Biology Reference
In-Depth Information
Chapter 13
Intra-epidermal Nerve Fibers Density and Nociception
in EPO-Treated Type 1 Diabetic Rats with Peripheral
Neuropathy
Bianchi Roberto , Lombardi Raffaella , Porretta-Serapiglia Carla ,
and Lauria Giuseppe
Abstract
Small-diameter nerve fibers, which subserve nociception, can be affected early in peripheral neuropathies,
although their injury may not be detectable by routine neurophysiologic tests. On the other hand, skin biopsy
has proved to be a reliable tool to examine nonmyelinated nerve fibers, as assessed by the quantification of
intra-epidermal nerve fiber (IENF) density not only along with the degenerative process but, noteworthy,
IENF density could be very helpful in evaluating drug efficacy such as erythropoietin (EPO) treatment.
Key words Diabetes, Erythropoietin, Diabetic neuropathy, Epidermal nerve fibers, PGP 9.5, Skin
1
Introduction
The global prevalence of type 2 diabetes appears to be increasing
dramatically, possibly as a consequence of a more sedentary lifestyle
and the adoption of Western diets. The World Health Organization
estimates the number of people with diabetes to be approximately
180 million and this figure is projected to more than double by the
year 2030. Furthermore, there is convincing evidence that the risk
of developing long-term complications, such as retinopathy, neph-
ropathy, and neuropathy, is related to the degree of hyperglycemia
( 1 ). Strict glycemic control by intensive insulin administration,
pancreas or islets transplantation, can significantly reduce, but nor
abolish, the incidence of diabetic complications such as neuropathy,
nephropathy and retinopathy, which are the major cause of morbid-
ity and mortality in type 1 insulin-dependent diabetic patients ( 2 ).
Diabetic Peripheral Neuropathy (DPN) that occurs in about 34%
of patients who have been hyperglycemic for more than 15 years,
is the most common complication of diabetes mellitus, and
1.1 Diabetic
Peripheral Neuropathy
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