Prevention of peripheral nerve dysfunction by an aldose reductase inhibitor in streptozotocin-diabetic rats.

A potent inhibitor of aldose reductase, (E)-3-carboxy-methyl-5-[(2E)-methyl-3-phenylpropenylidene]rhodanin e (ONO-2235), was orally administered at a dose of 20 mg X kg-1 X d-1 for 2 weeks to streptozotocin-diabetic rats from the beginning of the diabetic state, ie, 24 hours after streptozotocin injection. The impairment of motor nerve conduction velocity (MNCV) of the tail nerve found in nontreated diabetic rats was apparently prevented by the treatment with the aldose reductase inhibitor (24.5 +/- 0.4 v 29.0 +/- 1.4 m/s on day 14, P less than 0.005). Those diabetic rats treated with the compound actually showed an age-dependent increase in MNCV similar to that of normal control rats (25.5 +/- 1.5 v 26.4 +/- 1.0 m/s on day 7, 29.0 +/- 1.4 v 29.4 +/- 1.3 m/s on day 14, treated v normal, not statistically significant on both days). The sorbitol content of the sciatic nerve excised from ONO-2235-treated diabetic rats (0.067 +/- 0.018 nmol/g wet weight) was significantly lower than that of the nontreated diabetic rats (1.309 +/- 0.080 nmol/g wet weight, P less than 0.001) but significantly higher than that of normal control rats (0.229 +/- 0.015 nmol/g wet weight, P less than 0.001). These results suggest that the reduction in MNCV noted in the experimental diabetic animals is not the result of retarded maturation of peripheral nerves but of metabolic derangement caused by the diabetic state, which can be prevented by suppressing sorbitol accumulation in nerve tissue. It also appears that there may be a threshold level of sorbitol accumulation that causes the impairment of nerve conduction velocity.