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RESEARCH
FOCUS
Diabetic Neuropathy
Neuropathy is one
of the most important causes of morbidity and premature mortality in patients
with diabetes. It includes different forms: immune-mediated multiplex mononeuropathies
and chronic inflammatory polyradiculoneuropathy, but the most common type is
the length-dependent axonal sensorimotor and autonomic neuropathy. Given that
diabetes affects approximately 250 million people worldwide, it is estimated
that 30-40 million people worldwide are affected by symptomatic diabetic
neuropathy. Growing rates of obesity and the associated increase in the
prevalence of type 2 diabetes could cause these figures to double by the year
2030
Skin biopsy has
been used to investigate small nerve fibers in neuropathies of different etiology
and in particular in diabetic neuropathy, nerves are early and aggressively
affected by a dying-back process first leading to the degeneration of the
longest sensory axons. Small nerve fibers innervating the skin and its
autonomic organs are the longest axons in mammals and can be quantitatively and
qualitatively investigated in human beings though a minimally invasive 3-mm
punch biopsy and early changes can be detected in diabetic patients.
We are currently using skin biopsy to determine markers of degeneration
and regeneration of nerve fibers in patients with diabetes and to correlate
them to diabetic neuropathy complications. We are also working on a
translational investigation design including clinical and preclinical studies
(in vivo and in vitro) to address several issues: early diagnostic markers of
peripheral neuropathies, principle pathogenic mechanisms of diabetic
neurotoxicity and development of new effective agents of neuroprotection and
neuroregeneration Representative
Publications
Lauria G, Lombardi R. Skin biopsy: a new tool for diagnosing peripheral
neuropathy. Br Med J 2007;334(7604):1159-1162
Sommer C, Lauria G. The use of skin biopsy in the management of
peripheral neuropathy. Lancet Neurology 2007; 6:632-642
Roglio I, Bianchi R, Giatti
S, Cavaletti G, Caruso D, Scurati S, Crippa D, Garcia-Segura LM, Camozzi F,
Lauria G, Melcangi RC. Testosterone derivatives are neuroprotective agents in
experimental diabetic neuropathy. Cell Mol Life Sci 2007;64(9):1158-68
Leonelli E, Bianchi R,
Cavaletti G, Caruso D, Crippa D, Garcia-Segura LM, Lauria G, Magnaghi V, Roglio
I, Melcangi RC. Progesterone and its derivatives are neuroprotective agents in
experimental diabetic neuropathy: biochemical and functional analyses.
Neuroscience 2007;144:1293-1304
Bianchi R, Buyukakilli B, Brines M, Savino C, Cavaletti G, Oggioni N,
Lauria G, Borgna M, Lombardi R, Cimen B, Comelekoglu U, Kanik A, Tataroglu C,
Cerami A, Ghezzi P. Erythropoietin both protects from and reverses experimental
diabetic neuropathy. Proc Natl Acad Sci U S A 2004;10:823-828
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