Xue Tianyu, Zhang Xin, Xing Yiwen, Liu Shuhan, Zhang Lijun, Wang Xun, Yu Min
Department of Neurology, The Third People's Hospital of Dalian, Non-Directly Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Ophthalmology, The Third People's Hospital of Dalian, Non-Directly Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Pharmacol. 2021 Oct 4;12:748193. doi: 10.3389/fphar.2021.748193. eCollection 2021.
Most diabetic patients develop diabetic peripheral neuropathy (DPN). DPN is related to the increase of inflammatory cells in peripheral nerves, abnormal cytokine expression, oxidative stress, ischemia ,and pro-inflammatory changes in bone marrow. We summarized the progress of immune-inflammatory mechanism and treatment of DPN in recent years. Immune inflammatory mechanisms include TNF-α, HSPs, PARP, other inflammatory factors, and the effect of immune cells on DPN. Treatment includes tricyclic antidepressants and other drug therapy, immune and molecular therapy, and non-drug therapy such as exercise therapy, electrotherapy, acupuncture, and moxibustion. The pathogenesis of DPN is complex. In addition to strictly controlling blood glucose, its treatment should also start from other ways, explore more effective and specific treatment schemes for various causes of DPN, and find new targets for treatment will be the direction of developing DPN therapeutic drugs in the future.
大多数糖尿病患者会发展为糖尿病周围神经病变(DPN)。DPN与外周神经中炎症细胞增加、细胞因子表达异常、氧化应激、缺血以及骨髓中的促炎变化有关。我们总结了近年来DPN免疫炎症机制及治疗的进展。免疫炎症机制包括肿瘤坏死因子-α(TNF-α)、热休克蛋白(HSPs)、聚(ADP-核糖)聚合酶(PARP)、其他炎症因子以及免疫细胞对DPN的影响。治疗方法包括三环类抗抑郁药及其他药物治疗、免疫和分子治疗以及运动疗法、电疗法、针灸和艾灸等非药物治疗。DPN的发病机制复杂。除了严格控制血糖外,其治疗还应从其他方面入手,探索针对DPN各种病因更有效、更具特异性的治疗方案,寻找新的治疗靶点将是未来DPN治疗药物研发的方向。