|
糖尿病周围神经病变相关生物学标志物研究进展
|
Abstract:
糖尿病周围神经病变(DPN)是糖尿病最常见的慢性并发症,起病隐匿可导致足部溃疡及疼痛、步态紊乱、坏疽,严重降低患者生活质量甚至导致截肢、致死,而当前尚无逆转方法。目前发病机制尚未明确,近年来各项研究表明,多种生物标志物参与DPN的发生发展,本文就对DPN相关的生物学标志物研究进展进行阐述,为DPN的诊断及治疗提供新方向。
Diabetic peripheral neuropathy (DPN) is the most common chronic complication of diabetes, which can lead to foot ulcers and pain, gait disorders, gangrene, seriously reducing the quality of life of pa-tients and even leading to amputation and death, and there is currently no way to reverse it. At present, the pathogenesis is not clear, and various studies in recent years have shown that a variety of biomarkers are involved in the occurrence and development of DPN, and this article elaborates on the research progress of DPN-related biological markers, which provides a new direction for the diagnosis and treatment of DPN.
[1] | 中华医学会糖尿病学分会神经并发症学组. 糖尿病神经病变诊治专家共识(2021年版) [J]. 中华糖尿病杂志, 2021, 13(6): 540-557. |
[2] | Hicks, C.W. and Selvin, E. (2019) Epidemiology of Peripheral Neuropathy and Lower Ex-tremity Disease in Diabetes. Current Diabetes Reports, 19, 86. https://doi.org/10.1007/s11892-019-1212-8 |
[3] | Feldman, E.L., Nave, K.A., Jensen, T.S., et al. (2017) New Hori-zons in Diabetic Neuropathy: Mechanisms, Bioenergetics, and Pain. Neuron, 93, 1296-1313. https://doi.org/10.1016/j.neuron.2017.02.005 |
[4] | Sadosky, A., Schaefer, C., Mann, R., et al. (2013) Burden of Illness Associated with Painful Diabetic Peripheral Neuropathy among Adults Seeking Treatment in the US: Results from a Retrospective Chart Review and Cross-Sectional Survey. Diabetes, Metabolic Syndrome and Obesity, 6, 79-92. https://doi.org/10.2147/DMSO.S37415 |
[5] | Aghamiri, S.H., Komlakh, K. and Ghaffari, M. (2022) The Crosstalk among TLR2, TLR4 and Pathogenic Pathways; a Treasure Trove for Treatment of Diabetic Neuropathy. Inflammophar-macology, 30, 51-60.
https://doi.org/10.1007/s10787-021-00919-3 |
[6] | Mu, Z.P., Wang, Y.G., Li, C.Q., et al. (2017) Association be-tween Tumor Necrosis Factor-α and Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes: A Meta-Analysis. Molecular Neurobiology, 52, 983-996.
https://doi.org/10.1007/s12035-016-9702-z |
[7] | Elzinga, S., Murdock, B.J., Guo, K., et al. (2019) Toll-Like Re-ceptors and Inflammation in Metabolic Neuropathy; a Role in Early versus Late Disease? Experimental Neurology, 320, Article ID: 112967.
https://doi.org/10.1016/j.expneurol.2019.112967 |
[8] | Zhu, T., Meng, Q., Ji, J., et al. (2015) Toll-Like Receptor 4 and Tumor Necrosis Factor-Alpha as Diagnostic Biomarkers for Diabetic Peripheral Neuropathy. Neuroscience Letters, 585, 28-32. https://doi.org/10.1016/j.neulet.2014.11.020 |
[9] | Rudofsky, G., Reismann, P., Witte, S., et al. (2004) Asp299Gly and Thr399Ile Genotypes of the TLR4 Gene Are Associated with a Reduced Prevalence of Diabetic Neurop-athy in Patients with Type 2 Diabetes. Diabetes Care, 27, 179-183. https://doi.org/10.2337/diacare.27.1.179 |
[10] | Lehmann, S.M., Krüger, C., Park, B., et al. (2012) An Unconven-tional Role for miRNA: Let-7 Activates Toll-Like Receptor 7 and Causes Neurodegeneration. Nature Neuroscience, 15, 827-835. https://doi.org/10.1038/nn.3113 |
[11] | Bali, K.K. and Kuner, R. (2014) Noncoding RNAs: Key Molecules in Understanding and Treating Pain. Trends in Molecular Medicine, 20, 437-448. https://doi.org/10.1016/j.molmed.2014.05.006 |
[12] | Yang, K., He, Y.S., Wang, X.Q., et al. (2011) MiR-146a In-hibits Oxidized Low-Density Lipoprotein-Induced Lipid Accumulation and Inflammatory Response via Targeting Toll-Like Receptor 4. FEBS Letters, 585, 854-860.
