Peripheral Neuropathy Research with Type 2 Diabetes Management
Posted on December 21, 2011 by Lu Young RN
Peripheral neuropathy can be painful. Peripheral neuropathy research with type 2 diabetes management is currently working on genetic factors.
The National Institute of Neurological Disorders and Stroke (NINDS), a component of the Federal government’s National Institutes of Health (NIH) within the U.S. Department of Health and Human Services, has primary responsibility for research on peripheral neuropathy. Current research projects funded by the NINDS involve investigations of genetic factors associated with hereditary neuropathies, studies of biological mechanisms involved in diabetes-associated neuropathies, efforts to gain greater understanding of how the immune system contributes to peripheral nerve damage, and efforts to develop new therapies for neuropathic symptoms.
Because specific genetic defects have been identified for only a fraction of the known hereditary neuropathies, the Institute sponsors studies to identify other genetic defects that may cause these conditions. Presymptomatic diagnosis may lead to therapies for preventing nerve damage before it occurs, and gene replacement therapies could be developed to prevent or reduce cumulative nerve damage.
Several NINDS-funded studies are investigating some of the possible biological mechanisms responsible for the many forms of neuropathy, including the autonomic neuropathies that affect people with diabetes. The Institute also is funding studies to measure the frequency and progression rates of diabetic neuropathies, examine the effects of these disorders on quality of life, and identify factors that may put certain individuals at greater risk for developing diabetes-associated neuropathies.
Scientists have found that the destructive effects of abnormal immune system activity cause many neuropathies for which a cause could not previously be identified. However, the exact biological mechanisms that lead to this nerve damage are not yet well understood. Many NINDS-sponsored studies are studying inflammatory neuropathies, both in research animals and in humans, to clarify these mechanisms so that therapeutic interventions can be developed.
Neuropathic pain is a primary target of NINDS-sponsored studies aimed at developing more effective therapies for symptoms of peripheral neuropathy. Some scientists hope to identify substances that will block the brain chemicals that generate pain signals, while others are investigating the pathways by which pain signals reach the brain.
Studies of neurotrophic factors represent one of the most promising areas of research aimed at finding new, more effective treatments for peripheral neuropathies. These substances, produced naturally by the body, protect neurons from injury and encourage their survival. Neurotrophic factors also help maintain normal function in mature nerve cells, and some stimulate axon regeneration. Several NINDS-sponsored studies seek to learn more about the effects of these powerful chemicals on the peripheral nervous system and may eventually lead to treatments that can reverse nerve damage and cure peripheral nerve disorders.
Children’s Hospital Boston is also working on peripheral neuropathy research with type 2 diabetes management.
The Foundation for Peripheral Neuropathy and Children’s Hospital Boston are jointly supporting a proof of concept preclinical research project to find a new pain therapy for peripheral neuropathy. Having previously discovered a common variant in a gene called GCH1 that protects people (~3% of the population) from developing chronic pain after nerve injury, Dr. Clifford Woolf and his team now wish to discover if drugs can mimic this so that we can pharmacologically convert people who, by virtue of the particular type of GCH1 gene they happen to have inherited, are at a high risk of pain, to resemble those that are at a low risk. This is a completely novel approach to drug development and to finding a new pain therapy.
The premise of the study is to test if two candidate inhibitors of GCH1 can produce analgesia. If the project is successful, the plan then is to immediately develop related compounds suitable for testing in patients with peripheral neuropathy. Because the target has been identified by human genetics we are confident that if we can find inhibitors that are as effective as the gene variant we will find a completely new class of drugs to treat persistent neuropathic pain. The fact that the gene variant confers protection against pain without any other apparent harmful effects indicates that such drugs may also have a low side effect profile. This is a study that is much too risky for pharmaceutical companies because it is a quite different model from how they develop analgesics, but the partnership between the Foundation and Children’s Hospital Boston is willing to take the chance, because the science strongly supports it and the need is so great.
This author hopes that future for peripheral neuropathy research with type 2 diabetes management will soon find a cure. Realistically though, I know that research takes time and that many failures may soon bring small successes.
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