Markers of Peripheral Nervous System Lesion in Diabetes Mellitus

Abstract

Работа посвящена диабетической полинейропатии-распространенности, возможностям диагностики, в том числе с применением инструментальных методов. Приведены собственные данные о возможностях выявления бессимтомных поражений периферической нервной системы у пациентов с сахарным диабетом. Показана эффективность терапии данного состояния с помощью одного из препаратов тиоктовой кислоты (Берлитион®).

Laboratory Indicators of Diabetic Polyneuropathy

“…Microcirculatory disorders also play an important role in the development of DPN. However, despite the widespread use of DPN, its pathogenetic mechanisms are not fully understood, and the mechanisms underlying neuropathy in DM type I and DM type II are overlapping, but different [1].…”

“…Currently, the following metabolic and vascular factors underlie the development of DPN: activation under conditions of hypoxia in diabetes alternative, polyol, glucose oxidation pathway with the formation of sorbitol and fructose, reduced levels of myo-inositol and increased activity of protein kinase C, which leads to disruption membrane Na + /K + -ATPases and accumulation of sodium inside the cell, which causes an increase in intracellular osmolarity; violation of the synthesis of fatty acids contributes to inhibition of prostaglandin production by endothelium and impaired endoneural blood flow, which leads to the development of ischemia, hypoxia and damage to the membrane structures of the nerve, microvascular and hemorhe-ological disorders; oxidative stress; deficiency of neurotrophic factors (nerve growth factor (NGF), insulin-like growth factor, neurospecific enolase (NSE), etc.) and disruption of axonal transport; accumulation of the end products of excess glycation in nerve and/or vascular wall proteins; immunological processes with an increase in systemic inflammation and the formation of autoantibodies [1][2][3].…”

“…Similar results were obtained in patients with diabetes. Thus, it was shown that a decrease in neutrophin production and sensitivity to them plays an important role in the development of sensory impairments in diabetes [1,4].…”

“…Another neurospecific indicator is the protein S-100, which is a marker of astrocyte death. A number of researchers have shown that the simultaneous determination of NSE and S-100 allows detecting cerebral lesions at an early stage, when successful treatment is still possible [1,2].…”