Biology of GDNF in Diabetic Neuropathy

描述(申请人提供)：糖尿病神经病变(DN)是一种在许多糖尿病患者中发展起来的严重神经并发症。小的无髓鞘感觉纤维通常会受到影响，导致异常的皮肤感觉和疼痛。人们认为，相互关联的机制有助于糖尿病肾病的发生，最近，不足的神经营养支持被添加到可能的缺陷清单中。小纤维糖尿病肾病患者的伤害性感觉神经元对神经生长因子(NGF)或胶质细胞源性神经营养因子(GDNF)产生反应。虽然研究已经注意到糖尿病肾病患者NGF对感觉神经元的支持不足，但对GDNF的作用知之甚少。该项目的长期目标是在糖尿病的动物模型中，检查GDNF相关配体和受体的生物学，并将缺陷与糖尿病引起的生理和行为缺陷联系起来。我们的目的是揭示糖尿病肾病发生的潜在机制，从而提供有助于开发治疗糖尿病肾病的新疗法的信息。我们以前的研究表明，GDNF反应神经元的中枢突起对糖尿病很敏感，GDNF可以逆转GDNF反应的脊髓终末的缺陷。这项提议将检验以下假设：糖尿病时GDNF对初级感觉神经元的支持受损，GDNF反应神经元的解剖/生理缺陷可能导致对皮肤刺激的反应受损。第一个特定目标将描述STZ诱导的糖尿病小鼠GDNF/GDNF受体合成和运输的缺陷，并测试GDNF治疗是否可以改善配体/受体的异常。第二个目标将描述脊髓和皮肤中GDNF反应纤维的缺陷，然后测试GDNF刺激感觉神经轴突生长和再神经支配的能力。最终目标将通过在体外皮肤神经制剂中对单个已识别的神经元进行电生理记录来表征GDNF反应神经元的缺陷。生理缺陷将与糖尿病小鼠对有害的机械、化学和热刺激的反应异常相关。GDNF改变神经生理学和对皮肤刺激的行为反应的能力也将被测试。总之，这项资助建议使用分子、解剖学、生理学和行为学的方法来了解糖尿病肾病中GDNF的生物学，并测试GDNF是否对糖尿病动物受影响的皮肤神经元具有治疗作用。这项研究的结果将1)提供证据表明GDNF支持受损有助于糖尿病肾病的发展，2)将GDNF确立为用于改善糖尿病肾病患者皮肤功能的候选治疗方法。

DESCRIPTION (provided by applicant): Diabetic neuropathy (DN) is a serious neural complication that develops in many diabetic patients. Small unmyelinated sensory fibers are commonly affected, leading to abnormal cutaneous sensation and pain. It is believed that interrelated mechanisms contribute to DN and insufficient neurotrophic support has recently been added to the list of possible deficits. Nociceptive neurons affected in small-fiber DN respond either to nerve growth factor (NGF) or glial cell line-derived neurotrophic factor (GDNF). Whereas studies have noted deficits in NGF support to sensory neurons in DN, little is known about the role of GDNF. The long-term goal of this project is in an animal model of diabetes, examine the biology of GDNF-related ligands and receptors and correlate deficits with physiological and behavioral deficits that are caused by diabetes. Our purpose is to uncover mechanisms underlying the development of DN, thus providing information that will aid in developing novel treatments for DN. Our previous studies demonstrate that the central processes of GDNF-responsive neurons are sensitive to diabetes and GDNF administration can reverse deficits in GDNF-responsive spinal terminals. This proposal will test the hypotheses that GDNF support to primary sensory neurons is impaired in diabetes and anatomical/physiological deficits in GDNF-responsive neurons can lead to impaired responses to cutaneous stimuli. The first specific aim will characterize deficits in GDNF/GDNF-receptor synthesis and transport in STZ-induced diabetic mice, and test whether GDNF treatment can improve ligand/receptor abnormalities. The second aim will characterize deficits in GDNF-responsive fibers in the spinal cord and skin, and then test the ability of GDNF to stimulate sensory axon growth and reinnervation. The final aim will characterize deficits in GDNF-responsive neurons by performing electrophysiological recordings of single, identified neurons in an in vitro skin-nerve preparation. Physiological deficits will be correlated with abnormalities in the response of diabetic mice to noxious mechanical, chemical and thermal stimuli. The capacity of GDNF to modify neuronal physiology and behavioral responses to cutaneous stimuli will also be tested. In sum, this grant proposes to use molecular, anatomical, physiological and behavioral approaches to understand the biology of GDNF in DN and to test whether GDNF has therapeutic actions on cutaneous neurons affected in diabetic animals. Results from this study will 1) provide evidence that impaired GDNF support contributes to the development of DN and 2) establish GDNF as a candidate to be used in treatments to improve cutaneous function in DN.