https://doi.org/10.1016/j.febslet.2011.02.009 |
[13] | Feng, Y., Chen, L., Luo, Q., et al. (2018) Involvement of mi-croRNA-146a in Diabetic Peripheral Neuropathy through the Regulation of Inflammation. Drug Design, Development and Therapy, 12, 171-177.
https://doi.org/10.2147/DDDT.S157109 |
[14] | 王征, 李艳芳. microRNA-146a在2型糖尿病周围神经病变患者血清中的表达及其临床意义[J]. 中国慢性病预防与控制, 2019, 27(1): 28-31. |
[15] | Fukunaga, M., Miyata, S., Higo, S., et al. (2005) Methylglyoxal Induces Apoptosis through Oxidative Stress-Mediated Activation of p38 Mito-gen-Activated Protein Kinase in Rat Schwann Cells. Annals of the New York Academy of Sciences, 1043, 151-157. https://doi.org/10.1196/annals.1333.019 |
[16] | Sugimoto, K., Nishizawa, Y., Horiuchi, S., et al. (1997) Localization in Human Diabetic Peripheral Nerve of N(epsilon)-carboxymethyllysine-Protein Adducts, an Advanced Glycation End-product. Diabetologia, 40, 1380-1387.
https://doi.org/10.1007/s001250050839 |
[17] | Bierhaus, A., Haslbeck, K.M., Humpert, P.M., et al. (2004) Loss of Pain Perception in Diabetes Is Dependent on a Receptor of the Immunoglobulin Superfamily. The Journal of Clinical In-vestigation, 114, 1741-1751.
https://doi.org/10.1172/JCI18058 |
[18] | Thornalley, P.J. (2002) Glycation in Diabetic Neuropathy: Characteristics, Consequences, Causes, and Therapeutic Options. International Review of Neurobiology, 50, 37-57. https://doi.org/10.1016/S0074-7742(02)50072-6 |
[19] | Skapare, E., Konrade, I., Liepinsh, E., et al. (2013) Associa-tion of Reduced Glyoxalase 1 Activity and Painful Peripheral Diabetic Neuropathy in Type 1 and 2 Diabetes Mellitus Pa-tients. Journal of Diabetes and Its Complications, 27, 262-267. https://doi.org/10.1016/j.jdiacomp.2012.12.002 |
[20] | Groener, J.B., Reismann, P., Fleming, T., et al. (2013) C332C Genotype of Glyoxalase 1 and Its Association with Late Diabetic Complications.Experimental and Clinical Endocrinolo-gy & Diabetes, 121, 436-439.
https://doi.org/10.1055/s-0033-1345124 |
[21] | Negi, G., Kumar, A., Joshi, R.P., et al. (2011) Oxidative Stress and Nrf2 in the Pathophysiology of Diabetic Neuropathy: Old Perspective with a New Angle. Biochemical and Biophysical Research Communications, 408, 1-5.
https://doi.org/10.1016/j.bbrc.2011.03.087 |
[22] | Xu, C., Hou, B., He, P., et al. (2020) Neuroprotective Effect of Salvianolic Acid A against Diabetic Peripheral Neuropathy through Modulation of Nrf2. Oxidative Medicine and Cellular Longevity, 2020, Article ID: 6431459.
