A 52-week multicenter placebo-controlled double-blind parallel group study OBJECTIVE -The purpose of this study was to evaluate the efficacy of fidarestat, a novel aldose reductase (AR) inhibitor, in a double-blind placebo controlled study in patients with type 1 and type 2 diabetes and associated peripheral neuropathy.RESEARCH DESIGN AND METHODS -A total of 279 patients with diabetic neuropathy were treated with placebo or fidarestat at a daily dose of 1 mg for 52 weeks. The efficacy evaluation was based on change in electrophysiological measurements of median and tibial motor nerve conduction velocity, F-wave minimum latency, F-wave conduction velocity (FCV), and median sensory nerve conduction velocity (forearm and distal), as well as an assessment of subjective symptoms.RESULTS -Over the course of the study, five of the eight electrophysiological measures assessed showed significant improvement from baseline in the fidarestat-treated group, whereas no measure showed significant deterioration. In contrast, in the placebo group, no electrophysiological measure was improved, and one measure significantly deteriorated (i.e., median nerve FCV). At the study conclusion, the fidarestat-treated group was significantly improved compared with the placebo group in two electrophysiological measures (i.e., median nerve FCV and minimal latency). Subjective symptoms (including numbness, spontaneous pain, sensation of rigidity, paresthesia in the sole upon walking, heaviness in the foot, and hypesthesia) benefited from fidarestat treatment, and all were significantly improved in the treated versus placebo group at the study conclusion. At the dose used, fidarestat was well tolerated, with an adverse event profile that did not significantly differ from that seen in the placebo group.CONCLUSIONS -The effects of fidarestat-treatment on nerve conduction and the subjective symptoms of diabetic neuropathy provide evidence that this treatment alters the progression of diabetic neuropathy. Diabetes Care 24:1776 -1782, 2001D iabetic neuropathy is a degenerative disorder triggered by persistent hyperglycemia. The degenerative changes, consisting of axonal atrophy, demyelination, nerve fiber loss, and disordered nerve fiber repair, develop and progress even in the early stage of diabetes. Axonal atrophy, demyelination, and disordered repair can be clinically assessed as a decline in nerve conduction velocity. During hyperglycemia, nerve maturation secondary to nerve fiber loss is also disturbed. Abnormal excitement of these immaturely regenerated nerve fibers causes spontaneous pain, numbness, and paresthesia (1-3). In the majority of patients, these changes, characteristic of diabetic neuropathy, considerably deteriorate the quality of life.After the onset of subjective symptoms, only palliative treatments are currently available. Accordingly, early diagnosis and treatment before the onset of subjective symptoms is considered essential. Diabetic neuropathy is a long-term complication of diabetes that should not be underestimated, bec...

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The localization of the alpha subunit of the S-100 protein (S-100 alpha) and beta subunit (S-100 beta) was studied in the peripheral nervous system of the rat. In peripheral nerves, S-100 alpha and S-100 beta were found in the cytoplasm of Schwann cells. Axons were positively stained in part by S-100 alpha and almost totally by S-100 beta. In the dorsal root ganglia, S-100 alpha was found in satellite cells and their processes and in some neurons. S-100 beta was found in more of the large neurons, but almost all of the small neurons were negative for S-100 beta. In the anterior horn cells, S-100 beta staining was stronger than that of S-100 alpha. In Schwann cells, both S-100 alpha and S-100 beta were present on the rough endoplasmic reticulum, free ribosomes, and nucleus, as seen by electron microscopy. The S-100 alpha and S-100 beta in axons were associated with microtubules and neurofilaments.

Pniifrd in Bel~iiiiii -a// right.i resened Copyighr 0 Munksgourd IY 94 4CTA NEUROLOGICA SCANDINAVICA value of cerebrospinal fluid neuron-specific enolase and S-lOOb protein in Guillain-Barre syndrome. Acta Neurol Scand 1994: 89: 27-30. 0 Munksgaard 1994.We measured the cerebrospinal fluid (CSF) concentrations of neuron-specific enolase (NSE) and S-100b protein (S-100b) using enzyme immunoassay methods, in 24 patients with Guillain-Barre syndrome and 46 controls, and examined their prognostic values. Sixteen of 24 patients showed elevated levels ( > the mean + 2SD levels of controls) of NSE, S-IOOb, or both, and in those with higher NSE or S-100b levels there was a rather longer Material and methodsGBS pafients -Twenty-four patients (1 5 men and 9 women) aged 14 to 64years old (mean? SD,