Diabetic neuropathy oxidative stress

Yorek, MA. Oxidative Stress and Diabetes-Induced Vascular Dysfunction Role in Diabetic Neuropathy. Oxidative Stress Appl Basic Res Clin Pract, 2014 1-12. 

Patients with both type 1 and type 2 diabetes are prone to complications. The specific chronic diabetic complications are due to microangiopathy and include neuropathy, retinopathy and nephropathy. Recent data stress the vital role of hyperglycaemia and oxidative stress in their pathophysiology. Premature atherosclerosis (which can be considered... 

Greene DA, Stevens MJ, Obrosova I, Feldman EL. Glucose-induced oxidative stress and programmed cell death in diabetic neuropathy. Eur J Pharmacol 1999 375 217-223. 

Low PA, Nickander KK, Sciotti L. Role of hypoxia, oxidative stress and excitatory neurotoxins in diabetic neuropathy. In Dyck PJ, Thomas PK, eds. Diabetic Neuropathy. 2nd ed. Saunders, Philadelphia, 1999, pp. 317-329. 

Nagamatsu M, Nickander KK, Schmelzer JD, Raya A, Wittrock DA, TritschlerH, et al. Lipoic acid improves nerve blood flow, reduces oxidative stress, and improves distal nerve conduction in experimental diabetic neuropathy. Diabetes Care 1995 18 1160-1167. 

Oxidative stress causes increased formation of free radicals that potentially may cause destruction of nerve tissue. Diabetes is characterized by increased amounts of free radicals, and accordingly a number of antioxidants have been tested in diabetic neuropathy. 

Aldose reductase inhibitors (ARI) reduce the flux of glucose through the polyol pathway thereby inhibiting the accumulation of sorbitol and fructose and preventing NADPH consumption and oxidative stress. Numerous studies of ARI in animal models of diabetic complications have demonstrated the potential of ARI against diabetic neuropathy. However, animal models of neuropathy do not predict outcome in human beings well. 

Type 2 diabetes is associated with elevated oxidative stress (especially lipid peroxidation) and declines in antioxidant defense. This is thought to be due in part to elevated blood glucose levels (hyperglycemia), but severe oxidative stress may also precede and accelerate the development of type 2 diabetes and then of diabetic complications (CVD and micro-vascular complications such as retinopathy, neuropathy, and nephropathy). 

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