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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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2013
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.
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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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