https://doi.org/10.1155/2020/6431459 |
[23] | Odagiri, E. (2005) Neuron Specific Enolase. Nihon Rinsho, 63, 717-719. |
[24] | Li, J., Zhang, H., Xie, M., et al. (2013) NSE, a Potential Biomarker, Is Closely Connected to Diabetic Pe-ripheral Neuropathy. Diabetes Care, 36, 3405-3410. https://doi.org/10.2337/dc13-0590 |
[25] | Ummer, V.S., Maiya, A.G., et al. (2020) Effect of Photobiomodulation on Serum Neuron Specific Enolase (NSE) among Patients with Diabetic Peripheral Neuropathy—A Pilot Study. Diabetology & Metabolic Syndrome, 14, 1061-1063.
https://doi.org/10.1016/j.dsx.2020.06.065 |
[26] | Morgenstern, J., Groener, J.B., Jende, J.M.E., et al. (2021) Neu-ron-Specific Biomarkers Predict Hypo- and Hyperalgesia in Individuals with Diabetic Peripheral Neuropathy. Diabetolo-gia, 64, 2843-2855.
https://doi.org/10.1007/s00125-021-05557-6 |
[27] | Park, H.T., Kim, Y.H., Lee, K.E., et al. (2020) Behind the Pa-thology of Macrophage-Associated Demyelination in Inflammatory Neuropathies: Demyelinating Schwann Cells. Cellu-lar and Molecular Life Sciences, 77, 2497-2506.
https://doi.org/10.1007/s00018-019-03431-8 |
[28] | Jende, J.M.E., Groener, J.B., Kender, Z., et al. (2020) Structural Nerve Remodeling at 3-T MR Neurography Differs between Painful and Painless Diabetic Polyneuropathy in Type 1 or 2 Diabetes. Radiology, 294, 405-414.
https://doi.org/10.1148/radiol.2019191347 |
[29] | Groener, J.B., Jende, J.M.E., Kurz, F.T., et al. (2020) Understand-ing Diabetic Neuropathy—From Subclinical Nerve Lesions to Severe Nerve Fiber Deficits: A Cross-Sectional Study in Patients with Type 2 Diabetes and Healthy Control Subjects. Diabetes, 69, 436-447. https://doi.org/10.2337/db19-0197 |
[30] | Sandelius, ?., Zetterberg, H., Blennow, K., et al. (2018) Plasma Neurofil-ament Light Chain Concentration in the Inherited Peripheral Neuropathies. Neurology, 90, e518-e524. https://doi.org/10.1212/WNL.0000000000004932 |
[31] | Evans, L.J., Loescher, A.R., Boissonade, F.M., et al. (2014) Temporal Mismatch between Pain Behaviour, Skin Nerve Growth Factor and Intra-Epidermal Nerve Fibre Density in Trigeminal Neuropathic Pain. BMC Neuroscience, 15, 1.
https://doi.org/10.1186/1471-2202-15-1 |
[32] | Kim, H.C., Cho, Y.J., Ahn, C.W., et al. (2009) Nerve Growth Factor and Expression of Its Receptors in Patients with Diabetic Neuropathy. Diabetic Medicine, 26, 1228-1234. https://doi.org/10.1111/j.1464-5491.2009.02856.x |
[33] | Sun, Q., Tang, D.D., Yin, E.G., et al. (2018) Diagnostic Significance of Serum Levels of Nerve Growth Factor and Brain Derived Neurotrophic Factor in Diabetic Peripheral Neuropathy. Medical Science Monitor, 24, 5943-5950.
https://doi.org/10.12659/MSM.909449 |
[34] | Faradji, V. and Sotelo, J. (1990) Low Serum Levels of Nerve Growth Factor in Diabetic Neuropathy. Acta Neurologica Scandinavica, 81, 402-406. https://doi.org/10.1111/j.1600-0404.1990.tb00984.x |
[35] | Kamiya, H., Zhangm, W. and Sima, A.A. (2005) Apop-totic Stress Is Counterbalanced by Survival Elements Preventing Programmed Cell Death of Dorsal Root Ganglions in Subacute Type 1 Diabetic BB/Wor Rats. Diabetes, 54, 3288-3295.
https://doi.org/10.2337/diabetes.54.11.3288 |
[36] | Benn, S.C., Perrelet, D., Kato, A.C., et al. (2002) Hsp27 Upregu-lation and Phosphorylation Is Required for Injured Sensory and Motor Neuron Survival. Neuron, 36, 45-56. https://doi.org/10.1016/S0896-6273(02)00941-8 |