Richner Mette, Ferreira Nelson, Dudele Anete, Jensen Troels S, Vaegter Christian B, Gonçalves Nádia P
Danish Research Institute of Translational Neuroscience, Nordic EMBL Partnership for Molecular Medicine, Department of Biomedicine, Aarhus University, Aarhus, Denmark.
The International Diabetic Neuropathy Consortium, Aarhus University Hospital, Aarhus, Denmark.
Front Neurosci. 2019 Jan 14;12:1038. doi: 10.3389/fnins.2018.01038. eCollection 2018.
The incidence of diabetes mellitus is approaching global epidemic proportions and should be considered a major health-care problem of modern societies in the twenty-first century. Diabetic neuropathy is a common chronic complication of diabetes and, although an adequate glycemic control can reduce the frequency of diabetic neuropathy in type 1 diabetes, the majority of type 2 diabetic patients will develop this complication. The underlying cellular and molecular mechanisms are still poorly understood, preventing the development of effective treatment strategies. However, accumulating evidence suggests that breakdown of the blood-nerve barrier (BNB) plays a pivotal pathophysiological role in diabetic neuropathy. In the present review, we highlight the structural and functional significance of the BNB in health and disease, focusing on the pathological molecular events leading to BNB dysfunction in diabetic neuropathy. In addition, we discuss potential molecular targets involved in BNB homeostasis that may pave the way toward novel therapeutic strategies for treating diabetic neuropathy.
糖尿病的发病率正接近全球流行程度，应被视为21世纪现代社会的一个主要医疗保健问题。糖尿病神经病变是糖尿病常见的慢性并发症，尽管充分的血糖控制可降低1型糖尿病中糖尿病神经病变的发生率，但大多数2型糖尿病患者仍会发生这种并发症。其潜在的细胞和分子机制仍知之甚少，这阻碍了有效治疗策略的开发。然而，越来越多的证据表明，血神经屏障（BNB）的破坏在糖尿病神经病变中起着关键的病理生理作用。在本综述中，我们强调了BNB在健康和疾病中的结构和功能意义，重点关注导致糖尿病神经病变中BNB功能障碍的病理分子事件。此外，我们还讨论了参与BNB稳态的潜在分子靶点，这些靶点可能为治疗糖尿病神经病变的新治疗策略铺平道路。
