Painful diabetic neuropathy (PDN) is a debilitating complication of diabetes mellitus affecting millions worldwide. It is characterized by nerve damage from prolonged exposure to high blood sugar levels. It is a type of nerve damage that can occur in individuals with type 1 and type 2 diabetes. This condition manifests as a wide range of sensory and motor symptoms, such as pain, tingling, numbness, and muscle weakness, significantly impacting the quality of life for affected individuals. The pathophysiological mechanisms of PDN are complex and multifactorial, including metabolic disorders, vascular damage, oxidative stress, and chronic inflammation.
The most severe complications of diabetes arise in part from reactive dicarbonyl compounds via the covalent modification of proteins, resulting in advanced glycation end-products (AGEs). Type 2 diabetes is associated with elevated blood levels of methylglyoxal (MG), a highly reactive metabolite produced during glucose metabolism. It is known to be elevated in individuals with diabetes and has been implicated in the development of diabetic complications, including neuropathy. MG-derived AGE methylglyoxal-hydroimidazolone 1 (MGH1) also correlates with the development of PDN. MG can modify proteins and DNA, leading to cellular dysfunction and damage to nerve cells. In addition to MG, reactive oxygen species (ROS) are highly reactive molecules, including free radicals like superoxide and hydroxyl radicals. In diabetes, chronically elevated blood sugar levels can lead to increased ROS production. ROS can damage cellular components, including lipids, proteins, and DNA, through oxidative stress. In PDN, oxidative stress is a crucial contributor to nerve damage. Neuroinflammation is another critical aspect of PDN. Chronic hyperglycemia can activate immune cells and trigger an inflammatory response within the nerves. This inflammation leads to further damage to nerve cells and exacerbates the neuropathic symptoms experienced by individuals with diabetes.
Rodent models have played a crucial role in advancing our understanding of PDN. Researchers use these models to simulate the effects of diabetes on nerve function and study the mechanisms involved. They have been instrumental in investigating the roles of MG, ROS, and neuroinflammation in the development and progression of neuropathy. While rodent models provide valuable insights, it's essential to translate these findings to human patients. Studies involving humans have confirmed the relevance of MG, ROS, and neuroinflammation in PDN. Clinical trials targeting these mechanisms are ongoing to develop novel therapies to alleviate neuropathic symptoms and slow disease progression. Understanding these processes at the molecular level provides hope for the development of targeted therapies to prevent, manage, or mitigate the impact of PDN in both rodents and, most importantly, humans. Further research in this field promises improved treatments and enhanced quality of life for those affected by this debilitating complication of diabetes.
The primary goal of this Research Topic is to address the challenges associated with PDN and propose strategies to enhance its prevention, diagnosis, and treatment. By gathering cutting-edge research and multidisciplinary perspectives, we aim to foster a deeper understanding of the mechanisms involved in the development and progression of PDN. Additionally, we seek to identify novel biomarkers, imaging techniques, and therapeutic targets that can aid in early detection, risk stratification, and targeted interventions. Ultimately, this Research Topic aims to bridge the gap between research findings and clinical practice, providing actionable insights to improve patient outcomes. We invite contributions from researchers, clinicians, and experts in PDN. Topics of interest include, but are not limited to:
- Pathophysiology of PDN, including molecular mechanisms and cellular interactions
- Diagnostic approaches and assessment tools for timely and accurate identification of neuropathy
- Risk factors and predictive models for PDN development and progression
- Non-pharmacological interventions, such as exercise and lifestyle modifications, for preventing and managing neuropathy symptoms
- Novel pharmacological and therapeutic approaches, including neuroprotective agents and targeted therapies
- Rehabilitation strategies for improving functional outcomes and quality of life in patients with PDN
- Patient education and self-management strategies for effective neuropathy management
We welcome original research articles, systematic reviews, meta-analyses, clinical trials, translational studies, and perspectives that advance our understanding of PDN and propose actionable recommendations for clinical practice.
