Abstract
Diabetic neuropathy is one of the most common complications of diabetes. This complication is peripheral neuropathy with predominant sensory impairment, and its symptoms begin with hyperesthesia and pain and gradually become hypoesthesia with the loss of nerve fibers. In some cases, lower limb amputation occurs when hypoalgesia makes it impossible to be aware of trauma or mechanical stimuli. On the other hand, up to 50% of these complications are asymptomatic and tend to delay early detection. Therefore, sensitive and reliable biomarkers for diabetic neuropathy are needed for an early diagnosis of this condition. This review focuses on systemic biomarkers that may be useful at this time. It also describes research on the relationship between target gene polymorphisms and pathological conditions. Finally, we also introduce current information on regenerative therapy, which is expected to be a therapeutic approach when the pathological condition has progressed and nerve degeneration has been completed.
Highlights
Diabetic neuropathy is the earliest and most frequent complication of the three major complications associated with diabetes, but it is often not diagnosed until the disease has seriously progressed [1]
These include factors closely linked to the etiology, those associated with the progression of pathological conditions such as inflammation, and molecules involved in the cellular response to vascular endothelial cell damage and neurodegeneration
Biomarkers for diabetic neuropathy are divided into four groups: (a) advanced glycation end products (AGEs)-related molecules, (b) molecules that participate in the progression of inflammation (Toll-like receptors, TNF-α, miR-146a, adiponectin, etc.), (c) molecules associated with nerve damage, and (d) molecules involved in nerve protection
Summary
Diabetic neuropathy is the earliest and most frequent complication of the three major complications associated with diabetes, but it is often not diagnosed until the disease has seriously progressed [1]. Trauma and mechanical irritation cannot be noticed; as a result, foot ulcers and gangrene may occur, leading to amputation of the lower limbs [2] Since this disease imposes a physical and mental burden on patients and their families and decreases the quality of life, it is important to develop diagnostic methods with high sensitivity for its early detection. Since biomarkers reflect the complexity of these etiologies and the progression of the pathological condition, several types of factors have been identified as potential biomarkers of diabetic neuropathy These include factors closely linked to the etiology, those associated with the progression of pathological conditions such as inflammation, and molecules involved in the cellular response to vascular endothelial cell damage and neurodegeneration. This review outlines current information on regenerative therapy, which is expected to be a treatment method when the condition progresses and nerve degeneration is complete
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