Li F, Szabó C, Pacher P, Southan G J, Abatan O I, Charniauskaya T, Stevens M J, Obrosova I G
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA.
Diabetologia. 2004 Apr;47(4):710-7. doi: 10.1007/s00125-004-1356-0.
AIMS/HYPOTHESIS: Poly(ADP-ribose) polymerase activation depletes NAD+ and high-energy phosphates, activates protein kinase C, and affects gene expression in various tissues. This study was designed to characterise the effects of the potent, orally active poly(ADP-ribose) polymerase inhibitor PJ34 in the Wistar rat model of early diabetic neuropathy.
Control and streptozotocin-diabetic rats were maintained with or without PJ34 treatment (30 mg x kg(-1) x day(-1)) for two weeks, after two weeks without treatment. Endoneurial blood flow was assessed by hydrogen clearance; metabolites and high-energy phosphates were assayed by enzymatic spectrofluorometric methods; and poly(ADP-ribose) was detected by immunohistochemistry.
Blood glucose concentrations were increased to a similar extent in untreated and PJ34-treated diabetic rats compared with controls. Intense poly(ADP-ribose) immunostaining was observed in the sciatic nerve of diabetic rats, but not in other groups. Final sciatic motor nerve conduction velocity and digital sensory nerve conduction velocity were reduced by 24% and 22% respectively in diabetic rats compared with controls (p<0.01 for both), and both were 98% corrected by PJ34 (p<0.01 vs diabetic group for both). In contrast, with PJ34 treatment, nerve blood flow showed a modest (17%) increase, and vascular conductance showed a tendency to increase. Free mitochondrial and cytosolic NAD+:NADH ratios, assessed from the glutamate and lactate dehydrogenase systems, phosphocreatine concentrations, and phosphocreatine:creatine ratios were decreased in diabetic rats and essentially normalised by PJ34. In both untreated and PJ34-treated diabetic rats, nerve glucose, sorbitol and fructose were increased to a similar extent. PJ34 did not affect any variables in control rats.
CONCLUSIONS/INTERPRETATION: Short-term poly(ADP-ribose) polymerase inhibitor treatment reverses functional and metabolic abnormalities of early diabetic neuropathy. Complete normalisation of nerve blood flow is not required for correction of motor or sensory nerve conduction velocities, provided that a therapeutic agent can restore nerve energy state via direct action on Schwann cells.
目的/假设:聚(ADP - 核糖)聚合酶激活会消耗NAD + 和高能磷酸盐,激活蛋白激酶C,并影响各种组织中的基因表达。本研究旨在表征强效口服活性聚(ADP - 核糖)聚合酶抑制剂PJ34在早期糖尿病性神经病变的Wistar大鼠模型中的作用。
将对照大鼠和链脲佐菌素诱导的糖尿病大鼠在接受或不接受PJ34治疗(30mg·kg⁻¹·d⁻¹)的情况下维持两周,在两周无治疗期后进行实验。通过氢清除法评估神经内膜血流;通过酶促荧光分光光度法测定代谢物和高能磷酸盐;通过免疫组织化学检测聚(ADP - 核糖)。
与对照组相比,未治疗和PJ34治疗的糖尿病大鼠血糖浓度升高程度相似。在糖尿病大鼠的坐骨神经中观察到强烈的聚(ADP - 核糖)免疫染色,而其他组未观察到。与对照组相比,糖尿病大鼠最终的坐骨运动神经传导速度和指感觉神经传导速度分别降低了24%和22%(两者p<0.01),而PJ34使两者均校正了98%(与糖尿病组相比两者p<0.01)。相比之下,PJ34治疗后,神经血流适度增加(17%),血管传导有增加趋势。从谷氨酸和乳酸脱氢酶系统评估的游离线粒体和胞质NAD⁺:NADH比值、磷酸肌酸浓度以及磷酸肌酸:肌酸比值在糖尿病大鼠中降低,而PJ34使其基本恢复正常。在未治疗和PJ34治疗的糖尿病大鼠中,神经葡萄糖、山梨醇和果糖均有相似程度的增加。PJ34对对照大鼠的任何变量均无影响。
结论/解读:短期聚(ADP - 核糖)聚合酶抑制剂治疗可逆转早期糖尿病性神经病变的功能和代谢异常。只要治疗药物能够通过直接作用于施万细胞恢复神经能量状态,校正运动或感觉神经传导速度并不需要神经血流完全恢复正常。