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Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation
Diabetic neuropathy is associated with increased morbidity and mortality. To date, limited data in subjects with impaired glucose tolerance and diabetes demonstrate nerve fiber repair after intervention. This may reflect a lack of efficacy of the interventions but may also reflect difficulty of the...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Diabetes Association
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526062/ https://www.ncbi.nlm.nih.gov/pubmed/23002037 http://dx.doi.org/10.2337/db12-0574 |
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author | Tavakoli, Mitra Mitu-Pretorian, Maria Petropoulos, Ioannis N. Fadavi, Hassan Asghar, Omar Alam, Uazman Ponirakis, Georgios Jeziorska, Maria Marshall, Andy Efron, Nathan Boulton, Andrew J. Augustine, Titus Malik, Rayaz A. |
author_facet | Tavakoli, Mitra Mitu-Pretorian, Maria Petropoulos, Ioannis N. Fadavi, Hassan Asghar, Omar Alam, Uazman Ponirakis, Georgios Jeziorska, Maria Marshall, Andy Efron, Nathan Boulton, Andrew J. Augustine, Titus Malik, Rayaz A. |
author_sort | Tavakoli, Mitra |
collection | PubMed |
description | Diabetic neuropathy is associated with increased morbidity and mortality. To date, limited data in subjects with impaired glucose tolerance and diabetes demonstrate nerve fiber repair after intervention. This may reflect a lack of efficacy of the interventions but may also reflect difficulty of the tests currently deployed to adequately assess nerve fiber repair, particularly in short-term studies. Corneal confocal microscopy (CCM) represents a novel noninvasive means to quantify nerve fiber damage and repair. Fifteen type 1 diabetic patients undergoing simultaneous pancreas–kidney transplantation (SPK) underwent detailed assessment of neurologic deficits, quantitative sensory testing (QST), electrophysiology, skin biopsy, corneal sensitivity, and CCM at baseline and at 6 and 12 months after successful SPK. At baseline, diabetic patients had a significant neuropathy compared with control subjects. After successful SPK there was no significant change in neurologic impairment, neurophysiology, QST, corneal sensitivity, and intraepidermal nerve fiber density (IENFD). However, CCM demonstrated significant improvements in corneal nerve fiber density, branch density, and length at 12 months. Normalization of glycemia after SPK shows no significant improvement in neuropathy assessed by the neurologic deficits, QST, electrophysiology, and IENFD. However, CCM shows a significant improvement in nerve morphology, providing a novel noninvasive means to establish early nerve repair that is missed by currently advocated assessment techniques. |
format | Online Article Text |
id | pubmed-3526062 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-35260622014-01-01 Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation Tavakoli, Mitra Mitu-Pretorian, Maria Petropoulos, Ioannis N. Fadavi, Hassan Asghar, Omar Alam, Uazman Ponirakis, Georgios Jeziorska, Maria Marshall, Andy Efron, Nathan Boulton, Andrew J. Augustine, Titus Malik, Rayaz A. Diabetes Complications Diabetic neuropathy is associated with increased morbidity and mortality. To date, limited data in subjects with impaired glucose tolerance and diabetes demonstrate nerve fiber repair after intervention. This may reflect a lack of efficacy of the interventions but may also reflect difficulty of the tests currently deployed to adequately assess nerve fiber repair, particularly in short-term studies. Corneal confocal microscopy (CCM) represents a novel noninvasive means to quantify nerve fiber damage and repair. Fifteen type 1 diabetic patients undergoing simultaneous pancreas–kidney transplantation (SPK) underwent detailed assessment of neurologic deficits, quantitative sensory testing (QST), electrophysiology, skin biopsy, corneal sensitivity, and CCM at baseline and at 6 and 12 months after successful SPK. At baseline, diabetic patients had a significant neuropathy compared with control subjects. After successful SPK there was no significant change in neurologic impairment, neurophysiology, QST, corneal sensitivity, and intraepidermal nerve fiber density (IENFD). However, CCM demonstrated significant improvements in corneal nerve fiber density, branch density, and length at 12 months. Normalization of glycemia after SPK shows no significant improvement in neuropathy assessed by the neurologic deficits, QST, electrophysiology, and IENFD. However, CCM shows a significant improvement in nerve morphology, providing a novel noninvasive means to establish early nerve repair that is missed by currently advocated assessment techniques. American Diabetes Association 2013-01 2012-12-13 /pmc/articles/PMC3526062/ /pubmed/23002037 http://dx.doi.org/10.2337/db12-0574 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
spellingShingle | Complications Tavakoli, Mitra Mitu-Pretorian, Maria Petropoulos, Ioannis N. Fadavi, Hassan Asghar, Omar Alam, Uazman Ponirakis, Georgios Jeziorska, Maria Marshall, Andy Efron, Nathan Boulton, Andrew J. Augustine, Titus Malik, Rayaz A. Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation |
title | Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation |
title_full | Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation |
title_fullStr | Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation |
title_full_unstemmed | Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation |
title_short | Corneal Confocal Microscopy Detects Early Nerve Regeneration in Diabetic Neuropathy After Simultaneous Pancreas and Kidney Transplantation |
title_sort | corneal confocal microscopy detects early nerve regeneration in diabetic neuropathy after simultaneous pancreas and kidney transplantation |
topic | Complications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526062/ https://www.ncbi.nlm.nih.gov/pubmed/23002037 http://dx.doi.org/10.2337/db12-0574 |
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