Gabbay Kenneth H
Baylor College of Medicine, The Harry B. and Aileen B. Gordon Diabetes Research Center, 1102 Bates, Suite 830, MC 3-2353, Houston, TX 77030-2399, USA.
Curr Diab Rep. 2004 Dec;4(6):405-8. doi: 10.1007/s11892-004-0047-z.
Diabetic neuropathy is a major complication of poorly controlled diabetes mellitus. Aldose reductase, the first enzyme of the polyol pathway, is thought to play a role in initiating the metabolic damage to peripheral nerves during hyperglycemia. Aldose reductase inhibitors (ARIs) have been proposed to dampen the flux of glucose through the pathway during hyperglycemia; however, clinical trials in diabetic patients to demonstrate efficacy in the prevention or amelioration of diabetic neuropathy have failed thus far. Recent improved understanding of the pitfalls of past trials and some improved ARIs and clinical evaluation instruments show promise that success in the 20-plus year search for efficacious ARIs may soon be at hand.
糖尿病性神经病变是糖尿病控制不佳的主要并发症。醛糖还原酶是多元醇途径的首个酶，被认为在高血糖期间引发对周围神经的代谢损伤中起作用。醛糖还原酶抑制剂（ARIs）已被提议在高血糖期间抑制葡萄糖通过该途径的流量；然而，迄今为止，在糖尿病患者中证明其在预防或改善糖尿病性神经病变方面疗效的临床试验均告失败。最近对过去试验缺陷的进一步认识以及一些改进的醛糖还原酶抑制剂和临床评估工具表明，在长达20多年寻找有效醛糖还原酶抑制剂的过程中取得成功可能指日可待。
