on the treatment of heart failure, it is recommended to use multiple drugs in combination rather than a single-use drug for the treatment of DKD. Unearthing the mechanisms underlying DKD is urgent to optimize the management of DKD. Inflammatory and fibrotic factors (including IL-1, MCP-1, MMP-9, CTGF, TNF-a and TGF-β1), along with lncRNAs, not only serve as diagnostic biomarkers, but also hold promise as therapeutic targets. In this review, we delve into the potential mechanisms and the current therapies of DKD. We also explore the additional value of combing these therapies to develop novel treatment strategies. Drawing from the current understanding of DKD pathogenesis, we propose HIF inhibitors, AGE inhibitors, and epigenetic modifications as promising therapeutic targets for the future.

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Section: Introductionmentioning

confidence: 99%

Recent Advances in the Management of Diabetic Kidney Disease: Slowing Progression

Wang,

Zhang

2024

IJMS

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Protective role of SIRT1 (rs3758391 T > C) polymorphism against T2DM and its complications: Influence on GPx activity

Naseri,

Khalili,

Rahimi

et al. 2024

Health Science Reports

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Background and AimsSirtuin‐1 (SIRT1) has antidiabetic effects through the regulation of insulin secretion and modulation of inflammation. The SIRT1 rs3758391 gene polymorphism affects the level of SIRT1. The current study aimed to investigate the possible influence of SIRT1 gene variants in relation to oxidative stress parameters on the susceptibility to type 2 diabetes mellitus (T2DM) and its microvascular complications.MethodsIn this case‐control study 398 individuals including 300 patients with T2DM (100 T2DM without complication, 100 diabetic neuropathy patients and 100 patients with diabetic retinopathy) and 98 healthy subjects were studied for SIRT1 rs3758391 T > C variants. Also, the glutathione peroxidase (GPx) activity and the levels of glutathione (GSH), malondialdehyde (MDA), total antioxidant capacity (TAC), and total oxidative status (TOS) were determined by colorimetric methods. SIRT1 genotypes were detected using the polymerase chain reaction‐restriction fragment length polymorphism method.ResultsThe C allele of SIRT1 reduced the risk of T2DM, diabetic neuropathy and diabetic retinopathy. Significantly lower levels of GSH, GPx, and TAC were found in diabetic patients compared to control group. However, the level of MDA was significantly higher in patients compared to healthy individuals. Considering all individuals, the GPx activity increased in the presence of the SIRT1 CC, and TC genotypes compared to the TT genotype. Among all studied individuals the activity of GPx was significantly higher in normal body mass index (BMI) subjects than overweight, and obese individuals. However, among overweight and obese diabetic, diabetic retinopathy and diabetic neuropathy patients the mean level of TOS was significantly higher compared to patients with normal BMI.ConclusionsOur findings suggest a protective role for SIRT1 C allele against T2DM and diabetic neuropathy and diabetic retinopathy. We found in the presence of this allele the GPx activity increased. Also, we detected an enhanced oxidative stress level among overweight and obese patients with diabetes and its complications that could be involved in the pathogenesis of the disease.

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VEGF-B is involved in diabetic peripheral neuropathy in patients with type 2 diabetes

Zhou,

Xue,

Zhu

et al. 2024

Growth Factors

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Novel therapeutical approaches based on neurobiological and genetic strategies for diabetic polyneuropathy – A review

Cited by 4 publications

References 68 publications

Recent Advances in the Management of Diabetic Kidney Disease: Slowing Progression

Recent Advances in the Management of Diabetic Kidney Disease: Slowing Progression

Protective role of SIRT1 (rs3758391 T > C) polymorphism against T2DM and its complications: Influence on GPx activity

VEGF-B is involved in diabetic peripheral neuropathy in patients with type 2 diabetes

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