Pathogenesis of diabetic neuropathy: bad to the bone.

Pathogenesis of diabetic neuropathy: bad to the bone.
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DOI:
10.1111/j.1749-6632.2011.06309.x
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发表时间:
2011-12
影响因子:
5.2
通讯作者:
Kojima H
Kojima H
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Chan L;Terashima T;Urabe H;Lin F;Kojima H

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胰岛素和胰岛素原通常仅由胰腺和胸腺产生。我们在糖尿病啮齿动物的骨髓、肝脏和脂肪中检测到额外的胰腺产生胰岛素原的骨髓衍生细胞(PI-BMDC)。在患有糖尿病神经病变的小鼠和大鼠中,我们还在坐骨神经和背根神经节(DRG)神经元中发现了产生胰岛素原的细胞。使用基因标记的供体和受体小鼠进行的骨髓移植实验表明,DRG 中的胰岛素原产生细胞在形态上类似于神经元,实际上是神经元和 PI-BMDC 之间形成的多倍体胰岛素原产生融合细胞。其他实验表明,糖尿病性神经病变不仅仅是神经细胞因高血糖直接受损的结果。相反,高血糖会诱导融合性 PI-BMDC 进入周围神经系统,在那里与雪旺细胞和 DRG 神经元融合,导致神经元功能障碍和死亡,这是糖尿病神经病变的必要条件。糖尿病控制不好确实对骨骼有害。
Insulin and proinsulin are normally produced only by the pancreas and thymus. We detected in diabetic rodents the presence of extra pancreatic proinsulin-producing bone marrow-derived cells (PI-BMDCs) in the BM, liver, and fat. In mice and rats with diabetic neuropathy, we also found proinsulin-producing cells in the sciatic nerve and neurons of the dorsal root ganglion (DRG). BM transplantation experiments using genetically marked donor and recipient mice showed that the proinsulin-producing cells in the DRG, which morphologically resemble neurons, are actually polyploid proinsulin-producing fusion cells formed between neurons and PI-BMDCs. Additional experiments indicate that diabetic neuropathy is not simply the result of nerve cells being damaged directly by hyperglycemia. Rather, hyperglycemia induces fusogenic PI-BMDCs that travel to the peripheral nervous system, where they fuse with Schwann cells and DRG neurons, causing neuronal dysfunction and death, the sine qua non for diabetic neuropathy. Poorly controlled diabetes is indeed bad to the bone.
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