Abstract

Previously we have demonstrated that diabetes causes impairment in vascular function of epineurial vessels, which precedes the slowing of motor nerve conduction velocity. Treatment of diabetic rats with aldose reductase inhibitors, aminoguanidine or myo-inositol supplementation have been shown to improve motor nerve conduction velocity and/or decreased endoneurial blood flow. However, the effect these treatments have on vascular reactivity of epineurial vessels of the sciatic nerve is unknown. In these studies we examined the effect of treating streptozotocininduced rats with sorbinil, aminoguanidine or myo-inositol on motor nerve conduction velocity, endoneurial blood flow and endothelium dependent vascular relaxation of arterioles that provide circulation to the region of the sciatic nerve. Treating diabetic rats with sorbinil, aminoguanidine or myo-inositol improved the reduction of endoneurial blood flow and motor nerve conduction velocity. However, only sorbinil treatment significantly improved the diabetes-induced impairment of acetylcholinemediated vasodilation of epineurial vessels of the sciatic nerve. All three treatments were efficacious in preventing the appropriate metabolic derangements associated with either activation of the polyol pathway or increased nonenzymatic glycation. In addition, sorbinil was shown to prevent the diabetes-induced decrease in lens glutathione level. However, other markers of oxidative stress were not vividly improved by these treatments. These studies suggest that sorbinil treatment may be more effective in preventing neural dysfunction in diabetes than either aminoguanidine or myoinositol.

Highlights

  • Diabetic neuropathy is a multifactorial problem likely due to the poor control of hyperglycemia

  • We have shown that endothelial-dependent vasodilation of arterioles that provide circulation to the region of the sciatic nerve is impaired by diabetes and the reduction in vascular function precedes slowing of motor nerve conduction velocity [35,36]

  • Among the metabolic factors that potentially contribute to the development of diabetic neuropathy the polyol pathway and nonenzymatic glycation have been extensively studied [59]

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Summary

Introduction

Diabetic neuropathy is a multifactorial problem likely due to the poor control of hyperglycemia. Studies from numerous laboratories have shown that treating diabetic rats with an aldose reductase inhibitor improves nerve function as well as endoneurial blood flow [3,4,5,6,7,8,9,10,11,12]. This has led to wide speculation regarding the potential benefit of aldose reductase inhibitor treatment of diabetic complications [10,11,12,13,14,15,16]. More recent studies have indicated that diabetic neuropathy is likely due to multiple mechanisms involving hyperglycemia and decreased insulin and C-peptide levels that effect both nerve and vascular tissue [17]

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