Abnormal innervation of lower limb epineurial arterioles in human diabetes

Grover‐Johnson, Nicola; Baumann, F.Gregory; Imparato, Anthony M.; Kim, G. E.; Thomas, P. K.

doi:10.1007/bf01789110

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Innervation of epineurial microvessels is involved in diabetes, resulting in impaired blood supply in diabetic nerves 21,22 . Endoneurial microvessels show thickened and multilayered basement membranes, cell debris of pericytes, as well as disrupted endothelial cells, and thus constitute salient structural changes in diabetic nerves.…”

Section: Anatomy and Vascular Supply Of Peripheral Nervous Systemmentioning

confidence: 99%

Mechanism of diabetic neuropathy: Where are we now and where to go?

Yagihashi¹,

Mizukami²,

Sugimoto

2010

J of Diabetes Invest

379

271

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Neuropathy is the most common complication of diabetes. As a consequence of longstanding hyperglycemia, a downstream metabolic cascade leads to peripheral nerve injury through an increased flux of the polyol pathway, enhanced advanced glycation end‐products formation, excessive release of cytokines, activation of protein kinase C and exaggerated oxidative stress, as well as other confounding factors. Although these metabolic aberrations are deemed as the main stream for the pathogenesis of diabetic microvascular complications, organ‐specific histological and biochemical characteristics constitute distinct mechanistic processes of neuropathy different from retinopathy or nephropathy. Extremely long axons originating in the small neuronal body are vulnerable on the most distal side as a result of malnutritional axonal support or environmental insults. Sparse vascular supply with impaired autoregulation is likely to cause hypoxic damage in the nerve. Such dual influences exerted by long‐term hyperglycemia are critical for peripheral nerve damage, resulting in distal‐predominant nerve fiber degeneration. More recently, cellular factors derived from the bone marrow also appear to have a strong impact on the development of peripheral nerve pathology. As evident from such complicated processes, inhibition of single metabolic factors might not be sufficient for the treatment of neuropathy, but a combination of several inhibitors might be a promising approach to overcome this serious disorder. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2010.00070.x, 2010)

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Section: Anatomy and Vascular Supply Of Peripheral Nervous Systemmentioning

confidence: 99%

Mechanism of diabetic neuropathy: Where are we now and where to go?

Yagihashi¹,

Mizukami²,

Sugimoto

2010

J of Diabetes Invest

379

271

View full text Add to dashboard Cite

show abstract

“…To explain why peripheral circulatory disturbances develop in the leg rather than the arm of diabetic patients, neuropathy is known to develop more readily in the leg (Grover-Johnson et al, 1981). In diabetic patients, circulatory velocity of the erythrocytes in the capillaries of the leg is significantly lower than that of the arm (Jorneskog et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Thermographic measurement of skin temperature recovery time of extremities in patients with type 2 diabetes mellitus

Fujiwara¹,

Iwamoto²,

Aso³

et al. 2000

Exp Clin Endocrinol Diabetes

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To elucidate the relationship between the recovery of skin temperature in an extremity after exposure to cold water and various factors associated with diabetes, we measured skin temperature in type2 diabetic patients (N=61) and control subjects (N=16). A thermo-tracer was used in thermographic measurements. The right third toe of each subject was immersed in cold water at 0 degrees C for 10 sec. Rt represents the recovery rate of skin temperature at t min after exposure. Rt was significantly reduced in the diabetic patients every 5 min in the 20 min period following exposure compared with control subjects. The diabetic patients group exhibited a significantly positive correlation between R20 and the ankle-brachial index. R20 in the diabetic patients showed a significantly positive correlation with the reduction in systolic blood pressure at the arm observed in Schellong's test. In addition, R20 showed a significantly negative correlation with plasma levels of fibrinogen and plasminogen activator inhibitor-1. However, the severity of diabetic retinopathy and nephropathy was not significantly related to R20 in the diabetic patients. The present data indicate that the recovery of skin temperature after immersion in cold water was markedly reduced in patients with type 2 diabetes mellitus as compared with healthy control subjects. Peripheral arteriosclerosis, impaired sympathetic nerve function and the activation of the blood coagulation system may all contribute to this reduced recovery of skin temperature.

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Abnormal innervation of lower limb epineurial arterioles in human diabetes

Cited by 2 publications

References 29 publications

Mechanism of diabetic neuropathy: Where are we now and where to go?

Mechanism of diabetic neuropathy: Where are we now and where to go?

Thermographic measurement of skin temperature recovery time of extremities in patients with type 2 diabetes mellitus

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