Smith Sasha, Normahani Pasha, Lane Tristan, Hohenschurz-Schmidt David, Oliver Nick, Davies Alun Huw
Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London W6 8RF, UK.
Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London W6 8RF, UK.
Life (Basel). 2022 Jul 19;12(7):1074. doi: 10.3390/life12071074.
Distal symmetrical polyneuropathy (DSPN) is a serious complication of diabetes associated with significant disability and mortality. Although more than 50% of people with diabetes develop DSPN, its pathogenesis is still relatively unknown. This lack of understanding has limited the development of novel disease-modifying therapies and left the reasons for failed therapies uncertain, which is critical given that current management strategies often fail to achieve long-term efficacy. In this article, the pathogenesis of DSPN is reviewed, covering pathogenic changes in the peripheral nervous system, microvasculature and central nervous system (CNS). Furthermore, the successes and limitations of current therapies are discussed, and potential therapeutic targets are proposed. Recent findings on its pathogenesis have called the definition of DSPN into question and transformed the disease model, paving the way for new research prospects.
远端对称性多发性神经病变（DSPN）是糖尿病的一种严重并发症，与显著的残疾和死亡率相关。尽管超过50%的糖尿病患者会发生DSPN，但其发病机制仍相对不明。这种认知不足限制了新型疾病改善疗法的开发，且使治疗失败的原因不明，鉴于当前的管理策略往往无法实现长期疗效，这一点至关重要。本文对DSPN的发病机制进行了综述，涵盖外周神经系统、微血管系统和中枢神经系统（CNS）的致病变化。此外，还讨论了当前疗法的成功之处和局限性，并提出了潜在的治疗靶点。其发病机制的最新研究结果对DSPN的定义提出了质疑，并改变了疾病模型，为新的研究前景铺平了道路。
