Treat­ment Could Pre­vent Neu­ropa­thy in Di­a­betic Pa­tients

Wellness Update - - Content -

“It’s not that you just don’t have sen­sa­tion in your feet,” Menichella said. “You have shoot­ing pain, which is the un­bear­able part. Pain is a de­bil­i­tat­ing af­flic­tion and one of the worst com­pli­ca­tions of di­a­betes.”

CHICAGO — For the 25 per­cent of type-2 di­a­betes pa­tients who suf­fer from numb­ness and ex­treme nerve pain in their feet, a new der­ma­to­log­i­cal treat­ment be­ing tested by North­west­ern Medicine sci­en­tists could po­ten­tially help pre­vent and maybe even re­verse the neu­ropa­thy.

In a study just pub­lished in Molec­u­lar Pain, North­west­ern Medicine re­searchers showed that de­plet­ing a chem­i­cal called GM3 through ge­netic mod­i­fi­ca­tion pre­vented the devel­op­ment of neu­ropa­thy in obese di­a­betic mice.

The re­searchers are now ap­ply­ing a gene ther­apy oint­ment to de­plete GM3 and GM3 syn­thase, which is the enzyme that makes GM3. The hope is that this GM3-de­plet­ing oint­ment, ap­plied just to the foot­pad of di­a­betic mice, will pre­vent or, even bet­ter, re­verse the ex­ist­ing neu­ropa­thy. “We have such ter­ri­ble treat­ments right now for the neu­ropa­thy of di­a­betes,” said cor­re­spond­ing au­thor Dr. Amy Paller, the Wal­ter J. Ham­lin pro­fes­sor of dermatology at North­west­ern Univer­sity Feinberg School of Medicine and di­rec­tor of North­west­ern’s Skin Dis­ease Re­search Cen­ter. “We’re ba­si­cally only treat­ing the pain. This is a novel patho­gen­e­sis-based ap­proach that looks at what’s caus­ing the neu­ropa­thy and re­verses that in­stead of just treat­ing the pain.”

The type of neu­ropa­thy the re­searchers are try­ing to treat goes be­yond the typ­i­cal numb­ness some pa­tients with neu­ropa­thy ex­pe­ri­ence, said rst au­thor Dr. Daniela Menichella, as­sis­tant pro­fes­sor of neu­rol­ogy at Feinberg whose fo­cus is the clin­i­cal care and lab­o­ra­tory-based re­search of di­a­betic neu­ropa­thy. De­plet­ing GM3 in di­a­betic mouse mod­els pre­vents neu­ropa­thy.

Lead­ing up to this treat­ment, the re­searchers had dis­cov­ered that rou­tine di­a­betic mice had a lot more GM3 and GM3 syn­thase in their nerves com­pared to nor­mal mice. They found the same thing to be true in the skin of mice and hu­mans with di­a­betes.

The sci­en­tists then com­pared the ap­pear­ance and func­tion of the nerves in mice in which GM3 was de­pleted by ge­netic ma­nip­u­la­tion. In rou­tine di­a­betic mouse skin, the nerves had vir­tu­ally dis­ap­peared from de­gen­er­a­tion, but they were ab­so­lutely nor­mal in ap­pear­ance in the GM3-de­pleted mice, even though the mice were as obese and di­a­betic as the rou­tine di­a­betic mice.

Based on th­ese dis­cov­er­ies, the re­searchers have ad­vanced the ap­proach to re­gion­ally de­plet­ing GM3 in the feet with the novel oint­ment.

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