Emerging Biomarkers, Tools, and Treatments for Diabetic Polyneuropathy

Bönhof, Gidon J.; Herder, Christian; Strom, Alexander; Παπάνας, Νικόλαος; Roden, Michael; Ziegler, Dan

doi:10.1210/er.2018-00107

Cited by 163 publications

(162 citation statements)

References 362 publications

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“…VibraTip performs very well against both the NDS C 3 and NDS C 6 thresholds, but particularly against the NDS C 6 threshold. It is not necessary to examine sites other than the hallux with the Vibratip as the inclusion of addional sites in the examination provides only a very slight improvement in Overall, VibraTip appears to merit further use in clinical practice [14], which will promote larger-scale patient screening and improve early DSPN diagnosis [3,[15][16][17], in harmony with the need for a quick and reliable comprehensive foot examination [18].…”

Section: Discussionmentioning

confidence: 99%

“…In practice, it usually manifests as distal symmetrical polyneuropathy (DSPN), a chronic, insidious, duration-dependent sensory or sensorimotor neuropathy [1,2]. DSPN is a cardinal aetiological factor for diabetic foot lesions, and it may also lead to chronic pain and other further complications [1,3]. To avoid these complications, timely diagnosis of DSPN is an absolute priority [1,3].…”

Section: Introductionmentioning

confidence: 99%

“…DSPN is a cardinal aetiological factor for diabetic foot lesions, and it may also lead to chronic pain and other further complications [1,3]. To avoid these complications, timely diagnosis of DSPN is an absolute priority [1,3]. Clinical examination encompassing sensory and motor modalities remains the cornerstone of diagnosis in realworld settings [1,3].…”

Section: Introductionmentioning

confidence: 99%

“…To avoid these complications, timely diagnosis of DSPN is an absolute priority [1,3]. Clinical examination encompassing sensory and motor modalities remains the cornerstone of diagnosis in realworld settings [1,3]. Efforts to improve the diagnosis of DSPN and facilitate larger-scale patient screening have resulted in the development of new tests [3,4], such as the indicator test for sudomotor function (Neuropad [5]), the steel ball-bearing test [6], the automated nerve conduction study of the sural nerve [7,8], VibraTip [9,10], among others.…”

Section: Introductionmentioning

confidence: 99%

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The Diagnostic Utility of VibraTip for Distal Symmetrical Polyneuropathy in Type 2 Diabetes Mellitus

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Diagnostic Utility of VibraTip for Distal Symmetrical Polyneuropathy in Type 2 Diabetes Mellitus

et al. 2019

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“…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%

Elevated peripheral blood levels of CXCL10 are associated with the presence of diabetic polyneuropathy in subjects with type 2 diabetes

Ascaso

Palanca

Martínez-Hervás

et al. 2020

Preprint

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Background : Diabetic peripheral neuropathy (DPN) has high morbidity and mortality. Major risk factors of DPN include metabolic changes, duration of diabetes, nerve ischemia, and derangements in regeneration and nerve repair programs. The implication of chemokines in the pathogenesis of various neuropathies and neuropathic pain processes has been studied previously. This pilot study aimed to evaluate the association between plasma levels of chemokines CXCL9, CXCL10, and CXCL11 with the presence of DPN in a cohort of type 2 diabetes (T2D) patients. Methods : We have studied a total of 73 T2D patients (36 patients with DPN, and 37 without DPN). DPN was established through the Semmes-Weinstein test (SW). Plasma levels of circulating chemokines CXCL9, CXCL10, and CXCL11 were determined using Duoset ELISA kits (Abingdon, UK). Results: In T2D patients with similar gender distribution, duration of the disease, peripheral macroangiopathy, and metabolic control, we detected significantly higher serum levels of chemokine CXCL10 among patients with DPN than among patients without DPN (57.6 ± 38.3 vs. 38.1 ± 33.4 pg/mL, respectively; p = 0.034). Serum levels of chemokine CXCL9 were also higher among patients with DPN (188.1 ± 72.7 and 150.4 ± 83.6 pg/mL, respectively, p = 0.06). Conclusions : DPN in T2D patients was associated with a significant increase in CXCL10 circulating levels, suggesting a role for this chemokine in the DPN. Novel inflammatory markers that allow for early detection and therapeutic strategies in order to reverse and prevent the DPN should be investigated.

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BDNF as a biomarker for neuropathic pain: Consideration of mechanisms of action and associated measurement challenges

Thakkar

Acevedo

2023

Brain and Behavior

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Introduction:The primary objective of this paper is to (1) provide a summary of human studies that have used brain derived neurotrophic factor (BDNF) as a biomarker, (2) review animal studies that help to elucidate the mechanistic involvement of BDNF in the development and maintenance of neuropathic pain (NP), and (3) provide a critique of the existing measurement techniques to highlight the limitations of the methods utilized to quantify BDNF in different biofluids in the blood (i.e., serum and plasma) with the intention of presenting a case for the most reliable and valid technique. Lastly, this review also explores potential moderators that can influence the measurement of BDNF and provides recommendations to standardize its quantification to reduce the inconsistencies across studies. Methods:In this manuscript we examined the literature on BDNF, focusing on its role as a biomarker, its mechanism of action in NP, and critically analyzed its measurement in serum and plasma to identify factors that contribute to the discrepancy in results between plasma and serum BDNF values.Results: A large heterogenous literature was reviewed that detailed BDNF's utility as a potential biomarker in healthy volunteers, patients with chronic pain, and patients with neuropsychiatric disorders but demonstrated inconsistent findings. The literature provides insight into the mechanism of action of BDNF at different levels of the central nervous system using animal studies. We identified multiple factors that influence the measurement of BDNF in serum and plasma and based on current evidence, we recommend assessing serum BDNF levels to quantify peripheral BDNF as they are more stable and sensitive to changes than plasma BDNF. Conclusion:Although mechanistic studies clearly explain the role of BDNF, results from human studies are inconsistent. More studies are needed to evaluate the methodological challenges in using serum BDNF as a biomarker in NP.

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Emerging Biomarkers, Tools, and Treatments for Diabetic Polyneuropathy

Cited by 163 publications

References 362 publications

The Diagnostic Utility of VibraTip for Distal Symmetrical Polyneuropathy in Type 2 Diabetes Mellitus

The Diagnostic Utility of VibraTip for Distal Symmetrical Polyneuropathy in Type 2 Diabetes Mellitus

Elevated peripheral blood levels of CXCL10 are associated with the presence of diabetic polyneuropathy in subjects with type 2 diabetes

BDNF as a biomarker for neuropathic pain: Consideration of mechanisms of action and associated measurement challenges

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