Abstract
Diabetes mellitus (DM) is a major global public health problem that can cause complications such as diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. Besides the reporting of reduction in corneal nerve density and decrease in corneal sensitivity in diabetic patients, there may be a subsequent result in delayed corneal wound healing and increased corneal infections. Despite being a potential cause of blindness, these corneal nerve changes have not gained enough attention. It has been proposed that corneal nerve changes may be an indicator for diabetic neuropathy, which can provide a window for early diagnosis and treatment. In this review, the authors aimed to give an overview of the relationship between corneal nerves and diabetic neuropathy as well as the underlying pathophysiological mechanisms of corneal nerve fiber changes caused by DM for improved prediction and prevention of diabetic neuropathy. In addition, the authors summarized current and novel therapeutic methods for delayed corneal wound healing, nerve protection and regeneration in the diabetic cornea.
Highlights
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by abnormally increased blood glucose level, which over time leads to severe systemic damage such as diabetic foot ulcers, nephropathy and neuropathy
Diabetic corneal defects could be a biomarker for evaluating diabetic neuropathy (DN)
There was reported a greater loss of corneal nerve fiber in DN patients when compared with diabetic subjects without DN
Summary
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by abnormally increased blood glucose level, which over time leads to severe systemic damage such as diabetic foot ulcers, nephropathy and neuropathy. When compared with the control group, the number of dendritic cells and Langerhans cells of diabetic patients elevated significantly, which negatively correlated with the length and density of corneal nerve fibers (Tavakoli et al, 2011). Another clinical study reported that early immune activation and corneal nerve degeneration occurred in adolescents with T1D (Ferdousi et al, 2019). Another study showed that some miRNA-mRNA pairs, such as miR-350-5p/Mup, miR-592-5p/ Angptl and miR-351-5p/Elovl, are related to diabetic corneal neuropathy They reported that dysregulated genes could affect cell proliferation and death, glucose metabolism, and synaptic transmission (Zhang et al, 2020a).
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