Edwards James L, Vincent Andrea M, Cheng Hsinlin T, Feldman Eva L
Department of Neurology, The University of Michigan, Ann Arbor, MI 48109, USA.
Pharmacol Ther. 2008 Oct;120(1):1-34. doi: 10.1016/j.pharmthera.2008.05.005. Epub 2008 Jun 13.
Neuropathy is the most common and debilitating complication of diabetes and results in pain, decreased motility, and amputation. Diabetic neuropathy encompasses a variety of forms whose impact ranges from discomfort to death. Hyperglycemia induces oxidative stress in diabetic neurons and results in activation of multiple biochemical pathways. These activated pathways are a major source of damage and are potential therapeutic targets in diabetic neuropathy. Though therapies are available to alleviate the symptoms of diabetic neuropathy, few options are available to eliminate the root causes. The immense physical, psychological, and economic cost of diabetic neuropathy underscore the need for causally targeted therapies. This review covers the pathology, epidemiology, biochemical pathways, and prevention of diabetic neuropathy, as well as discusses current symptomatic and causal therapies and novel approaches to identify therapeutic targets.
神经病变是糖尿病最常见且使人衰弱的并发症，会导致疼痛、运动能力下降以及截肢。糖尿病神经病变包括多种形式，其影响范围从不适到死亡。高血糖会在糖尿病神经元中引发氧化应激，并导致多种生化途径的激活。这些被激活的途径是损伤的主要来源，也是糖尿病神经病变潜在的治疗靶点。尽管有疗法可缓解糖尿病神经病变的症状，但消除根本原因的选择却很少。糖尿病神经病变巨大的身体、心理和经济代价凸显了针对病因进行治疗的必要性。本综述涵盖了糖尿病神经病变的病理学、流行病学、生化途径和预防，同时讨论了当前的对症治疗和病因治疗以及识别治疗靶点的新方法。