Painful diabetic neuropathy (PDN) is a debilitating complication of diabetes mellitus affecting millions worldwide. It is characterized by nerve damage from prolonged exposure to high blood sugar levels. It is a type of nerve damage that can occur in individuals with type 1 and type 2 diabetes. This condition manifests as a wide range of sensory and motor symptoms, such as pain, tingling, numbness, and muscle weakness, significantly impacting the quality of life for affected individuals. The pathophysiological mechanisms of PDN are complex and multifactorial, including metabolic disorders, vascular damage, oxidative stress, and chronic inflammation.
The most severe complications of diabetes arise in part from reactive dicarbonyl compounds via the covalent modification of proteins, resulting in advanced glycation end-products (AGEs). Type 2 diabetes is associated with elevated blood levels of methylglyoxal (MG), a highly reactive metabolite produced during glucose metabolism. It is known to be elevated in individuals with diabetes and has been implicated in the development of diabetic complications, including neuropathy. MG-derived AGE methylglyoxal-hydroimidazolone 1 (MGH1) also correlates with the development of PDN. MG can modify proteins and DNA, leading to cellular dysfunction and damage to nerve cells. In addition to MG, reactive oxygen species (ROS) are highly reactive molecules, including free radicals like superoxide and hydroxyl radicals. In diabetes, chronically elevated blood sugar levels can lead to increased ROS production. ROS can damage cellular components, including lipids, proteins, and DNA, through oxidative stress. In PDN, oxidative stress is a crucial contributor to nerve damage. Neuroinflammation is another critical aspect of PDN. Chronic hyperglycemia can activate immune cells and trigger an inflammatory response within the nerves. This inflammation leads to further damage to nerve cells and exacerbates the neuropathic symptoms experienced by individuals with diabetes.
Rodent models have played a crucial role in advancing our understanding of PDN. Researchers use these models to simulate the effects of diabetes on nerve function and study the mechanisms involved. They have been instrumental in investigating the roles of MG, ROS, and neuroinflammation in the development and progression of neuropathy. While rodent models provide valuable insights, it's essential to translate these findings to human patients. Studies involving humans have confirmed the relevance of MG, ROS, and neuroinflammation in PDN. Clinical trials targeting these mechanisms are ongoing to develop novel therapies to alleviate neuropathic symptoms and slow disease progression. Understanding these processes at the molecular level provides hope for the development of targeted therapies to prevent, manage, or mitigate the impact of PDN in both rodents and, most importantly, humans. Further research in this field promises improved treatments and enhanced quality of life for those affected by this debilitating complication of diabetes.
The primary goal of this Research Topic is to address the challenges associated with PDN and propose strategies to enhance its prevention, diagnosis, and treatment. By gathering cutting-edge research and multidisciplinary perspectives, we aim to foster a deeper understanding of the mechanisms involved in the development and progression of PDN. Additionally, we seek to identify novel biomarkers, imaging techniques, and therapeutic targets that can aid in early detection, risk stratification, and targeted interventions. Ultimately, this Research Topic aims to bridge the gap between research findings and clinical practice, providing actionable insights to improve patient outcomes. We invite contributions from researchers, clinicians, and experts in PDN. Topics of interest include, but are not limited to:
- Pathophysiology of PDN, including molecular mechanisms and cellular interactions
- Diagnostic approaches and assessment tools for timely and accurate identification of neuropathy
- Risk factors and predictive models for PDN development and progression
- Non-pharmacological interventions, such as exercise and lifestyle modifications, for preventing and managing neuropathy symptoms
- Novel pharmacological and therapeutic approaches, including neuroprotective agents and targeted therapies
- Rehabilitation strategies for improving functional outcomes and quality of life in patients with PDN
- Patient education and self-management strategies for effective neuropathy management
We welcome original research articles, systematic reviews, meta-analyses, clinical trials, translational studies, and perspectives that advance our understanding of PDN and propose actionable recommendations for clinical practice.