EVALUATION AND DIAGNOSIS OF DIABETIC ENTERIC NEUROPATHY

糖尿病肠神经病的评估和诊断

• 批准号: 7951664
• 负责人: WILLIAM R KENNEDY
• 金额: $ 0.4万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-12-01 至 2009-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7951664
• 关键词: Abdomen; Affect; Blood Glucose; Blood Vessels; Brain; Clinical Research; Computer Retrieval of Information on Scientific Projects Database; Device or Instrument Development; Diagnosis; Enteral; Enterocytes; Funding; Gastric Emptying; Grant; Hyperglycemia; Hypertrophy; Hypoglycemia; Institution; Insulin-Dependent Diabetes Mellitus; Intestines; Knowledge; Lead; Methods; Nausea; Nerve; Neuropathy; Pancreas Transplantation; Pathology; Patients; Postoperative Period; Reflex action; Research; Research Personnel; Resources; Schedule; Sensory; Skin; Source; Spinal Cord; Staining method; Stains; Stomach; Surgeon; Symptoms; United States National Institutes of Health; autonomic neuropathy; base; blood glucose regulation; cell motility; diabetic; diabetic patient; diagnosis evaluation; improved; jejunum; nerve supply; prevent; relating to nervous system

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Patients with type 1 diabetes and symptoms of abdominal fullness, bloating, distention and nausea are usually considered to have autonomic neuropathy. Limitations of staining methods have presented pathological confirmation of this diagnosis and restricted research. We have used immunohistochemical methods to stain unmyelinated epidermal nerves in skin for many years. Using these methods on stomach and jejunum of diabetic patients we discovered degeneration of enteric mucosal nerves, dilated blood vessels, and hypertrophic enterocytes. The affected nerves are mainly afferents that provide the sensory input about lumen contents to the brain and spinal cord for modulation of peristaltic and secretory reflexes. We believe that this is the first histological confirmation of autonomic neuropathy. We propose to study mucosal nerves of the stomach in type I candidates for pancreas transplantation to further charcterize our initial findings, to develop specific criteria for diagnosis of neuropathy, and to quantify entercyte hypertrophy. We will also determine whether epidermal nerves can act as surrogates for diagnosis of enteric nerve pathology. In addition to diagnosis, the results will provide new information about the innervation of the normal and diabetic stomach, lead to better understanding of the neural basis of abnormal accomodation, delayed gastic emptying and fluctuating hypo- and hyperglycemia, and stimulate research in this field. This research should lead to better patient understanding of the factors that complicate blood glucose control thereby leading to improved management. We hope the research will stimulate development of instruments to promote scheduled gastric emptying as a means to prevent hypoglycemia. It can also provide surgeons with knowledge of the motility potential of operated diabetic intestine for more rational therapy of postoperative intestinal stasis.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 通常认为患有1型糖尿病，腹胀，膨胀和恶心的症状的患者通常被认为具有自主神经病。 染色方法的局限性已列出了该诊断和限制研究的病理确认。 我们已经使用免疫组织化学方法来染色皮肤中不髓鞘的表皮神经多年。 使用这些方法在糖尿病患者的胃和空肠上，我们发现了肠粘膜神经，扩张的血管和肥大肠细胞的变性。受影响的神经主要是传入，这些传入为脑含量和分泌反射的调节提供有关腔内含量的感觉输入。 我们认为，这是自主神经病的第一个组织学确认。我们建议在I型候选物中研究胃的粘膜神经进行胰腺移植，以进一步负责我们的初始发现，制定诊断神经病的特定标准，并量化肠胃肥大。我们还将确定表皮神经是否可以充当肠道神经病理学诊断的替代物。除诊断外，结果还将提供有关正常和糖尿病性胃神经支配的新信息，从而更好地理解异常良好的神经基础，延迟的速度排空和波动的低血糖和高血糖，并刺激该领域的研究。这项研究应使患者对使血糖控制复杂化的因素更好地理解，从而改善治疗。我们希望这项研究能够刺激仪器的发展，以促进预定的胃排空，以预防低血糖症。 它还可以为外科医生提供有关手术糖尿病性肠道运动潜力的知识，以便对术后肠道停滞进行更合理的治疗。