Growing Nerves Anew

Diabetic neuropathy treatment may involve targeting blood vessels and Schwann cells

(RxWiki News) It's not easy to understand what causes most health problems. The path to fighting a disease may be where it is least expected. This may be the case with treating nerve damage caused by diabetes.

Researchers found that repairing blood vessels and Schwann cells (cells that support nerves) may speed up the process of regrowing nerves in diabetic patients with nerve damage.

"Ask your Internist about fixing diabetic nerve damage."

Around 20 percent of patients with diabetes are faced with neuropathy - a painful tingling, burning, or numbness in the hands and feet. Neuropathy is a sign of nerve damage that can sometimes lead to infections and amputations.

Past studies have shown that the part of nerve cells called axons take longer to regrow in people with diabetes. So the question now is: why do axons regrow slowly in people with diabetes?

Michael Polydefkis, M.D., M.H.S., associate professor of neurology at the Johns Hopkins University School of Medicine, and Gigi Ebenezer, M.B.B.S., M.D., assistant professor of neurology at Johns Hopkins, and colleagues set out to answer to this question.

They found that blood vessels and Schwann cells regrew into healing skin before axons were able to do so. It appeared as though the axons needed the blood vessels as a sort of scaffold or support structure.

According to Polydefkis, these findings suggest that diabetes affects more than the healing process of nerves. The disease is also affecting blood vessel growth and the spread of Schwann cells.

He adds that these results may also explain why diabetes is linked to blood vessel-related problems like heart attack and stroke. That is, diabetes may be causing more than slow regrowth of nerves. The disease may also be slowing down the regrowth of damaged blood vessels.

For their study, Polydefkis and colleagues took small chunks of skin from the thighs of 10 people with diabetic neuropathy and 10 healthy individuals. A few months later, the researchers took another chunk from the same spot to see how the nerves, blood vessels, and Schwann cells were growing back.

They found that blood vessels were the first to grow back into the healing skin. After that, the Schwann cells and axons grew in. However, the regrowth process was much slower in those with diabetic neuropathy than in the healthy patients.

While this study was small, Polydefkis says the findings may offer a new target for treating neuropathy and vascular problems. Researchers may have more success treating diabetic nerve damage if they focus on blood vessels and Schwann cells, instead of focusing only on the damaged nerves themselves. Doing so may speed up the repair process of nerves while also fighting vascular problems at the same time.

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Review Date: 
June 20, 2011